Joschka Haltaufderheide

Institute for Ethics and History of Medicine, University Medical Centre Greifswald

Against the backdrop of the current technological leap in medicine, the engagement of medical ethics with – and its affinity for – new health technologies appears to be ubiquitous. This lecture challenges this assessment and argues that, despite their apparent sensitivity to technology, central concepts of medical ethics perpetuate structurally technosceptical, and in some cases technophobic, premises. This is illustrated using the model of the doctor-patient relationship (DPR) as an example.

The MPR is one of the paradigmatic reference points of medical ethical thought and serves as a fundamental framework for deliberating on ethical rights and duties. At the same time, it is striking that technology – and thus an explicit concept of technology – is not conceived as an integral part of this model. This lecture critically examines this gap and interprets the MPR as a model of so-called ‘surrogate reasoning’, in which selected features of a context of action are transferred into a conceptual model to enable normative conclusions to be drawn for sufficiently similar situations. From this perspective, the selection of essential parameters of the modelled context of action can be examined in a temporal framework.

Within this temporal framework, it is demonstrated that the definition of essential model parameters is normatively charged and, in terms of the implied understanding, runs parallel to broader societal developments. In particular, in the development and critique of the model from the mid-20th century onwards, technosceptical positions and a strongly anthropocentric ideal of relationships can therefore be identified, which systematically marginalise the role of technologies and continue to have an impact to this day. These are closely linked to time-bound understandings of technology and ideals of relationships, and continue to influence the formulation of models in medical ethics—as historically entrenched premises—right up to the present day.

This lecture is not intended as a plea for alternative models of APB, but rather as an invitation to reflect on the temporal persistence of implicit concepts of technology in medical ethics. The aim is to demonstrate how such implicit assumptions shape the scope and limits of medical-ethical analysis, and why their critical reconstruction – particularly against the backdrop of current developments – represents a central priority of contemporary medical-ethical research.