Uncovering social structures and informational prejudices to reduce inequity in delivery and uptake of new molecular technologies
Sara Filoche, Peter Stone, Fiona Cram, Sondra Bacharach, Anthony Dowell, Dianne Sika-Paotonu, Angela Beard, Judy Ormandy, Christina Buchanan, Michelle Thunders & Kevin Dew
Journal of Medical Ethics 46 (11):763-767 (2020)
AbstractAdvances in molecular technologies have the potential to help remedy health inequities through earlier detection and prevention; if, however, their delivery and uptake are not more carefully considered, there is a very real risk that existing inequities in access and use will be further exacerbated. We argue this risk relates to the way that information and knowledge about the technology is both acquired and shared, or not, between health practitioners and their patients.A healthcare system can be viewed as a complex social network comprising individuals with different worldviews, hierarchies, professional cultures and subcultures and personal beliefs, both for those giving and receiving care. When healthcare practitioners are not perceived as knowledge equals, they would experience informational prejudices, and the result is that knowledge dissemination across and between them would be impeded. The uptake and delivery of a new technology may be inequitable as a result. Patients would also experience informational prejudice when they are viewed as not being able to understand the information that is presented to them, and information may be withheld.Informational prejudices driven by social relations and structures have thus far been underexplored in considering equitable implementation and uptake of new molecular technologies. Every healthcare interaction represents an opportunity for experiencing informational prejudice, and with it the risk of being inappropriately informed for undertaking such screening or testing. Making knowledge acquisition and information dissemination, and experiences of informational prejudice, explicit through sociologically framed investigations would extend our understandings of equity, and offer ways to affect network relationships and structures that support equity in delivery and uptake.
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