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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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1

Introduction


Progress in science, technology, and innovation is a collaborative effort that involves choices and actions made by multiple parties, acting within systems that begin even before the conception and development of research questions; encompass the experiences of those who use the resulting products; and extend to analyses that inform the next generation of questions, approaches, and technologies. The development of emerging technologies is also integrally embedded in national and international ethical, social, economic, and regulatory contexts, which shape the values reflected in the innovation process, as well as influence who participates in and controls the choices made along the way, who receives the benefits and bears the burdens generated in the process, and how elements of the system are governed.

A vast array of technologies is applicable to the health and medicine sphere: tools for more precise genome editing, mRNA platforms for faster vaccine production, new sources of transplantable organs, research aimed at counteracting effects of aging, the integration of data and machine learning algorithms to accelerate cancer diagnosis, consumer products such as transcranial brain stimulation devices, and many, many others. One estimate has placed the annual direct economic impact of biotechnology advances in the domain of “human health and performance” at $0.5–1.2 trillion (McKinsey Global Institute, 2020).

PAST AND CURRENT EFFORTS TOWARD ADVANCING EQUITY

It would be impossible for a single set of recommendations to address in detail the implications of this landscape and its alignment with ethical and social values. Rather, multiple efforts by national and international networks of researchers and policy makers, along with numerous publications from scholars of emerging science and technology, responsible innovation, bioethics, and anticipatory governance, have explored these questions through the development of frameworks and strategies and in the context of given questions and technologies. Government agencies, foundations, professional societies, and philanthropic

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×
Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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donors all contribute to supporting and advancing efforts directed toward the ethics and governance of emerging technologies. A very small sampling of these efforts—intended only as broadly illustrative and far from comprehensive—is presented in Box 1-1.

Advancing equity is also an ongoing priority across the U.S. government. In 2021, President Biden issued Executive Order 13985 on Advancing Racial Equity and Support for Underserved Communities through the Federal Government. This Executive Order called on federal agencies to develop equity action plans; evaluate whether agency policies produce racial inequities; and identify opportunities to increase coordination, communication, and engagement with community-based organizations and civil rights organizations supporting underserved communities (White House, 2021a). The Executive Order also called on the director of the Office of Management and Budget to “study methods for assessing whether agency policies and actions create or exacerbate barriers to full and equal participation” and “identify opportunities to promote equity in the budget that the President submits to the Congress.” Finally, recognizing that a first step in promoting equity is to gather the data necessary to inform that effort, the Executive Order established an Interagency Working Group on Equitable Data. In addition, the White House issued Executive Order 14020, establishing a White House Gender Policy Council (White House, 2021b), and Executive Order 14031, aimed at reinvigorating the White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders to advance equity, justice, and opportunity (White House, 2021c).

Agency equity plans were released in 2022. According to its plan, for example, the Department of Defense is attempting to mitigate algorithmic bias and increase the safety and equity of artificial intelligence (AI) by investing in such actions as partnerships with historically Black colleges and universities and minority-serving institutions to create a more diverse workforce (White House, 2022a).

The above Executive Orders prioritize equity in ways that encompass the whole of government and go well beyond the domain of biomedical science, extending to agencies whose purviews range from the U.S. tax code to housing.

The focus on this priority has continued. In December 2022, the White House Office of Science and Technology Policy (OSTP) released a vision for a national effort toward achieving equity in the U.S. science and technology ecosystem, supported by $1.2 billion in funding for science, technology, engineering, and mathematics (STEM) programs, investments, and opportunities targeted to historically underserved populations and areas. The programs thus supported include degree and teaching scholarships, experiential learning and training programs, internships, grants, and technical assistance. Agencies such as the National Science Foundation and the National Institutes of Health (NIH), nonprofit and educational institutions such as Spelman College and The Johns Hopkins University, and private companies such as Micron and Intel are contributing (White House, 2022b,c). In February 2023, the White House issued Executive Order 14091 on Further Advancing Racial Equity and Support for Underserved Communities through the Federal Government,1 establishing Equity Teams within agencies to coordinate the implementation of initiatives (White House, 2023). Each agency Equity Team is to be led by a senior designee responsible for ensuring “sufficient

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1 The term “equity” as defined by Executive Order 14091 “means the consistent and systematic treatment of all individuals in a fair, just, and impartial manner, including individuals who belong to communities that often have been denied such treatment, such as Black, Latino, Indigenous and Native American, Asian American, Native Hawaiian, and Pacific Islander persons and other persons of color; members of religious minorities; women and girls; LGBTQI+ persons; persons with disabilities; persons who live in rural areas; persons who live in United States Territories; persons otherwise adversely affected by persistent poverty or inequality; and individuals who belong to multiple such communities.”

