Using ideas gleaned from the philosophy of technology of Martin Heidegger and Hans Jonas and the philosophy of health of Georges Canguilhem, I argue that one of the characteristics of emerging medical technologies is that these technologies lead to new conceptions of health. When technologies enable the body to respond to more and more challenges of disease, we thus establish new norms of health. Given the continued development of successful technologies, we come to expect more and more that (...) our bodies should be able to respond to ever-new challenges of environment and disease by establishing ever-new norms of health. Technologies may aim at the prevention and treatment of disease, but they also bring about modifications of what we consider normal for the human being. Thus, new norms of health arise from technological innovation. (shrink)

In this article we explore how diagnostic and therapeutic technologies shape the lived experiences of illness for patients. By analysing a wide range of examples, we identify six ways that technology can (trans)form the experience of illness (and health). First, technology may create awareness of disease by revealing asymptomatic signs or markers (imaging techniques, blood tests). Second, the technology can reveal risk factors for developing diseases (e.g., high blood pressure or genetic tests that reveal risks of falling (...) ill in the future). Third, the technology can affect and change an already present illness experience (e.g., the way blood sugar measurement affects the perceived symptoms of diabetes). Fourth, therapeutic technologies may redefine our experiences of a certain condition as diseased rather than unfortunate (e.g. assisted reproductive technologies or symptom based diagnoses in psychiatry). Fifth, technology influences illness experiences through altering social-cultural norms and values regarding various diagnoses. Sixth, technology influences and changes our experiences of being healthy in contrast and relation to being diseased and ill. This typology of how technology forms illness and related conditions calls for reflection regarding the phenomenology of technology and health. How are medical technologies and their outcomes perceived and understood by patients? The phenomenological way of approaching illness as a lived, bodily being-in-the-world is an important approach for better understanding and evaluating the effects that medical technologies may have on our health, not only in defining, diagnosing, or treating diseases, but also in making us feel more vulnerable and less healthy in different regards. (shrink)

Corporeality, Medical Technologies and Contemporary Culture engages the confusions and contradictions in current attitudes to, and practices of, the body. On the one hand, the body is where we turn for the certainties of nature; yet, on the other, it is the locus of a desire for permanent transformation and for constant reinvention. The body is at the same time worshipped and despised: so that now it has come to constitute not just an object of desire, but an object (...) of design. Addressing practices of corporeal ascesis- such as bodybuilding and dietetics - medical technologies - such as plastic surgery, prosthetics, and pharmacological interventions - and radical anatomical modifications- such as voluntary amputations, Francisco Ortega analyses how the body has become a screen for the projection of our ideas and imaginings about ourselves; and has also been turned into an object of suspicion, fear, anxiety, insecurity and discomfort. From the disembodied ideal of the digital purity of models - in which every little piece of fat is digitally eliminated - through the disembodiment implicit in social constructivist rejections of materiality, to the various projects of virtual reality, artificial intelligence, and posthumanism, Corporeality, Medical Technologies and Contemporary Culture documents the ambiguous legacy of a western theoretical tradition that has always despised the body. (shrink)

Against the backdrop of emerging medical technologies that promise transgression of temporal limits, this paper aims to show the importance that an individual lifetime’s finitude and fugacity have for the question of the good life. The paper’s first section examines how the passing of an individual’s finite lifetime can be experienced negatively, and thus cause “suffering from the passing of time.” The second section is based on a sociological analysis within the conceptual framework of individualization and capitalism, which characterizes (...) many modern individualized and consumerist societies and explains how the described problem of time’s passage is particularly relevant today. The paper then proceeds to show and discuss how individuals employ various, primarily medical, enhancement-technologies like social egg freezing, anti-aging-medicine and physical- and neuro-enhancement in an attempt to overcome time’s passing. Finally, the paper seeks to explain why such attempts fail and, moreover, why it is exactly the awareness of time’s passing that can constitute a prerequisite for a good life. (shrink)

