Wednesday, March 31, 2004

medicine and technology

My history of american technology class is reading Edward Tenner, Why Things Bite Back: Technology and the Revenge of Unintended Consequences. Tenner has a couple of chapters on medicine but he makes too many points and so I confined myself in class to two. One was the obvious one that as medicine can do more things it costs an increasing proportion of our gross national product, a trend that cannot go on forever. The other came from what I have learned about diabetes--I talked about how technology (and policy decisions) determine where you draw the line of when you will diagnose a disease. If you can't measure it or identify a clear set of symptoms, you can't diagnose it. Before blood sugar testing diabetes could only be diagnosed or monitored if blood sugar was above 180, when sugar starts to appear in the urine. Now we can measure problems long before that, but when do the advantages of diagnosing a person start outweighing the disadvantages (extra cost for health and life insurance)? That depends not only on what doctors can do for people but also on whether people will be willing to change their lifestyles.

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