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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resources, including staffing and data collection capacity, to advance the agency’s equity goals” and to deliver equitable outcomes. The Executive Order also established a White House Steering Committee on Equity to coordinate government efforts, monitor agencies’ activities, and promote accountability.

Federal investments and priority setting in the U.S. science, technology, and innovation enterprise also encompass recent actions such as the Creating Helpful Incentives to Produce Semiconductors (CHIPS) and Science Act (Public Law 117-167) and Executive Order 14081, Advancing Biotechnology and Biomanufacturing Innovation for a Sustainable, Safe, and Secure American Bioeconomy (White House, 2022d). All of these actions reflect substantive recognition of the importance of equity across the U.S. government, providing substantial opportunities to support equitable science, technology, and innovation and foster a system that recognizes and can meet the needs of the many diverse populations that live and work in the United States.

This body of work—from both the U.S. federal government and public and private actors such as those listed in Box 1-1—forms the context for this report. Collectively, these and other efforts have helped advance an understanding of shared responsibilities in health and medicine and the identification of additional opportunities to better anticipate and manage the benefits and harms of emerging technologies.

NATIONAL ACADEMY OF MEDICINE’S EMPHASIS ON EMERGING SCIENCE, TECHNOLOGY, AND INNOVATION

Under its current strategic plan, the National Academy of Medicine (NAM) emphasizes the vision of “a healthy future for everyone” (NAM Strategic Plan 2018–2023). In early 2020, NAM established a standing Committee on Emerging Science, Technology, and Innovation in Health and Medicine (CESTI) to explore technologies contributing to this future and discuss how to address their potential societal, ethical, legal, and other implications. CESTI’s discussions emphasized the importance of developing approaches for integrating multiple sectors of the innovation ecosystem, including academia, industry, government, venture capital, philanthropy, and members of the public. Over the course of 2 years, CESTI developed illustrative case studies in regenerative medicine, telehealth, and noninvasive neuromodulation devices. Each case study included a visioning component exploring possible future scenarios for how the technology might develop and what additional ethical, legal, and regulatory concerns such futures might raise. Drawing on these cases, CESTI articulated five foundational ethical principles for emerging technologies in health and medicine—justice, autonomy, fairness, collective good, and individual good—concluding that commitments to upholding the values embodied by these principles could guide the further development of policies and practices for the governance of emerging technologies (Mathews et al., 2022a,b) (see Figure 1-1). Other committees have developed similar sets of ethical principles as the basis for assessing implications associated with new biomedical technologies (see, for example, NASEM 2019a).

CESTI’s analysis emphasized the engagement of multiple actors—including those who play central roles in the design and development of a technology, policy makers and regulators, and individual users and society—as an essential component of the technology landscape. Its analysis also highlighted the importance of considering the principles cited above and included in Figure 1-1 as early as possible in technology development, stating that “if a governance structure is not designed to consider equity questions early in a technology’s life cycle, it may be considerably more difficult to address them later…. A governance structure

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Image
FIGURE 1-1 Principles and commitments articulated by the National Academy of Medicine’s Committee on Emerging Science, Technology, and Innovation in Health and Medicine.
SOURCE: Mathews et al., 2022b.

that could anticipate this potential challenge through fair and inclusive procedures and attention to structural injustice might prevent similar equity concerns from arising in the future” (Mathews et al., 2022b, p. 46).

BEYOND RESEARCH ETHICS: ENHANCED ATTENTION TO EQUITY, JUSTICE, AND FAIRNESS

The body of work described above and other efforts described in the text and boxes throughout this report reflect how responsible research and innovation in health and medicine is built on foundational research ethics that guide what is considered acceptable or unacceptable while requiring a focus that extends beyond individual-level concerns to encompass collective values and needs. Which aspects are emphasized by these guiding principles and how those principles have been implemented in national and international oversight structures have evolved over time, as reflected in extensive bodies of scholarship on the development and evolution of bioethics in health and medicine (see, e.g., London, 2022).

