Today we invited Professor Han Qide to give a lecture on “Reflections on the Value of Medical Technology Development.” This series of lectures in the course seems to have rather a lot of topics related to medicine, but there is a reason for having more rather than fewer: after all, the medical field is the place where the complex relations among science, technology, the humanities, ethics, society, politics, and so on are most concentrated and clearly embodied.
Although many of the related issues had already been heard in previous lectures, Professor Han still brought quite a few fresh examples and viewpoints. What Professor Han focused on was the development of new technologies in medical care—the continuous advancement of medical technology has indeed brought improvements in many respects; however, from the perspective of the whole, are these improvements actually worth it? A new drug extends the survival time of cancer patients—for example, by postponing the average time of death by four months. This is certainly an improvement, but is the corresponding hundredfold surge in treatment costs also worthwhile? What is more, many new technologies may not bring any substantial improvement at all. Professor Han cited the example of CT screening for lung cancer in the United States: this case shows that the regular use of CT technology has indeed greatly increased the detection rate of lung cancer cases; however, the mortality rate from lung cancer in the overall population has not changed. This means that many cases being detected are ones that might originally have healed themselves or would not have led to death. Is the development of such diagnostic technology ultimately a good thing or a bad thing? Professor Han also cited many domestic examples, such as the treatment of gastric cancer at Peking University Hospital: over the past twenty years, costs have multiplied many times over, but apart from a reduction in the side effects of medication, the survival rate has not changed significantly.
New technologies do indeed bring improvements, but the social resources invested in the development, introduction, and application of new technologies, as well as the social effects brought about by the application of new technologies, still lack reflection. Professor Han asked: Has medicine already been capitalized? This is a deeply thought-provoking question. So-called capitalization is not simply a kind of commodification; commodification refers to a mode of circulation and exchange, while the value of commodities can also be understood in multiple ways—for example, one can consider the value of things from the standpoint of use, or from the perspective of promoting the public interest of society, or from the standpoint of maintaining and advancing human health. “Capitalization,” however, means the abstraction and unidimensionalization of meaning: value degenerates into a numerical figure, all the rich dimensions of value are stripped away, and “capital” and its self-expansion become the central, even the only, value.
The quantification of value has also fueled the rampant logic of technology—30% of heart disease incidence prevented, success rate increased by 20%, survival time extended by 15%… The value of new technologies is recognized because of these numbers, and in pursuit of these numbers people are compelled to flock toward new technologies. But are these numbers really so important? Of course, we say that life is priceless. Precisely this sentence means that the question of life should not be measured by empty numbers; it does not mean that the value of life is “infinite,” such that a technology that can extend life by four months therefore possesses infinite value. There is no such thing as infinite value. Any value is bounded and contextual; seeing the multiplication of numbers does not mean that the assessment of value is complete.
December 2, 2010
Translated from the Chinese original with AI assistance. The original text is authoritative.
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