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Lecture 1

HSS 3332 Lecture Notes - Lecture 1: Erykah Badu, Human Genome Project, Pharmacogenetics


Department
Health Sciences
Course Code
HSS 3332
Professor
Sarah Fraser
Lecture
1

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HSS 3332A Winter 2015 Study Questions for Assigned Readings
1. Introduction
i. Webster: Chapter 1 (Understanding Innovative Health Technologies)
What is meant by 'a sociological perspective' on health technologies?
'Sociological perspective' on health technologies argues that health technologies and the
techniques, models and assumptions on which they are based are given meaning through the
way they are tied into other technologies and social practices. It recognizes that health
technologies will be subject to vastly different local interpretations and uses. The meaning of
health technologies will also vary in different settings (from the clinic, to the home, to the
internet), and vary in the way they shape diverse notios of health foud ithi ad etee
cultures. In this sense, technologies are best understood as an expression of, and thereby
always expressed through, social relationships.
Apart from asking about the meaning, value, regulation and ethical implications of health
technologies, a sociological perspective is also interested in the processes through which new
health technologies are introduced in the first place, and what factors have shaped their
introduction.
What is meant by "medical technologies are two-sided"?
This means they provide new, more details, sources of information about our illness but also to
the expectations that inform and guide the social relationships through which we define and
manage it.
Why does Webster suggest that the value of technologies changes over time?
Overtime, the value of technologies changes, perhaps because better ways of getting patient
information or delivering the treatment they provide, or through changing social expectations
about treatment (particularly evident when patient advocacy groups seek access to
epeietal dugs. Moeoe the alue of edial tehiues, deies o theapeutis
(such as new drugs) is typically subjected to national (and international) evaluation, regulation
and monitoring. These evaluations are anchored in wide social and political cultures, explaining
the global diversity one sees in the regulation of fields such as stem cells research. This points
more generally to ethical debate over new technologies and the very different perspectives
that can be found between and within countries.
Is there such a thing as a pure 'health' technology? Explain.
Health ad its defiitio deped ot eel o a pesos sese of ell-being, but on a
powerful professional, commercial and institutional interests that capture health in order to
defie, otol, eploit o delie it. Health tehologies i this sese ae deeloped as pat of
a much wider innovation system and indeed may well emerge from fields that have nothing
directly to do with the conventional clinical management of health. This is the case, for example
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in regard to widespread introduction management purposes and treatment (as the growth of
telehealthcare illustrates).
This means that products on health share many features of products used elsewhere, while the
convergence bioinformatics and nanotechnology blurs the boundaries of what is to be regarded
elusiel as a health teholog.
Why does Webster say that important health technologies do not appear randomly?
While it is certainly the case that some technologies appear in a rather ad hoc fashion,
championed by individual clinicians, there is a clear structure of health care, medical research
and commercial investment specific areas. While the internet and consumer markets open up
and increase the demand for more diverse health goods and services, it is nevertheless the case
that there is a strong relationship between the profile of disease in modernity and the clinical
technologies that are seen as most important and effective in managing disease.
For example, US physicians recently identified the top five innovations according to their
relative ipotae i the teatet of patiets disodes: these ee MRI/CTC scanning, ACE
inhibitors, Balloon angioplasty, the Statin drugs and Mammography. All five r related to the
most common chronic and/or high mortality diseases of advanced consumer societies-
cardiovascular disorders (angioplasty and strains), cancer (MRI, CTC and mammography), and
hypertension (ACE inhibitors). In turn in those countries where it is the state that acts as the
main procurer and provider of care, there is a growing trend towards procurement according to
certain standards (technical & clinical), targets and costs in these and other areas. This may
constrain the adoption of new technologies. In market-based systems, such as the U.S., new
technologies r much more quickly adopted as physicians competes with others part through
what state of the art medicine they have on offer.
What 3 categories of health technologies are considered to be innovative? How is
innovation recognized in each category?
1. Genetics-related developments (especially the advent of new technologies for genetic
diagnosis, testing and screening; gene therapy; pharmocogenetics and pharmacogenomics and
nneutrigenomics).
Regarded as innovative because of the creation of the Human Genome Project (HGP)-
sequencing of DNA that make up the human genome. It was drafted in 2000 and then a more
developed version in 2004. HGP is represented as a blueprint of the human genome from which
it would be possible to read off genetic mutation and its effect on the body, and more as a
useful reference point through which gene hunting is made possible. It has also inspired claims
that new genetic information would transform medicine. 3 main things made possible by
contemporary genetics is: 1. The diagnosis and treatment of both single and multifactorial
disease. Brings about predictive testing which will allow for risk assessment of diseases to which
individuals including pre-borns r susceptible to but may only obtain later in life. 2. The
development of target disorders. Key to this is move in medicine away from looking at clinical
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