Technological Determinism: A Social Process with Some Implications for Ambulance Paramedics

Abstract

Medical technology has been presented as a driving force behind a range of social changes, both positive and negative. These changes include escalating health care costs and inequalities in health care outcomes, the deskilling and hyperskilling of health care practitioners, and increased human longevity and quality of life. Medical technology is sometimes clouded by mystique in that each new drug, device, or machine tends to appear as a thing with a life of its own, as if the technology not only arrived independent of social, cultural, political and economic forces but was also the driving force for social change. By not considering the emergence and adoption of a medical technology as a social process, the resulting social change appears as a natural consequence of technological innovation. This has been termed technological determinism.This paper examines technological determinism as a social process and provides some explanation as to why ineffective, expensive, and harmful medical technologies have proliferated since the late 1970's. Four implications arising from technological determinism are identified, and they all have consequences for Ambulance Paramedics and their everyday practice as health care professionals.Firstly, the intuition acquired as a skilled practitioner cannot be replaced by technology and an increase in invasive interventions has resulted in increased iatrogenesis. Secondly, there can be the blocking of a more effective and/or cheaper technology due to the resistance of powerful commercial and/or status groups. Thirdly, borrowing/sharing the technological symbols of an already dominant group may only serve to continue and/or construct a subordinate relationship. Fourthly, there can be a devaluing of Ambulance Paramedics when success is attributed to a technology rather than the skills of practitioners who use it.