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• Ethical innovation from the roots- a response to Ethics and innovation in medicine
  Saad Moughal
  Published on: 18 June 2018

• Published on: 18 June 2018

  Ethical innovation from the roots- a response to Ethics and innovation in medicine

  • Saad Moughal, Junior Doctor ELTH and SGUL

  Innovation is derived from the Latin innovatus which means “to renew or change”. In the broadest sense of the term, it can be viewed as the stimulus that modifies existing processes. Further, innovation has been one of the driving forces in the evolution of society through various revolutionary periods. This concept incorporates connotations of invention and creativity as impulses in themselves, however has recently been applied to commercialised settings. Hence, despite scientific interests, civic duties and altruism providing motivation for innovation, the strongest motive in recent times seems to be with a view to increasing profit. From a bottom-up level, inexperienced and junior innovators with the former inclinations could be met with resistance from the complexity of deriving economic viability. Furthermore, a central component to successful innovation involves promoting a culture to challenge outdated norms and the status quo. Change cannot occur if it is believed that present methods are infallible, as this removes the impetus for a goal-driven action. Consequently, many ideas may not reach fruition. However, within the medical field, it is wise that innovation occurs with incremental and calculated adjustments by enlarge, rather than with abrupt renovations. Wherever innovation leads to novel technology, the ultimate outcome of such is unforeseeable. The collingridge dilemma highlights an important notion that in early stages a new technology is still open to soc...

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  Innovation is derived from the Latin innovatus which means “to renew or change”. In the broadest sense of the term, it can be viewed as the stimulus that modifies existing processes. Further, innovation has been one of the driving forces in the evolution of society through various revolutionary periods. This concept incorporates connotations of invention and creativity as impulses in themselves, however has recently been applied to commercialised settings. Hence, despite scientific interests, civic duties and altruism providing motivation for innovation, the strongest motive in recent times seems to be with a view to increasing profit. From a bottom-up level, inexperienced and junior innovators with the former inclinations could be met with resistance from the complexity of deriving economic viability. Furthermore, a central component to successful innovation involves promoting a culture to challenge outdated norms and the status quo. Change cannot occur if it is believed that present methods are infallible, as this removes the impetus for a goal-driven action. Consequently, many ideas may not reach fruition. However, within the medical field, it is wise that innovation occurs with incremental and calculated adjustments by enlarge, rather than with abrupt renovations. Wherever innovation leads to novel technology, the ultimate outcome of such is unforeseeable. The collingridge dilemma highlights an important notion that in early stages a new technology is still open to social manipulation and as this malleability is lessened over time the potential for change is reduced.

  The NHS system delivers care based on bioethical principles with emphasis on justice- that is, healthcare is widely accessible and free to all members of society, without discrimination on the grounds of socio-economic status, age and ethnicity. An evidence-based approach to treatment was exemplified with the inception of NICE in 2005. The use of scientific, robust research undoubtedly aids in the service of healthcare and ensures harm is reduced to a minimum. NICE publish updates and review their recommendations to reach this end, and in this way it is a protagonist in medical innovation. However, as the subject of healthcare is the human body, the complexities of such make it difficult to be certain of therapeutic successes being attributed to medical care alone. Other factors such as spontaneous remission, placebo and fundamental attribution error may skew our judgements of efficacy. In this way it is pertinent that we challenge customary management protocols wherever treatment failure occurs. Medical innovation, then, is essential to improve patient care.

  However, speculation that financial motivations appear to provide the incentive for developing new therapies has naturally arisen. Authors have suggested this may manifest as delaying research results while researchers ascertain patents; leading to a culture of data distortion and neglect of the primary bioethical principles [1]. As the financial market provides the driving force for medical innovation to reach a profit goal, it follows that limiting product development through sanctioning of financial resources necessarily can limit innovation potential. Is it not then possible to foresee how this can be detrimental to patient care? Provided that political and social commitments i.e. moral, may impact the significance of medical research and its goals, innovation is an ideal. The competitive stimulus to acquire financial gains may drive innovation in other settings as well as medicine. This provides enough force for most individuals irrespective of personal concern for duty.

  For medical professionals including medical students, the aim is for the improvement and promotion of care. Beginning with fundamentals; the adage “Primum non nocere”, is known to most students from the onset of medical studies. Medical students devote considerable time to through studying the principles of medical science, that it is often easy to forget the reason and aim of their work. With respect to bioethical principles, medical students ought to be encouraged to further medical progress but with an awareness that their actions are primarily for the benefit of patients. To improve the status quo, it is necessary to promote and implement a change in attitudes predominating medical schools. Naturally, when one devotes time, resources and efforts to achieve an aim, one would like compensation for these efforts. Despite the instrumental improvements that financial incentives influence with positive change, it is necessary that one remains conscious of the holistic approach to the patient.

  References:
  [1] Blumenthal D, Causino N, Campbell E, Louis K. Relationships between Academic Institutions and Industry in the Life Sciences — An Industry Survey. New England Journal of Medicine. 1996;334(6):368-374.

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  Conflict of Interest:
  None declared.

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