The ethics of applying new medical technologies.

Medical technology itself, including minimally invasive surgery, has no morals; our morality revolves around when and how we use technology. This often involves the individual clinician's assessment of their own abilities and an awareness of two aspects of the technology: its proven efficacy and its safety. Is technology outpacing knowledge? Or do physicians adopt new technologies in a responsible way with good motives? No one knows for sure. Technological progress in medicine has been a mixed blessing. The only ethical element involved in the use of new technologies over which individual medical practitioners have control, is that of user proficiency with the device, procedure, or drug, and the related information they provide to their patients when obtaining their consent for its use. New technologies fall into two broad categories: evolutionary, the most common, and revolutionary, which occur sporadically and may completely change the face of medical care. The learning curve for all new technologies can be steep. So, when should physicians be permitted to use these new technologies without supervision? Who is responsible for setting and monitoring standards for new technologies? With the moving target of medical technological innovation, individual practitioners are primarily responsible for the ethical use of new (to them) technologies. It is physicians' ethics that govern their use of new technologies, being certain that they have the requisite training and experience to use the modality, and that the intervention is safe for their patients. Institutional practitioner credentialing at the local level, despite its faults, will often be the primary control over a technology's use. What will ultimately govern the use of new technologies is the ethics (if they exist) of healthcare institutions and individual practitioners, as well as patient need. This is simply another reason why ethics education is vital for physicians-and other health practitioners and healthcare administrators. Copyright 2002, Elsevier Science (USA). All rights reserved.