By Cailynn Klingbeil
When the surgical robotic system the NeuroArm was officially unveiled to the world nearly four years ago, the invention garnered global media attention, and rightly so. The creation of the world’s first MRI-compatible surgical robot by University of Calgary professor Dr. Garnette Sutherland and his team of Canadian scientists was a milestone in medical technology that shifted surgery from the organ towards the cell level and enhanced the spatial resolution that surgeons operate at.
Inventions like the NeuroArm are increasingly defining medicine today, while even more creations are positioned to take over in the future. Shawna Pandya is one of those future doctors who will be working with such technologies thirty to forty years from today.
Pandya is a third-year medical student at the University of Alberta. She has a background in neuroscience and space studies, and spent a year completing a technology and leadership program at Singularity University – where she co-founded CiviGuard, an organization dedicated to providing mobile phone applications to assist civilians and officials. Pandya was also a NeuroArm research associate, helping to conduct pre-clinical testing of the robot. Given these projects she’s well suited to comment on the future of medicine and she has a variety of ideas on just what those technologies might look like.
“What we’ve accomplished in the last 20 years definitely outweighs the last 100 years prior to that, and technology is only becoming more powerful,” says Pandya.
Smart pill bottles will become commonplace – bottles with labels that are activated when you twist the cap. The label displays information including when the last dose was taken and when a refill is needed, and beeping reminders can be programmed, while a button built into the cap communicates wirelessly with the patient’s pharmacist.
Even more impressive is the possibility of custom-printed organs and tissue-engineering, as medical researchers create robots that can bioprint new tissues and organs. Bioprinting is a rapid prototyping process that patterns and assembles, layer by layer, functional living tissue. Eventually, bioprinters may be able to “print” complex cellular structures, including human organs. “It’s basically saying here are the basic cellular components, now print me a heart,” says Pandya. “It sounds fantastical, but think of the implications, about never having to worry about an organ shortage, or never having to worry about matching that organ to a recipient type.”
Gene sequencing, and soon gene synthesis, is another not-so-far-off medical practice. “Once we master the art of reading genes, the next step is synthesis,” says Pandya. The concept is a powerful one, as genetic diseases now considered terminal could be cured.
Tele-Anesthesia?
For Matthew Sheppard, the president of the Canadian Federation of Medical Students and a fourth-year medical student at Memorial University, his planned specialization could change greatly in the future.
Sheppard hopes to specialize in anesthesia and to that end he has taken an elective course at McGill University that included a talk on tele-anethesia, centered on its use in pre-operative assessment. Though applying telecommunications to anesthesia initially seems odd and a bit risky, Sheppard notes the talk discussed some pretty interesting potential uses. “It limits the amount of time patients from far away would have to come into larger centers,” says Sheppard. “I could certainly see an increased role of telecommunications happening in many areas of medicine in the future.”
Sheppard thinks advances around tele-anesthesia and in areas like stem-cells and electronic medical records will continually shape medicine, but he notes that technology isn’t always entirely problem-free.
“When you have so much technology it’s really easy to get caught up in it sometimes, especially in today’s medical world,” says Sheppard. “Sometimes we’re cautioned as medical students to treat the patient, not the machines that did the tests.”
The Doctor-Philosopher
As technologies that were once thought to be science fiction actually exist now, the future of medicine seems limitless. With that, though, comes technology’s displacement of people, as a machine becomes as good as, and oftentimes better, at doing what a person once did. Brendan Leier, a clinical ethicist at the University of Alberta and Stollery Children’s Hospitals and Mazankowski Heart Institute, has already seen doctors displaced by technology. Twenty years ago, he says, cardiac surgery was considered a great sub-specialty to get into. But in the last five years, Leier has met doctors who were trained as cardiac surgeons who had to retrain, because few positions are still available in the area.
“I think in the next ten to 15 years, medicine will keep advancing in the way it has, becoming more sub-specialized and far more technical and technology-oriented. But after that, we’re going to see the role of the physician change,” says Leier.
Leier believes that change will come in doctors having to operate in a much more philosophical manner, and for two main reasons. Currently, medicine relies greatly on evidence over experience, meaning peer-reviewed publications and clinical trials are the go-to source. But in order to govern what constitutes good evidence in all the relevant data, and in turn make decisions, Leier thinks doctors will have to become more philosophical. “If you’re a family physician, it’s literally impossible to be up to speed on all the current evidence-based practice there is out there,” says Leier. “At some point, we’re going to be able to use technology to cull the relevant data. But, the question then becomes, what counts as good evidence-based practice?”
Additionally, Leier thinks the second main philosophical demand of doctors will surround the notion of a patient’s well-being. “The more technology advances, the question is just because we can do something, is it necessarily the case that we ought to do that?” says Leier. The scenario of walking into a doctor’s office and outlining the physical characteristics desired in a potential child could be a future reality, while treatments for once-fatal illnesses that now prolong people’s lives may also exist. But just because the technology exists, that doesn’t mean it should be used without any consideration.
“The role of the physician is going to have to involve more philosophical reflecting on the nature of what it is to be a physician and what it is to fulfill those ethical mandates that all physicians have,” says Leier.
Technology has presented these sorts of challenges in the past. Questions surrounding keeping a patient alive on a ventilator or on dialysis after kidney failure, for example, once didn’t exist, simply because the technology to do just that didn’t exist. But with an increasing amount of innovation in the medical field, many of it sci-fi in nature, these challenges will only increase.
“Technology can always potentially benefit us as a tool, but I think the question for physicians is going to be is every tool the ideal tool in every particular context?” says Leier. “And if you’ve ever attempted to open a paint can with a screwdriver or pound a nail into your wall with a shoe – the answer is no.”
Category: Work
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