Pain Medicine, Biotechnology and Market Effects: Tools, Tekne, and Moral Responsibility

Despite advances in neurotechnology, pain remains a subjective experience that cannot be identified solely through objective means. The technological turn has led to and been synergized by market effects within medicine. In this paper we pose that this has led to

1. sidestepping of the discriminative intellectual integrity of science to inform and sustain the good of medicine,
2. diversion and/or subversion of physicians' capacity to make wellinformed clinical decisions,
3. the excessive use (if not misuse) of certain technologies and technologically-based techniques,
4. a compromised 'discretionary space' in which physicians may use technology to uphold patients' best interest(s) and
5. a decremented medical fiduciary.

In response, we propose four principal goals that could enable a more integrative use of technology. These are

1. promotion of 'customary' and 'out of the box' basic and clinical science as needed for new technologies in more personalized therapeutic settings and regimes,
2. eliminating unnecessary, inapt or inconsequential use(s) of technology,
3. development and provision of healthcare coverage that enables use of high technology as necessary and appropriate, and
4. incorporation of this insurance system within a broad Samaritan ethic of care.