Ethics and Health Policy: Neurotechnology, Evidence, and Ethics
by James Giordano, PhD
 On the
“Groundswell” of Neurotechnology
Recently, a reader wrote to comment on my essays regarding neurotechnology in light of the
growing number of advertisements for various neurotechnologically-based devices seen in
this, and other, pain journals. Writing, “…there’s been practically a
groundswell [of information and advertisement]…that often is confusing, seems
contradicting and, in some cases, it’s obvious that real evidence isn’t
available…how can physicians and the general public, for that matter, know
what’s ‘snake oil’ and what’s legitimate, and if these devices are
safe, and how they ought to be used?” this reader’s thoughtful comment takes
note of an increasing presence of neurotechnology in pain care, if not medicine and other
dimensions of public life in general.
The medical use of machines is certainly not new, and a brief history of medicine since
the second industrial revolution will reveal the steady infiltration of various devices
into the clinical milieu.1 This has tended to reflect the iterative
technologization of much of western society. As previously noted, the aims of such
technologization—namely to ease the human condition and to incur time- and
cost-efficiency—married well to the expansion of medicine as a profession and
practice in the early 20th century.
These incentives also wedded technology and its use(s) to a broadening influence of the
market, and this fusion was mirrored—even if somewhat in caricature—by the
profligate claims of “wonder devices” that could “cure” a host of
disorders including, if not most typically, pain.2 To be sure, many such claims
were sheer quackery, and the Flexnerian reformation of American medicine certainly
lessened the frequency and abundance of these transgressions.3 Yet, every new
technologic turn is accompanied by speculation, expectation, hopes and fears, and the
outgrowth of neurotechnology following the Decade of the Brain (DoB, 1990-2000) certainly
reflects this process. The astute comment provided by the reader speaks to the apparent
“pop-up” of neurotechnologies germane to the diag-nosis and treatment of pain,
attributable at least in part, to the carry-over effect of technologies developed during
the DoB being focused upon practical applications during the Decade of Pain Control and
Research (DPCR, 2000-2010).4
Please refer to the March 2010 issue for the complete text. In the event you need to order a back issue, please click here.
— March 2010
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