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×

The current approach to responsible conduct and oversight of research with human subjects was significantly informed by events and discussions during the 1960s and 1970s, including public revelations about the infamous Tuskegee Syphilis Study (carried out from 1932 to 1972) (Breed, 2022) and the publication of other examples that raised critical questions about how participants’ risks, benefits, and consent were addressed in clinical studies (see, for example, Beecher, 1966). The Declaration of Helsinki: Ethical Principles for Research Involving Human Subjects was adopted by the World Medical Association in 1964 (WMA, 1964; multiple revisions). In the United States, the National Research Act, signed in 1974, authorized the U.S. Department of Health and Human Services (HHS) to establish regulations for research with human subjects [Pub. L. No. 93-348, § 214, 88 Stat. 342 (1974)]. This was followed in 1979 by the Belmont report from the National Commission for the Protection of Human Subjects in Biomedical and Behavioral Research, which emphasized respect for persons, beneficence, and justice (Department of Health, Education and Welfare, 1979), particularly as applied to the individual risks, benefits, and treatment of research participants. The Belmont report’s recommendations were pivotal in shaping the expansion and revision of federal regulations governing human subjects research under 45 Code of Federal Regulations (CFR) 46 (“the Common Rule”), most recently amended in 2018. Influential international bioethics statements and reports have also been released in prior decades, including the Universal Declaration on Bioethics and Human Rights (UNESCO, 2005); International Ethical Guidelines for Health-Related Research Involving Humans (CIOMS and WHO, 2016; multiple revisions); and documents emphasizing the right to health of such communities as persons with disabilities, women, and children (United Nations, 1989, 2006, 2015).

Structures that provide for periodic reviews and responsive decision making—including institutional review boards, bioethics committees, peer review panels to advise on funding and publication decisions, and premarket regulatory reviews—have become well established as mechanisms for embedding these principles in biomedical research and development (see Chapter 3 for more detail on the current U.S. system of science and technology research and development). New concerns arising from technical advances—those resulting, for example, from research using recombinant DNA molecules, human stem cells, or pathogen “gain of function” experiments—have led to periodic reviews of policies governing the health and medicine field. Over time, bodies such as the HHS Office of Research Integrity and the NIH Novel and Exceptional Technology and Research Advisory Committee (NExTRAC) have been established,2 requirements for researchers to receive training in responsible research conduct have been implemented, practices for conducting clinical trials at international sites have been updated, and policies governing the protection and sharing of personal health information have been incorporated (Baker et al., 2016; London, 2022). Responsible practices continue to evolve in other areas as well, including the ethical care and use of research animals (NRC, 2011).

These developments largely reflect concepts of balancing potential benefits and harms that accrue to individual research participants, including an emphasis on obtaining appropriate, informed consent. As efforts of the federal government, CESTI, and others have emphasized, additional focus is needed on the social contexts in which research, development, and innovation take place, and thus on the importance of aligning innovation with principles that support collective good and of recognizing the social responsibility of science and technology to advance health for everyone. Research and innovation systems are not disconnected from social purposes, and so it is important to acknowledge the ethical grounds “for holding a wider range of actors accountable for decisions that affect the questions that are asked;

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2 See https://ori.hhs.gov/ and https://osp.od.nih.gov/policies/novel-and-exceptional-technology-and-research-advisory-committee-nextrac/ (accessed June 19, 2023).

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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the methods that are used to address them; the terms on which studies are carried out; and the prospects for incorporating the resulting knowledge, practices, and interventions into the social systems charged with safeguarding and advancing the basic interests of community members” (London, 2022, p. 25). Such issues go beyond those that have been the traditional focus of research ethics and the translation of those ethics into practice. The prioritization of principles and values addressing broad social and ethical considerations also reflects and builds on an increasing emphasis over the past decades on meaningful involvement of patients and community members in research and cogovernance and on the imperative to address the values and concerns of historically underrecognized communities, including Indigenous populations and people with disabilities (Claw et al., 2018; DeCormier Plosky et al., 2022; Fair et al., 2022; Selker and Wilkins, 2017). See Chapter 2 and Appendix B for a fuller discussion of these issues and a historical review of equity and technology governance.

