Abstract
In this article the authors, a philosopher and a social development practitioner, formulate recommendations for responsible planning of technical interventions in health care relations under circumstances of uncertainty and moral risk. It is proposed that the hermeneutic approach followed in this article could serve as a heuristic guide to research and development teams in the planning phase of similar projects to proceed in a responsible manner. The introduction of mobile phone technology by a managed health care service provider to clients from a low-income South African context is used as a test case to illustrate the value of the proposed heuristic approach. The strength of this approach is situated in its coordination of general anthropological considerations, with interpretative attention to particularities. The test case is a relevant to the problem since it cannot be assumed that the same habitus of acquaintance with the mobile phone apparatus has been formed in the low-income South African context as in contexts or societies where people have been using telephones for decades.
Highlights
In the South African context, where the current study is situated, the term managed health care is commonly used to refer to the range of techniques intended to reduce the cost of providing health benefits while simultaneously improving the quality of care rendered
We present the hermeneutic framework we believe could be of help as a heuristic component of a responsible research and development process
The framework is designed to make a contribution to the preparation (1) for the development of a practical and effective communication system, and (2) for the evaluation of the technical changes involved in this project with regard to its users’ quality of life
Summary
In the South African context, where the current study is situated, the term managed health care is commonly used to refer to the range of techniques intended to reduce the cost of providing health benefits while simultaneously improving the quality of care rendered (adapted from NCBI). According to Chabikuli et al (2008) three key role players are involved in the production of managed health care services: the patient and his/her family (first party), the health care provider (second party, e.g. a doctor) and the medical insurance and/or medical aid administrator (third party). Managed care seeks to define the roles and duties of each party in such a way that health care cost escalation is contained and benefits of the services to the patient optimised. When the idea gradually emerged that mobile phone technology as means of communication could possibly be employed to improve the health benefits of clients, these shared values lead to at least two decisions: i) The ethical pitfalls of a one-sided technocratic implementation of mobile technology had to be avoided, and ii) the introduction of mobile technology to facilitate communication between the key role players had to be designed to complement rather than substitute human interaction
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