Obstacles to Prosthetic Care—Legal and Ethical Aspects of Access to Upper and Lower Limb Prosthetics in Germany and the Improvement of Prosthetic Care from a Social Perspective

Martina F. Baumann, Daniel Frank, Lena-Charlotte Kulla and Thomas Stieglitz
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Martina F. Baumann: Institute for Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, 76133 Karlsruhe, Germany
Daniel Frank: Chair for Ethics, Theory and History of the Life Sciences, Eberhard Karls University of Tübingen, 72074 Tübingen, Germany
Lena-Charlotte Kulla: Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering—IMTEK, University of Freiburg, 79110 Freiburg im Breisgau, Germany
Thomas Stieglitz: Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering—IMTEK, University of Freiburg, 79110 Freiburg im Breisgau, Germany

Societies, 2020, vol. 10, issue 1, 1-20

Abstract: Prosthetic technology for people with missing limbs has made great progress in recent decades. However, acceptance rates and user satisfaction are not only dependent on technical aspects, but also to a great extent on social and psychological factors. We propose that these factors should receive greater attention in order to improve prosthetic care and give recommendations how to incorporate the findings from social science in research and development (R&D) and in care practice. Limited access due to high costs of new prosthetic technology combined with rising costs in health care systems in general is a further issue we address. Our legal and ethical analysis of the reimbursement process in Germany shows that this issue requires further empirical investigation, a stakeholder dialogue and maybe even policy changes. Social science knowledge and participatory methods are of high relevance to answer questions about the benefit of prosthetics for users, based on individual needs and preferences, which should be at the core of debates on ethical resource allocation.

Keywords: prosthetics; disability; reimbursement; regulation; HTA; ELSI; (just) resource allocation in health care; clinical practice guidelines; equity; inclusion (search for similar items in EconPapers)
JEL-codes: A13 A14 P P0 P1 P2 P3 P4 P5 Z1 (search for similar items in EconPapers)
Date: 2020
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