STUDY SCOPE AND APPROACH

To build on and advance the work of the federal government, CESTI, and other stakeholders described above, the National Academies of Sciences, Engineering, and Medicine and the National Academy of Medicine convened an ad hoc committee of experts to consider how governance systems for emerging science, technology, and innovation in health and medicine can meaningfully incorporate ethical principles and facilitate the development and use of transformative technologies with a particular focus on equity. See Box 1-2 for the committee’s full statement of task.

Study Scope

The charge to the committee supports the development of anticipatory and cross-sectoral governance and focuses on the concept of equity from among the broader set of individual- and collective-level ethical principles identified by CESTI. The understanding of equity used in this report is described in Chapter 2 and combines elements of justice and common good, used by the CESTI standing committee, along with concepts of fairness and equality. Different stakeholders and communities are likely to most resonate with different terms from among this set; the report’s primary aim is to discuss how the current system of emerging science, technology, and innovation in medicine and health fails to sufficiently address the needs of all of the system’s stakeholders and users, and largely uses the term “equity” to capture these gaps, challenges, and opportunities for action. Equity, as understood in this report, is about bridging gaps between the needs of community members and the ability of social institutions to respond to, protect, or advance those needs. As described in Chapter 2, an understanding of equity does not equate simply to enhancing access to resources or products, nor is it limited to considerations based on race or ethnicity. Rather, a broad approach to equity in innovation calls for an effective and fair system for the development and governance of medical technologies, one that moves toward an ideal of universalization by acting to remedy inequities across the full range of the system’s users. It involves a multidimensional focus on factors that help shape the questions that are asked, the technologies that are developed, who has access to their benefits, and how they contribute to closing or widening gaps in the ability of different parties to lead healthy lives. By focusing on this multifaceted concept of equity instead of addressing all five ethical principles identified by CESTI simultaneously, the committee was able to assess the challenges, opportunities, strategies, and tools entailed in creating such a system, and

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×

to consider the full complexity of the concept at a level of detail that can advance the discussion beyond an individual’s potential benefits and harms.

Even with this focus on equity from among CESTI’s set of foundational ethical principles, the committee’s scope was unusually large. The committee’s charge centers on emerging medical technologies or the direct application of related technical developments to medical products (such as the increasing integration of AI in medicine); it is not limited to a given area of research or technology development. Accordingly, this report develops a cross-cutting conceptual framework and set of action areas that draw on features common to the development of seemingly different technologies and products.

The committee recognizes that health can be advanced in multiple ways, many of which are not centered on discovering and deploying emerging technologies; examples include improving natural and built environments in ways that benefit health, better addressing socioeconomic factors such as poverty, enhancing access to information through programs that extend high-speed internet coverage, or better implementing care practices that have been shown to be effective.3 While these action areas can have significant impacts on health and health equity,

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3 See, for example, National Clinical Care Commission (2021) as an example of a holistic approach to diabetes prevention.

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×

the report does not address them in detail because of the need to focus rather than broaden the study scope and to adhere to the committee’s statement of task, which requires that the focus be on emerging science, technology, and innovation in health and medicine.

Finally, the committee recognizes the global nature of technology development and the diversity of national, regional, and international systems for conducting, sharing, and regulating research and innovation in health and medicine. This report focuses on the U.S. system, particularly in Chapter 3, which describes U.S. policies and agencies active in the current medical technology ecosystem. Nevertheless, the concept of equity and the conceptual framework proposed in the report for aligning the development and governance of emerging science, technology, and innovation with complex ethical considerations may be applicable to other contexts and across borders. Thus, although the strategies set forth in the report are targeted to U.S. actors, the report’s guidance may be adaptable to discussions in other forums, such as the Organisation for Economic Co-operation and Development (OECD) or the World Health Organization. The global reach of the implications associated with emerging technologies in health and medicine underscores the importance of global consideration of governance and equity in innovation. This report could help inform such conversations.

Study Approach

Reflecting the complexity of its task, the committee included 19 members and two fellows of the National Academy of Medicine with expertise in technology development and assessment, representing academia, industry, and government in the areas of public health, philosophy and the social sciences, economics, innovation policies, regulatory oversight, the rights and needs of historically marginalized or underrepresented communities, and other domains. The committee met five times over the course of the study to discuss and analyze the available evidence and to develop the conclusions and recommendations presented in this report.

