Moerenhout Tania, Devisch Ignaas, Cornelis Gustaaf C
Department of Family Medicine and Primary Health Care, Research Unit Ethics, Autonomy and Responsibility in Health Care, University of Gent, De Pintelaan 185 - Building 6K3, 9000, Ghent, Belgium.
Department of Philosophy and Moral Sciences, University of Gent, Blandijnberg 2, 9000, Ghent, Belgium.
Med Health Care Philos. 2018 Mar;21(1):31-41. doi: 10.1007/s11019-017-9780-3.
Information and computer technology has come to play an increasingly important role in medicine, to the extent that e-health has been described as a disruptive innovation or revolution in healthcare. The attention is very much focused on the technology itself, and advances that have been made in genetics and biology. This leads to the question: What is changing in medicine today concerning e-health? To what degree could these changes be characterized as a 'revolution'? We will apply the work of Thomas Kuhn, Larry Laudan, Michel Foucault and other philosophers-which offers an alternative understanding of progress and revolution in medicine to the classic discovery-oriented approach-to our analysis. Nowadays, the long-standing curative or reactive paradigm in medicine is facing a crisis due to an aging population, a significant increase in chronic diseases and the development of more expensive diagnostic tools and therapies. This promotes the evolution towards a new paradigm with an emphasis on preventive medicine. E-health constitutes an essential part of this new paradigm that seeks to solve the challenges presented by an aging population, skyrocketing costs and so forth. Our approach changes the focus from the technology itself toward the underlying paradigm shift in medicine. We will discuss the relevance of this approach by applying it to the surge in digital self-tracking through health apps and wearables: the recognition of the underlying paradigm shift leads to a more comprehensive understanding of self-tracking than a solely discovery-oriented or technology-focused view can provide.
信息和计算机技术在医学领域发挥着越来越重要的作用，以至于电子健康被描述为医疗保健领域的颠覆性创新或革命。人们的注意力主要集中在技术本身以及遗传学和生物学方面所取得的进展上。这就引出了一个问题：当今医学在电子健康方面发生了哪些变化？这些变化在多大程度上可以被称为一场“革命”？我们将运用托马斯·库恩、拉里·劳丹、米歇尔·福柯等哲学家的著作——这些著作提供了一种不同于经典的以发现为导向的方法来理解医学中的进步和革命——来进行分析。如今，医学中长期存在的治疗或反应性范式正面临危机，原因包括人口老龄化、慢性病显著增加以及更昂贵的诊断工具和治疗方法的发展。这推动了向强调预防医学的新范式的演变。电子健康构成了这一新范式的重要组成部分，该范式旨在解决人口老龄化、成本飙升等带来的挑战。我们的方法将重点从技术本身转向医学中潜在的范式转变。我们将通过把它应用于通过健康应用程序和可穿戴设备进行的数字自我追踪热潮来讨论这种方法的相关性：认识到潜在的范式转变会带来比单纯以发现为导向或专注于技术的观点更全面的对自我追踪的理解。