Although the use of new health technologies in healthcare and medicine is generally seen as beneficial, there has been little analysis of the impact of such technologies on people's lives and understandings of health and illness. This book explores how new technologies not only provide hope for cure and well-being, but also introduce new ethical dilemmas and raise questions about the "natural" body. Focusing on the ways new health technologies intervene into our lives and affect our ideas about normalcy, the (...) body and identity, New Health Technologies explores: how new health technologies are understood by lay people and patients how the outcomes of these technologies are communicated in various clinical settings how these technologies can alter our notions of health and illness and create "new illness." Written by authors with differing backgrounds in phenomenology, social psychology, social anthropology, communication studies and the nursing sciences, this book is essential reading for students andacademics of medical sociology, health and allied studies, and anyone with an interest in new health technologies. (shrink)

In this article, transhumanism is considered to be a quasi-medical ideology that seeks to promote a variety of therapeutic and human-enhancing aims. Moderate conceptions are distinguished from strong conceptions of transhumanism and the strong conceptions were found to be more problematic than the moderate ones. A particular critique of Boström’s defence of transhumanism is presented. Various forms of slippery slope arguments that may be used for and against transhumanism are discussed and one particular criticism, moral arbitrariness, that undermines both (...) weak and strong transhumanism is highlighted. (shrink)

Summary This volume undertakes to determine the fundamentals and limits of an ethical assessment of the methods of modern medical technology with regard to the concepts of human dignity and human image, which are particularly important for this purpose. It shows that the philosophical-legal foundation of the term human dignity has not yet been clearly clarified; one even has to ask whether the term is (still) suitable for assessing ethical problems in medical technology. The term human (...) image also needs clarification and clarification in order to be taken seriously as a topos in the medical ethical discussion. The volume emerged from the work of an interdisciplinary and international research group at the Center for Interdisciplinary Research (ZiF), Bielefeld. It deals primarily with the theoretical foundation of the terms human dignity and human image and is supplemented by a volume, the contributions of which illustrate the problems of practice using examples from different areas of medical technology. (shrink)

First I discuss the rights as unavoidable part of the human dignity. There are four possible relations: dignity has a wider extension, the volume of both is equivalent, dignity includes in itself a bundle of rights, or it is just a simple right. There are good reasons to support the last two, even the last position. Then I evaluate some of the challenging innovations in the medical technology, if they are acceptable in front of this close connection. The (...) focus falls on three topics: PGD, cloning, and fusion of human-animal cells. Using moral principles such as non discrimination and non instrumentalization I look for some normative framing. (shrink)

The current model of technology assessment treats ethics itself as just another problem‐solving technology. Ethics should resist this model to play a more critical role in technology assessment by better understanding the complex relationship between society, medicine, and technology—and by recasting how problems are defined.

The current model of technology assessment treats ethics itself as just another problem‐solving technology. Ethics should resist this model to play a more critical role in technology assessment by better understanding the complex relationship between society, medicine, and technology—and by recasting how problems are defined.

Biomedical practice can encode and perpetuate oppressive ideologies. This encoding and perpetuation, scholars like Liao and Carbonell (2023) convincingly argue, can occur not only via social practi...

This article explores the relationship between medicine’s history and its digital present through the lens of the physician-patient relationship. Today the rhetoric surrounding the introduction of new technologies into medicine tends to emphasize that technologies are disturbing relationships, and that the doctor-patient bond reflects a more ‘human’ era of medicine that should be preserved. Using historical studies of pre-modern and modern Western European medicine, this article shows that patient-physician relationships have always been shaped by material cultures. We discuss three activities (...) – recording, examining, and treating – in the light of their historical antecedents, and suggest that the notion of ‘human medicine’ is ever-changing: it consists of social attributions of skills to physicians that played out very differently over the course of history. (shrink)

Technological innovations are commonplace today and usually provide great social benefits. The case of medical technology is of prime interest, for though it seems to provide primarily advantages, it may unwittingly turn over to technocrats the governance of modem society. This essay warns against the pitfalls of the age of technocracy, and calls for the maintenance of democratic controls over the development and implementation of modem technology.

This book brings phenomenology, the main player in the continental tradition of philosophy, to bioethics. Medical science and emerging technologies are examined as endeavours that bring enormous possibilities in relieving human suffering but also great risks in transforming our fundamental life views.

