/ 31 July 2023

New medical technologies risk exacerbating inequalities

2023 Waic Smart Medical Services
In healthcare, AI can now conduct clinical diagnosis with a better accuracy rate than their human “colleagues.” (CFOTO/Future Publishing via Getty Images)

“Smart” technologies have become ubiquitous since the last decade and have proliferated in several domains. 

We use artificial intelligence (AI) in simple technologies, such as our phones and gadgets, to more complex technologies, like vehicles (driverless cars and autopilot in planes and ships). 

Businesses have employed AI in various domains, from creating AI-powered chatbots to assist customers with queries to more robust jobs such as analysing market structures for trading purposes. 

In the military, autonomous weapon systems are now proliferating with the potential to change the dynamics of warfare. 

In healthcare, AI can now conduct clinical diagnosis with a better accuracy rate than their human “colleagues.” 

This continuous widespread use of AI in many domains leads to what Jeroen Hopster, a researcher in ethics, terms socially disruptive — the constant change to our norms, values, conception of the world, and so on. 

The focus of this article is not directly on expanding the concept of socially disruptive technologies but on two new medical technologies with the capacity to change healthcare on the one hand and to see their implications to the social strata of our societies, on the other hand.

The first technology is an AI-powered full-body scan technology developed by an American company called Prenuvo. This technology can potentially revolutionise healthcare through its preventive approach to diseases. 

The AI-powered full-body scan uses magnetic resonance imaging (MRI) technology to conduct a full-body scan on patients, flagging and escalating potential health problems. 

This implies that before the symptoms of any disease emerge, the technology already predicts the disease to enable physicians to figure out prevention methods. 

It analyses every part of the body and the organs from head to toe to detect any anomalies from cancer to liver stones and kidney diseases, virtually all forms of pathologies. 

It achieves this without invasive procedures or radiation, and the results are made available to the patient 48 hours after the examination. The pricing for these scans is as follows: a torso scan of 20 minutes is $999; a head and torso scan of 45 minutes is $1 799; a full-body scan of one hour is $2,499.

The second technology is an innovation from the Fountain Life Health Technology Company in the United States. It recently developed an AI-powered coronary artery scan technology that can detect heart pathologies, especially heart attacks, almost a decade before the symptoms surface. 

The company is transforming healthcare from a reactive to a proactive domain. The Fountain Life AI coronary artery scan (CAS) is similar to the coronary computed tomography angiography (CCTA) that has been used for several decades to diagnose heart diseases. 

The difference between the Fountain AI-powered CAS and the traditional CCTA is that the former employs not only the result analyses of radiologists and cardiologists but also AI to analyse the results of the scan as opposed to the latter technology. 

Using the analyses of AI in reading the results ensures that plagues that are concealed from the human eyes are seen. Finally, access to this technology is for self-insured employers who intend to offer access to their employees and those in “high-end residential centres”.

The designs of these technologies confirm the promises of AI-powered technologies in transforming and revolutionising the different domains of societies. These technologies are socially disruptive because they constantly revolutionise our norms, practices, social relations, and how we interact with the world. 

Given their capacities, these technologies can now contribute to longevity. Because these technologies can flag pathologies before the symptoms emerge, they provide physicians ample time to prevent diseases before they occur. This will minimise the presence of chronic diseases such as cancer, heart attack and cardiac diseases. 

Although these innovations are remarkable, these technologies may come with some adverse effects on the socio-economic structures and hierarchies of our societies if policies on how these technologies should be used are not put in place to circumvent or mitigate possible inequalities.

Some of the ethical questions that should be addressed are: who will benefit from these technologies? Will these technologies be widely available, and will the rich and the poor have access to these technologies equally? What are the economic and health implications if low-income earners cannot afford access to these technologies? Is it a matter of justice/injustice that some people might not be able to afford longevity and increased lifespan? 

For example, Fountain Health specifies that CAS is available for high-end residential areas. But what about the low-end residential centres? Do they not deserve better healthcare systems and elongated lifespans? These are precise forms of classism and discrimination against people experiencing poverty.

Two questions might emerge here: first, how should private companies make profits if they must care about the wellbeing of “the poor?”

I think this is simple, governments should put policies in place to regulate capitalist-oriented firms from excessive profit-making that discriminates against and is  detrimental to the well-being of those at the bottom ladder of our societies. 

Second, one might also ask, how do these ordeals in the US affect us in South Africa and Africa? Prima facie, it does seem like they don’t, but ultima facie, they do.  

Because we live in a global economy and technology transfer continuously occurs, we are affected in different ways. When these technologies proliferate, they will find their way into Africa, or we will find our way to them. When this happens, the possibility of aggravating inequalities will become a present one.

Undoubtedly, AI technology is transformative. But it can also broaden inequalities and the divide between the economically advantaged and the disadvantaged. 

AI technologies can push the lower social class to the margin, suffocating them. The concept of “letting the poor breath” has recently proliferated in the Nigerian social and political spaces. 

Though it is now a buzz concept, I use it strictly from a justice perspective. Letting the “‘poor’ breathe” means ensuring not to make caricatures and jokes of their plights such as the members of the Upper Chambers of the Nigerian legislative arm of government did. 

Letting the poor breathe entails seeing them as possessing inalienable dignity, which positions them to seek equal access to innovative technologies. Allowing the poor breath is a matter of justice.

As John Rawls espouses, people are free and equal so they should be entitled to the equal distribution of society’s resources, whether they are regardless of whether they are rich or poor. This equal distribution should benefit the former more. We must ensure that the designs and use of AI technologies do not lead to the aggravation of inequality.

Edmund Terem Ugar is a doctoral student and a philosopher of AI, medicine, and public health, at the University of Johannesburg and a researcher at the UJ Centre for African-China Studies and Centre for the Philosophy of Epidemiology, Medicine, and Public Health, UJ-Durham.