New ethics study on technology that is making healthcare more ‘personal’
Thu, 16 October 2008
The Nuffield Council on Bioethics today launched a study which will consider the ethical issues raised by new technologies that are making healthcare increasingly personalised. Such technologies include whole body CT or MRI scans, ‘personal genomics’ where the genome of individual patients is sequenced, and ‘telemedicine’ – the delivery of healthcare services over a distance.
“Imagine a future situation where a young woman has her entire genome sequenced and this tells her that she has an increased risk of developing Alzheimer’s disease later in life,” said Professor Christopher Hood, Chair of the study and Professor of Government at the University of Oxford. “This does not tell her whether she will develop the disease at all and, even if she does, there are no proven ways of preventing the disease from developing. Would she have been better off not knowing? How might it affect her insurance policies, and might it increase the burden on the NHS?”
The launch of the study coincides with the publication of the Healthcare Commission’s annual report on the performance of the NHS.
“On the day the NHS receives its annual health check, we are starting to look at a range of new technologies that may affect the way individuals receive healthcare in future. Although these new technologies have the potential to improve healthcare, we also have to consider the ethical issues. We will be advising policy makers on the impact of this kind of technology and how it might be regulated,” said Professor Hood.
The Working Party includes members with expertise in medicine, science, law, philosophy and sociology. The group will hold evidence gathering sessions and a public consultation in spring 2009 to draw together wider views on the issues raised. A report with recommendations for policy and practice will be published in early 2010.
Background information
The NHS has used imaging technology, such as CT and MRI, to diagnose disease for many years. However, it is now possible for individuals to pay commercial companies up to £3000 to carry out a range of scans before they become ill, sometimes marketed as an ‘MOT for your body’. The implication is that the tests will pick up any health problems early and that these can be treated. However, it is disputed whether these tests lead to reductions in disease and there are questions about their safety, particularly CT scans.
Advances in genetics mean that it will soon be possible to sequence a person’s whole genome at an affordable cost. Finding a gene that increases the risk of disease may enable the individual to be more vigilant towards the early signs or symptoms, or to take action to prevent the disease from developing. However, companies may exaggerate the risk of disease to cover themselves against possible legal action, which may cause unnecessary anxiety and an increased burden on NHS services as people seek follow-up. There are also issues about confidentiality and who should have access to the genetic information arising from such tests.
Telemedicine involves using communications technology to provide healthcare services over a distance. It includes consultations over the telephone, surgery from a distance using robotics, monitoring a patient’s vital signs at home and transmitting these to a doctor, and the use of electronic tags to monitor the whereabouts of vulnerable people. This kind of technology has the potential to reduce unnecessary hospital admissions and improve access to healthcare. However, with less face-to-face interaction, telemedicine may have a detrimental effect on the way that people experience care. Issues about confidentiality and access to information are again raised.
As well as technological advances, a number of political and social developments have focussed attention on the individual. There has been a trend towards ‘person-centred care’ in the NHS, along with a shift from curative to preventative services. Private healthcare companies offering personalised services may just be meeting market demands. However, it is questionable whether people take up such services because they had a pre-existing need, or only because they were encouraged by advertising campaigns.
Notes to editors
1. Further information:
Catherine Joynson
Communications & External Affairs Manager
Nuffield Council on Bioethics
28 Bedford Square
London WC1B 3JS
Tel: +44 (0)20 7681 9619
Mob: +44(0)7747 635863
Email: cjoynson@nuffieldbioethics.org
Web: www.nuffieldbioethics.org
2. The Council
The Nuffield Council on Bioethics is an independent body which examines the ethical issues raised by developments in medicine and biology. Established in 1991, it is funded by The Nuffield Foundation, the Medical Research Council and The Wellcome Trust.
3. Members of the Working Party
Professor Christopher Hood FBA (Chair)
Gladstone Professor of Government and Fellow of All Souls College Oxford; Director of the ESRC's Public Services Research Programme
All Souls College
Professor Kay-Tee Khaw CBE FRCP
Professor of Clinical Gerontology, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital
Dr Kathy Liddell
Lecturer, Faculty of Law, University of Cambridge
Professor Susan Mendus FBA
Professor of Political Philosophy, University of York
Professor Nikolas Rose
Martin White Professor of Sociology, BIOS Centre for the Study of Bioscience, London School of Economics and Political Science
Professor Sir John Sulston FRS
Chair, Institute of Science, Ethics and Innovation, University of Manchester
Professor Sir Nicholas Wald FRS
Professor of Epidemiology & Preventive Medicine; Director, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry
Professor Jonathan Wolff
Head of the Department of Philosophy, University College London
Professor Richard Wootton
Director, The Scottish Centre for Telehealth
Last Updated Thu, 16 October 2008