Cultura

Technology-Driven Medicine and its Impact On Clinical Judgment and Ethical Care: A Comprehensive Review

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Fatimah Jalal Maroof Al Yamany, Layla Hasan Ali Mahnashi, Aisha Okais Hamoud Mobarki, Salha Hassan Ali Mahraied, Badriah Mohammed Alamri
Mahdi Zadin Alzbadeen, Saleh Hassin Hasen Alzbadin, Badie Difallah Almashham, Zidane Saleh Muhammad Zabadin, Saeed Saleh Muhammad Zabadin

Abstract

The rapid integration of digital technologies—including artificial intelligence, clinical decision support systems, electronic health records, and automation—has profoundly transformed contemporary medical practice. While these technologies enhance efficiency, diagnostic accuracy, and access to information, they also introduce new challenges that affect clinical judgment and ethical care. This comprehensive review explores the impact of technology-driven medicine on clinicians’ decision-making processes and the ethical dimensions of healthcare delivery. Drawing on recent multidisciplinary literature, the review examines how increasing technological dependency reshapes clinical reasoning, professional autonomy, and moral responsibility. Key ethical concerns discussed include automation bias, erosion of critical thinking skills, accountability in technology-assisted decisions, algorithmic bias, and the potential weakening of clinician–patient relationships. The review further highlights tensions between standardized, data-driven care and the need for contextual, patient-centered judgment grounded in ethical principles such as beneficence, autonomy, non-maleficence, and justice. The findings underscore that technology is not ethically neutral and must be implemented with safeguards that preserve human oversight, ethical reflection, and professional accountability. The review concludes that sustainable, ethical healthcare requires positioning technology as a supportive tool that augments—rather than replaces—human clinical judgment.

Keywords : Clinical judgment; Ethical care; Technology-driven medicine; Digital health; Artificial intelligence in healthcare; Clinical decision-making; Medical ethics.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty