The manipulation of health tech

The news that not only have scientists and tech developers created a series of 3D printed heart valves but Neurolink are starting to release (albeit) early findings and proof(s) of concepts for some of their AI supportive implants is sure to generate not only excitement but ever more important conversations around the ethics and moral challenges that the use of such advancements bring.

There will be considerable debate and many much more erudite pieces written on this subject over the coming months and years – but one thing that I have observed is that ethical questions and considerations are moving from the laboratory into the start-up space, with it bringing challenges that we are just not prepared for or indeed capable of meeting.

One of the underlying triggers for the creation of a 3D printed heart valve is that humans are living longer and their original ones wear out. So, I’m sure most would agree in this instance that creating the ability for the very personalised and almost immediate creation of new valves is a great step forward.

Another underlying trigger is that some modern diets are directly leading to obesity further complicated by a lack of exercise. Now, this is obviously a very complex, personal issue – and evidence shows that bad diets are more prevalent in lower income households and areas – but it does lie at the heart of the ethical debate.

Some commentators have said that if one chooses to have a certain lifestyle then you should go to the back of the queue in terms of access to these new technical advancements – even if in the case of lower income households the lifestyle is not completely a choice. It was ever thus – should smokers be treated for cancer? Should alcoholics be treated for liver disease or should drug users be treated for associated mental health issues?

The iceberg ahead is not in terms of will the technology deliver improved healthcare or opportunities for an extended (or enhanced) life – but rather will we see a two-tiered approach to accessing such technology? Will the advancements of tech expediate and further split the fissures in  society between the ‘haves’ and ‘have-nots’?

This is a bigger question than 3D heart valves – it lies at the very core of tech and the internet being the great ‘leveller’ and enabler of shared access to knowledge, information and support.


I believe that we are already I the world of a multi-tiered internet, a place where division is encouraged and where access to information is limited dependent on your lifestyle or ability to pay.

Ahhh, well that’s capitalism right?

Maybe, but here we are seeing human behaviour changed, influenced and controlled by a relatively small number of tech leaders. We can see this most effectively and simply with access to news.

Do you get your news from Facebook or ‘reputable’ sources?

If  you get news from Facebook you are using a platform which has been designed with addiction in mind – designed for you to spend the maximum amount of time on there as possible, therefore (as we know), your newsfeed will be populated with content that has been created to keep you on the platform – to allow you to see more ads. The truth, accuracy or fact-checking comes secondary to keeping you in.

If, on the other hand you access news from (more frequently) paid for sources (The Guardian, The UK Times, The New York Times) you are paying for a level of factual accuracy – although of course the angle of truth comes in many ways from your political standpoint. But you pay – because you can afford it.

These second group of people are what Trump calls ‘Liberals’ – the ones which he uses the first group to attack, shout down and dismiss. Much like Michael Gove dismissing experts in the UK – Trump has used people’s access to an addictive platform to remove his opponents. He has used the foundation of a multi-tiered internet (based to some extent on ability to pay) to enhance division - splitting society further apart for his own benefit.

This has been done to such an extent that we now see it as the norm. This multi-tiered access to news will be replicated across all digital platforms and all technology – the ‘have’s’ and the ‘have-not’s’ will change depending on the tech or the situation – but people will be facing off with each other, simply because the tech encourages it.

As Andrew Bosworth, a senior Facebook exec wrote in 2016;

“….anything that allows us to connect more people is de facto good…all the questionable contact importing practices… all of the work we do to bring more communication in… The best products don’t win. The one everyone uses win….”

The best products don’t win… The one everyone uses will win. Hold that thought – but what has news got to do with 3D valves? That is a fair question dear reader but let me pose a few in response;

·       What will stop the 3D valve tech creators withholding access to the tech for certain groups?

·       What will stop them requesting additional commitments (financial, data etc.) from potential users to access their services?

·       What will stop them providing lower quality blueprints for those that don’t agree for different countries, NHS Trusts or states (depending on their support for specific legislation – oh maybe say GDPR?). 

·       What will stop the most powerful using the tech for their own advancements?

It’s happening with news. But again you may say, these things have always happened, right? That’s what the industrial revolution was based on, its what the developed and developing world is based on?

And on this point I would argue that the reach of tech, the connectivity of over 60% of the global population means that humanity is changing, our pure reliance on tech is such that all it needs is a little tweak here, a push there and we get more of what we’ve seen with (fake) news – more division, more conflict, more haves and ‘have-nots’.  

The temptation to use tech for one’s own political, idealistic or pure commercial benefit is simply too strong – manipulating society through tech has only just started – news is the canary in the mine and I think that health tech could well be not too far behind.

Collectively we as a society and as digital professionals need to develop solutions, practices and principles that directly prevent our tech being manipulated. Tech is neither good or bad – its what humans do with it that we need to control.   

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