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Notes Lectures eph1025: Health-Technological Innovation and EU Competencies

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  • 3 juni 2022
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Lectures Health-Technological Innovation and EU Competencies

Introduction lecture

Technology
Ideas and processes that make it possible to produce a new product.
OR
Products made by humans that make our lives easier and more comfortable.

Hard technology = tangible products
Soft technology = intangible, knowledge on how hard technology works

Social construct
People, private organizations, and public institutions, interact and jointly construct
technology to meet their goals and needs.

Technology determinism
E.g. once it has started it may not be easy to reverse it.


Positive effects of technology:
• useful in achieving our goals
• takes over routine monotonous tasks
• makes our life comfortable
• makes complex tasks, easier
• creates value for users and society

Negative effects of technology:
• offers “lazy aids” which contribute obesity
• too much use of technology has resulted in waste
• environmental pollution due to technology
• creates stress if not used properly


Health technology
World Health Organization:
“A health technology is the application of organized knowledge and skills in the form of
devices, medicines, vaccines, procedures, and systems developed to solve a health problem
and improve quality of lives.”

Health technology:
- concerns both hard and soft technology
- evolves over time
- is shaped by social construction
- is adapted to specific conditions

,Priority areas:
o emerging and recurring public and population health threats
o social, economic, and physical conditions and environments, which significantly impact
the health and wellbeing
o complexity of population health issues, which increasingly
emphasis the importance of working together


Innovation
Various definitions:
- new, better, more effective ways of solving problems
- a new idea, device, or method
- the act or process of introducing new ideas, devices, or
methods

In health care, the term means describe policies, systems, technologies, ideas, services, and
products that provide solutions to existing healthcare problems.

Innovation characteristics:
▪ new idea (invention) = new product, process, service, business
▪ exploitable = implementable and valuable idea
▪ successful = adopted by the target audience


Social innovation:
new approaches to tackle social issues and solve problem

Health innovation:
new mechanisms to improve population health

Product innovation:
new goods and services within the market

Process innovation:
enhancement of the production of goods and services

,Case Law Reading Legal Document

What we seek to do with the law:
- Description
- A critical analysis


The struggle for the truth
What is ‘truth’?
Right now: evidence-based medicine (“We are in the hands of science”) → thus, the truth is
important.

Justice is about truth, but also about a telling story. The judge is then to believe one story
over another and ‘choose a side’ in court.

The truth can also be an opinion (e.g. picking the best dancer/political view).
Is the truth objective or subjective? What is the nature of a fact?
People can observe things differently, and thus can both be telling their ‘truth’.
Our concept of things is open to interpretation.




If you cannot see a table, does that mean it is not there?
The table exists regardless of the label/word we give it.
But the label ‘table’ only exists because of the human observation.

A lot of assumptions in law/policy is couched in the sense of authority of objective science!
(Objective claims about facts)

,Authority of science:




Postmodern truth…

,Safety Theory

We currently operate innovation in the paradigm of the market.
We don’t regulate what pharmaceutical companies can explore (free market/social market).
This can backfire. Things like rare diseases, are not going to be served well due to the costs
of drug production for these.

Adam smith, Wealth of nations (= book)
Built on a platform of morality and the independents of the individuals.

Efficiency → Alternative to this = state run economy

Reluctant collectivism (by JM Keynes)
Certain infrastructure is more efficiently provided by the state, for example transport
networks.
If the free market doesn’t provide something in the most efficient way, then we should step
in and find who can produce it in the most effective way.
So, if rare diseases are not being tackled properly, we should look to other mechanisms to
provide that.

Issues with the (free) market:
Rand said the market is not ‘free’ enough, and there is too much sentimentality.

In 2008 the banks weren’t scared to ‘fail’ because they felt that if they would, the
government would help them out and they would be fine. There was no regulation at all.

In healthcare, we are not sure if the market can regulate itself. The market has not got a
great track record → beginning 20th century doctor gave many women Honoria and Syphilis
on purpose without their consent to do medical investigation because he was interested in
infectious disease. Thus, we do need regulation, for our own protection.

Regulation and the free market
“Caveat emptor = let the buyer beware.”
So, the inventor can bring anything to the market. Then the buyer can choose if it’s
safe/good enough. The risk is regulated through the consumers choice (what is the buyer
prepared to accept?).
But if the product fails, the producer must compensate. The States sets the terms for the
compensation, and the producer works out how much to ‘cost in’ to the product to cover
potential losses. However, sometimes we can’t fully compensate. For example, when
someone lost a leg (we try to with money but it’s never equally compensated).

‘Costing in’
The idea that losses for failure (and other things, e.g. research and development) are part of
the price.

‘Reputation loss’
Cannot be costed in, as it goes to the integrity of the producer in the marketplace.

, Who owes the duty of care in the market?
The producer:
o Confidentiality
Because of the need for trade secrecy in a competitive market, the producer
withholds information from the consumer.

o Complexity
The product is more complex than the consumer can comprehend, and therefore
cannot protect themselves.

Parties involved in the regulation and the free market:
▪ Product
▪ Producer
▪ Consumer
▪ Regulator


Normativity – a constant question
Questions about blue skies, applied work, product development, and user dilemma.
- How can one individual bind the choices of another?
- How can the State bind the choices of individuals?

Callon and Latour
They think about questions like:
o Who decides what is good science?
o Who is allowed to do science?
o What makes science work?

Standard ‘Legal Positivist’ basis
A law is a law because it has been created through the constitutionally defined process of
law-making in any given society.
- Basis: democracy (modern)
- Problem: legal but ethically challenging

Information revolution
Right now, we are in a knowledge economy.
It’s all about safety, confidentiality, and access.

→ Personal data
Medical history, genetic information, environment information, lifestyles
information, etc.

→ Commercial data
Scientific understanding, clinical testing, licensing, marketing, etc.

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