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April 16, 2008

Gizmo Idolatry

JAMA. 2008;299(15):1830-1832. doi:10.1001/jama.299.15.1830

It seems that “gizmo idolatry” now exists in the practice of medicine. “Gizmo” is defined by the American Heritage Dictionary as “a mechanical device or part whose name is forgotten or unknown; a gadget.” In this article, gizmo is used to refer to a mechanical device or procedure for which the clinical benefit in a specific clinical context is not clearly established, and gizmo idolatry refers to the general implicit conviction that a more technological approach is intrinsically better than one that is less technological unless, or perhaps even if, there is strong evidence to the contrary. The credulous acceptance and rapid diffusion of frontal lobotomies in the 1930s and 1940s led to great harm, and to a Nobel Prize for Egas Moniz in 1949 “for his discovery of the therapeutic value of leucotomy in certain psychoses.”1 Autologous bone marrow transplantation for breast cancer2 is a more recent example of gizmo idolatry. The widespread belief in and unintended consequences of technology have been described from several perspectives,3 including medical.4 In this Commentary, we examine factors that promote, and harms that could result from, gizmo idolatry in a market-driven society that is aging.