This chapter introduces the field of advanced technology within the orthotics and prosthetics profession, a healthcare profession that combines technology and engineering science with medical and health science to produce medical devices (orthoses and prostheses) to treat medical conditions that cause physical dysfunction. The chapter sets the background to the ethical dilemmas that are encountered within the field, which technologically advanced devices cause such dilemmas and why, and then discusses the ethical dilemmas as encountered by the three stakeholders within the profession, namely the manufacturers/innovators, the prosthetic and orthotic practitioners, and the users of the devices themselves, the patients. In conclusion, the chapter looks at some solutions and recommendations to overcome or at least reduce these dilemmas.
TopBackground
On the frontline of the orthotics and prosthetics industry are the orthotists and prosthetists; these are the healthcare professionals, allied to medicine, who, on a daily basis, are faced with patients who are in need of their services.
Prosthetists and orthotists work within the medical and health sector, but they are very much unique in how they practise their profession, as compared to other professions allied to medicine, such as physiotherapists, occupational therapists or podiatrists, in that after they perform their initial assessment of the patient, and the patient’s functional and aesthetic needs have been established, prosthetists and orthotists have to prescribe and design an orthotic or prosthetic device for that patient. Such a device comes at a cost, over and above the clinician’s consultation fees.
In a nutshell, funding of orthotic and prosthetic services, like all other medical and rehabilitation services, may come from one of two sources:
- 1.
A Universal Healthcare system, where healthcare is provided free at the point of delivery to patients. This does not mean that the cost of healthcare is zero, but that the care is funded by taxpayers’ contributions. The state collects the taxes and distributes some of those funds to healthcare entities so they can treat patients free of charge, including orthotic and prosthetic services.
- 2.
A Private Healthcare system, which can be either:
- a.
An Insurance-based system, where individuals take out a medical insurance which covers, fully or partially, the cost of medical care and rehabilitation depending on the premium paid by that individual; orthotic and prosthetic services can also be funded in this way, or
- b.
Self-funding, when a patient who needs medical care, including rehabilitation and/or orthotic and prosthetic services, decides to pay for such services from their own private funds.