In conducting the study, the committee drew on materials developed by CESTI and on presentations and discussions during a virtual workshop in 2022 organized by CESTI to explore examples of public engagement and health technology assessment, and to discuss the translation of guiding ethical principles into governance. The committee reviewed three case studies developed by CESTI and sought to better understand how these cases illustrate the dynamic, distributed nature of innovation, the roles of actors at different stages in the innovation life cycle, the incentives and the regulatory landscapes associated with the case study areas, and potential intervention points at which nudges to promote alignment with equity might be possible. The committee also explored a “heatmap” tool developed by CESTI to visually represent a technology’s alignment with CESTI’s set of foundational ethical principles for a context of use at a point in time (see Chapter 5).

Additional evidence gathered during the study included responses to a public call for input on successes and challenges in the current ecosystem for governance of emerging technologies in health and medicine, and on strategies and approaches for better aligning technology development and governance with ethical principles that include equity. Committee members also reviewed the relevant literature and prior reports of the National Academies; commissioned two white papers; and held public, virtual information-gathering sessions in June, August, and October 2022, which featured speakers who generously shared their knowledge. See Appendix A for further information on how the committee conducted its work; Appendixes B and C for the commissioned papers; and Appendix D for brief biographies of committee members, fellows, and staff.

Finally, to better understand perspectives on ethical and societal implications of emerging technologies, the committee gathered information from a public survey conducted in

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×

2022 by The Johns Hopkins University.4 The survey presented respondents with two short vignettes—one on genetically modified stem cells as a treatment for sickle cell disease and the other on use of a noninvasive brain stimulation device—and asked about their views on the potential benefits and harms of these technology areas, as well as their personal experiences with new technologies. Survey respondents expressed interest in using technologies for advancing health, but also raised concerns such as unknown longer-term outcomes, unequal availability, and the importance of conducting rigorous clinical trials and ensuring sufficient oversight (see Box 1-3 for selected survey responses). The frequency with which respondents identified equity and fairness as critical elements for health and medical technologies contributed to this report’s emphasis on opportunities for enhancing the alignment of innovation systems with this principle.

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4 The public survey on which the content of this section draws was conducted by The Johns Hopkins University in accordance with its institutional policies and procedures (Mathews, 2022). Additional deidentified responses to the survey, reflected in Box 1-3, were provided by Debra Mathews in a personal communication (11/22/22). See Appendix A for additional information.

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×
Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×

ORGANIZATION OF THE REPORT

In Chapter 2 of this report, the committee explains why consideration of equity is critical to ensuring that a medical technology and innovation system functions for everyone, and delves further into what attention to equity entails. Chapter 3 describes a simplified conceptual model of biomedical innovation, including the major phases of development, points at which choices are made, and who is involved in making them. It also presents the committee’s analysis of potential gaps and unintended consequences arising from the current U.S. ecosystem for emerging science, technology, and innovation. Chapter 4 provides a conceptual framework guided by five imperatives for enhancing coordinated, multiactor/multistakeholder governance of emerging technologies and promoting alignment with ethical values, with a focus on equity. The second part of the chapter shows how this framework translates to the technology development life cycle and describes how the framework provides a basis for improved innovation and governance processes. Chapter 5 presents the committee’s recommendations and guidance for advancing progress in key areas of action aligned with the proposed framework. It also suggests how resources developed by CESTI and described throughout the report can serve as starting tools for others interested in better aligning the development, use, and governance of emerging biomedical technology with the principle of equity.

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×

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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×
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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Advances in biomedical science, data science, engineering, and technology are leading to high-pace innovation with potential to transform health and medicine. These innovations simultaneously raise important ethical and social issues, including how to fairly distribute their benefits and risks. The National Academies of Sciences, Engineering, and Medicine, in collaboration with the National Academy of Medicine, established the Committee on Creating a Framework for Emerging Science, Technology, and Innovation in Health and Medicine to provide leadership and engage broad communities in developing a framework for aligning the development and use of transformative technologies with ethical and equitable principles. The committees resulting report describes a governance framework for decisions throughout the innovation life cycle to advance equitable innovation and support an ecosystem that is more responsive to the needs of a broader range of individuals and is better able to recognize and address inequities as they arise.

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