Course:LIBR559A/Blume2013

Citation

Blume, S. S. (2013). Medical innovations: Their diffusion, adoption, and critical interrogation. Sociology Compass, 7(9), 726-737.

Purpose of article

Critique the ways and methods that medical technologies enter the market and reach patients.

Main Argument(s) and supporting evidence

Blume’s purpose for writing this article was to critique the ways and methods that medical technologies enter the market and reach patients. He writes this article from the perspective of the patient using the social construction of technology theories put forth by Bijker and Pinch. Blume’s main argument in this article is that health technologies are not neutral and that evidence-based medicine is not without flaws.

Supporting his main argument, Blume shows that patient care is not always the primary concern of physicians in the context of emerging technologies. Using the example of the Computed Tomography (or CT) scanner, Blume says that although this technology had “virtually no published evidence for any benefit to patients” when it became available on the market, many hospitals purchased one anyway because many “research and teaching hospitals were particularly keen to acquire new technologies that could be used for research” (727; emphasis added). The high costs associated with purchasing the CT scanner also meant that only the economically and financially privileged patients in the US could have access to it and this theme is apparent in most expensive, emerging medical technologies.

Blume critiques evidence-based medicine for the way it creates a hierarchy for the kinds of evidence considered. Clinical trials, which are prioritized evidence, have become a huge business interested in profit (727). To add to this, most clinical trials operate in the poorest and most disease-ridden regions of the world, taking advantage of other’s disadvantages (727). Meanwhile, patients’ experiences are excluded from evidence-based medicine, even though patients themselves want to hear the experiences of others; patients will often compose groups and movements of their own to collect and organize the experiences of other patients like them (728). Blume categories medical innovations into three “emphases”: prevention of infectious diseases, reduction in the incidence of disability and prolonging active (working) life. These “emphases” show the main values of medical technology entering the market today and they are not neutral because some of them disadvantage patients and some even discriminate against certain groups. For example, Blume uses the example of the maternal serum alpha fetoprotein test to show how much society values the reduction in the incidence of disability. This test, taken during pregnancy, shows potentials for developmental abnormalities. According to a cited study by Press and Brower, the test was offered in a way which “not only encouraged women to be test, but simultaneously discouraged them from thinking carefully about their decisions” (731). It has now become routine to screen for abnormalities and give options for abortion when abnormalities are present, which de-values the disabled human life.

Method(s) (e.g., case studies, interviews, thought piece, survey)

Literature review

Pitfalls, blind spots, and weaknesses of this article

The one major weakness of this article is that although it appears to be a literature review, the author does not state that explicitly, nor does he provide his search parameters.

Potential Contribution to the scholarship of Social Studies of Library and Information and to the practice of Librarianship

The values of this article for the scholarship of social studies of information is that it shows that medical data and medical technologies are value-laden, and not always with values patients would agree with.

Page author: Caroline Mniszak