Table 2 Challenges and drivers of the various types of moral expansion of medicine
Expansion of moral imperative | Challenges | Drivers (Stakeholders) |
|---|---|---|
1. From pain and suffering to other phenomena (indicators, ordinary-life experience, aesthetics) (expansion of morally relevant phenomena) | Overdiagnosis Overtreatment Risk aversion Health anxiety Healthism Ethical issues: Non-maleficence Beneficence Justice Power of professionals Responsibility Distracting responsibility Altering the professional-beneficiary relationship | People (demands, needs, preferences) Professionals (increasing knowledge, actionability, ability to help, status, prestige) Industry (tech/solutions, revenues) Media (attention, setting agenda) |
2. From present to future pain and suffering (temporal expansion) | Law (liability, defensive medicine) Beliefs/biases (“early is better than late,” “prevention is better than cure”) | |
3. From negative wellbeing (pain and suffering) to positive wellbeing (expansion of wellbeing) | Society (“magic bullet,” perfectionism, risk aversion, ambitions, welfarism) Individuals (pursuit of positive wellbeing and happiness) |