Arbitrary Boundaries and Stigma

High-tech modifications of ubiquitous examination equipment call particular attention to the arbitrary boundaries between assistive technology and medical devices. A clear example emerges through comparison of these two local news stories featuring digital stethoscope technology. A local NBC affiliate in Little Rock, Arkansas, aired the story of Clarissa Hardman in 2018 (Brunner, 2018). The story focuses on how digital stethoscope technology enables Hardman, who is hard of hearing, to efficiently and accurately complete patient physical examinations through sound amplification played through audio headphones. The description of the stethoscope as “changing the quality of life for one nurse” positions it squarely within the definition of assistive technology, wherein the intended purpose is to support functional independence on an individual level. As such, Hardman describes having to apply for an outside grant in order to purchase the costly device for herself, rather than being provided with the necessary equipment from her employer.

In contrast, the 2020 story from a Baltimore, Maryland, CBS affiliate presents the exact same stethoscope technology in an entirely new context (Specialized unit at Johns Hopkins, 2020). This piece details new procedures implemented at Johns Hopkins Hospital aimed at minimizing contamination in preparation for “a highly-contagious virus, like the coronavirus [COVID-19]” (Specialized unit at Johns Hopkins, 2020). While not explicitly described, the video footage accompanying this piece depicts a mock physical examination using the same digital stethoscope technology. In this instance, the technology is used to overcome physical barriers to patient assessment related to maintaining a safe distance and wearing necessary personal protective equipment. Within this new context, the identical stethoscope is presented as a medical device aimed at addressing public health needs while protecting providers from contagious respiratory illness.