Technology and the management of trust in insurance medicine

Theoretical Medicine and Bioethics 21 (1):39-61 (2000)
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Abstract

This article deals with the question how technologycontributed to the performing of objective assessmentsof health risks and to the public trust in theinsurance institution. Many authors have pointed tothe relevance of medical or statistical technologywith regard to the constitution of objectivity,because these technologies should be capable ofdiminishing the influence of social interactions – the``human element'' – on the process of producingknowledge about health risks. However, in this articleit is shown that the constitution of objective riskassessments and public trust cannot be seen as theproduct of one particular type of technology, but thatit is the product of a socio-technical network, inwhich several heterogeneous elements becomeinterrelated and interdependant. The historicalreconstruction of this network also sheds a new lighton the role of `the human element' in the constitutionof objectivity and trust. It shows that elements inthe network which regulate the social interactionbetween the subjects involved are of no lessimportance to generate trust than technologies whichtend to abstract from this interaction. In otherwords, objective and subjective elements areintertwined much more than is often recognized, andpublic trust is to a fairly large degree depends onconventions in social interaction.

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