Viability at 23 weeks 6 days

New chances accompany new moral dilemmas when technology is applied to human reproduction.  Don’t miss this thought-provoking podcast from Radiolab:

Technology has had a profound effect on how we get pregnant, give birth, and think about life and death. The decision to become parents was not an easy one for Kelley and Tom. Even after they sorted out their relationship issues and hopes for the future, getting pregnant wasn’t easy. But, thanks to a lot of technology, they found a way to a baby. Then, about halfway through the pregnancy, the trouble began. Neonatal nurse practitioner Diane Loisel describes helping Kelley and Tom make the most important decision of their lives. And Nita Farahany helps Jad and Robert understand the significance of viability, and how technology has influenced its meaning…making a difficult idea even harder to pin down. [Listen here]

(tip of my Stormy Kromer cap to the Twitter feeds of Somatosphere and AnthroRepro)

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The robot in the white coat

The cover story of the March print edition of The Atlantic is “The Robot Will See You Now”, which explores the various ways that technology is queued to disrupt the medical establishment.  IBM’s Watson is now working through case histories from Memorial Sloan-Kettering, a step toward a much more sophisticated diagnostic and treatment recommendation tool than symptom searches in medical databases.

While I don’t undervalue the talent of an experienced doctor to perceive symptoms that may not be mentioned as complaints and put them together into a better diagnosis, I found myself nodding when one physician on Watson’s training team mentioned the problem of “anchoring bias”, in which one symptom is given priority and others are ignored or seen as unimportant.  That can be multiplied with other prejudices, such as the implicit and explicit bias against fat people that was shown in a study released a few months ago (this post from Jezebel describes the situation well), making it more difficult for members of some populations to receive a valid diagnosis.

The article also discusses the improvements in monitoring technology that are being pioneered by the enthusiasts in the quantified self movement that I’ve posted about previously.  It may soon be possible to wear a monitor that reports regularly and wirelessly to your doctor on an important statistic that is being tracked: blood pressure or heart rate, for example.  A scale or blood sugar tester could share data every time it’s used in the same way.

Potential changes in the career paths of medical workers are considered and decreased contact between doctors and patients for routine issues seems likely.  This could boost the already strong prospects for nurses and physician assistants and — as the article states — allow “everyone to practice at the top of their license.”

This article comes out the same time as a study of robot-assisted hysterectomies determined they are increasing in prevalence despite costing 100-200% more than the standard surgery.  There is little evidence of any improvement in outcome and the suggestion is that the surgery is becoming more widespread due to marketing, not only to the medical establishment but also to patients.  We’ll be wise to remember that new and high-tech doesn’t always mean it’s better for patient care, as Monty Python tried to show us decades ago:

 

Addition: For a half hour audio discussion of this topic, take a listen to Talk of the Nation with Ira Flatow from June 1, 2012.  Flatow speaks with guests Dr. Eric Topol, author of The Creative Destruction of Medicine, Dr. Reed Tuckson, head of UnitedHealth Group, and Dr. Arnold Relman, former editor-in-chief of the New England Journal of Medicine.

2012 Wired Health Conference, simulcast tomorrow & Tuesday

This year, the Wired Health Conference will be exploring personalized medicine, which includes the fascinating growing area of the quantified self:

The theme of the event is “Living By Numbers” — the notion that new data and analytics are enabling better healthcare delivery and research. The idea is straightforward on its face: By paying heed to our health, and taking advantage of new tools for self-monitoring, feedback, and community, we can empower our own actions and skirt the disease risks that life throws at us. But this potential is only just upon us, with the combination of new computing power, ample data storage, and having the right questions at hand. This technology is just beginning to enable the new frontier of personalized medicine: combining the insights of epidemiology with our own personal metrics to customize medical science to individuals.

You can watch the simulcast live, free.  Talks begin at 4:00pm Eastern on Monday, and run from 9:00am-5:00pm Tuesday, with an exciting roster of speakers.

Bodily contact from afar

Like-A-Hug sketch from designer Melissa Kit Chow

The Internet has been abuzz in the last couple days about this social media vest, though some have taken it as more technological and less artistic than the original intent.  PC Magazine has a good summary:

Scientists at the Massachusetts Institute of Technology (MIT) have developed a vest that lets Facebook users hug each other, from any distance.

The fashionable technology, dubbed Like-A-Hug vest, is being touted as “wearable social media” – it inflates to embrace wearers whenever Facebook friends “Like” items they post on the network, according to the website of designer Melissa Chow.

She worked with Andy Payne and Phil Seaton at the MIT Media Lab to build the puffy black vests, which, according to Chow’s website, allows the wearer to “feel the warmth, encouragement, support, or love that we feel when we receive hugs.”

I’ve been doing a lot of thinking about virtual embodiment lately and don’t want to write my capstone paper here on the blog, but consider this for a moment. There are a lot of reasons why someone may not be in physical proximity with those who could supply a needed hug.  Is the tactile sensation of “warmth, encouragement, support, or love” important? Could a product of this sort be therapeutic? I can’t help thinking of Harlow’s monkeys or Temple Grandin’s squeeze machine.

What does it mean when a machine takes the place of human contact? Continue reading