The independent Medical Device Equality Survey once again highlights the many ways in which the development of medical technology can lead to solutions that distribute benefits unevenly across society, or further exacerbate health inequalities (UK report reveals bias within medical devices and aids, March 11). While the report is welcome, the challenge facing scientists and engineers is how to innovate medical devices differently to respond to long-standing societal biases and inequities.
This means you have to do two things. First, it is essential to go beyond superficial engagement with patients. As the report highlights, technological development cannot be based solely on the expertise of engineers or the knowledge of healthcare professionals. It must respond to the different social, cultural and health experiences of diverse groups of people. To be effective, this means recognizing differences and actively supporting marginalized groups to represent themselves.
Second, engineers must recognize that the outcomes of medical technologies are not produced solely by the devices themselves – the algorithms or chemicals. How people interact with devices in the environment they live in is just as important. For example, equal attention should be paid to how access to health professionals, or the cultural values associated with different social groups, can change the way medical resources are used and how benefits are distributed over time.
To be fair, technological development must take into account the way exclusion occurs and provide solutions that are social and technical. The funding the review calls for will need to focus on these challenges if the benefits of future medical devices are to be shared by all.
Prof. Steven Johnson and Prof. Jonathan Ensor
Equitable Technology Laboratory, University of York