This paper describes a new course in Medical Technology and Critical Decisions, part of the Technology Studies Program at Wellesley College, established with the support of the Alfred P. Sloan Foundation's New Liberal Arts Program. The course uses the dramatic new options in medicine presented by technology to individuals and society as a vehicle for promoting general technological literacy in liberal arts students. The course motivates the study of the scientific principles on which the technology (...) rests and the mathematical principles of a methodology for making rational choices. A case in point is the decision of a pregnant woman whether or not to undergo amniocentesis, a procedure used to determine the genetic make-up of a fetus from cells in the amniotic fluid. The course introduces students to the underlying notions of genetics; the physical principles behind the ultrasound imaging technique used to position the needle that draws the fluid; the probability and statistics needed to understand the risks to the woman and fetus both of having and of not having the procedure; and the methodology of decision analysis, increasingly used by genetic counselors to help prospective parents incorporate their personal values into the decision-making process. (shrink)

In the film Never Let Me Go, clones are forced to donate their organs anonymously. As a work of fiction, this film can be regarded as a negotiation of limited agency, since the clones are depicted as vulnerable individuals. Thereby, it evokes a confrontation with underprivileged positions in technocratic societies, encouraging the audience to take the perspective of the marginalised. The clones are situated in ‘privileged deprivation’; from the audience’s point of view, they are unable to evolve into autonomous agents—but (...) from their own perspective within the dystopian system, they are still ‘privileged’. In this paper, we analyse the depiction of the clones’ personal development. Further, we examine references to bioethical aspects as well as technologies that affect the human body both on a micro and macro level—cloning and its impact on the human embryo and organ donation practised on the full-grown human body. We argue that this film as a reference for the discussion in popular culture focuses on individuals who do not profit from modern technical progress or do not have enough agency to refuse it. To make this point, we analyse the film’s fictional story, set in a form of alternate history, as a negotiation of a historical context which brings out the idea of neglected voices. (shrink)

Modern health care relies extensively on the use of technologies for assessing and treating patients, so it is important to be certain that health care technologies perform their professed functions in an effective and safe manner. Philosophers of technology have developed methods to assign and evaluate the functions of technological products, the major elements of which are described in the ICE theory. This paper questions whether the standard of evidence advocated by the ICE theory is adequate for ascribing and (...) assessing technologies employed in health care. The paper proposes that the general problem with the standard of evidence embodied in the ICE theory is too permissive for assessing medical technologies, in that it does not take into account the relative benefit and harm of medical technologies in ensuring safe functional performance in patients. The paper illustrates how evidence-based medicine has demonstrated the value of clinical research methods, including observational studies, randomized and non-randomized clinical trials, and formal techniques, such as meta-analysis, to measure therapeutic effectiveness. I argue, therefore, that evidence from clinical research studies should take precedence over the testimonial evidence and other types of non-clinical evidence, in providing justification for health technologies. (shrink)

Modern health care relies extensively on the use of technologies forassessing and treating patients, so it is important to be certain that health care technologies (i.e., pharmaceuticals, devices, procedures, and organizational systems) perform their professed functions in an effective and safe manner. Philosophers of technology have developed methods to assign and evaluate the functions of technological products, the major elements of which are described in the ICE theory. This paper questions whether the standard of evidence advocated by the ICE (...) theory is adequate for ascribing and assessing technologies employed in health care. The paper proposes that the general problem with the standard of evidence embodied in the ICE theory (i.e.,testimony and evidence of mechanisms) is too permissive for assessing medical technologies, in that it does not take into account the relative benefit and harm of medical technologies in ensuring safe functional performance in patients. The paper illustrates how evidence-based medicine (EBM) has demonstrated the value of clinical research methods, including observational studies, randomized and non-randomized clinical trials, and formal techniques, such as meta-analysis, to measure therapeutic effectiveness. I argue, therefore, that evidence from clinical research studies should take precedence over the testimonial evidence and other types of non-clinical evidence, inproviding justification for health technologies. (shrink)

Embodied cognition is an interpretative—or hermeneutical—cognition inherent in motor-sensory perception intrinsically informed by biological and sociocultural memory, a cognition embedded in the organism as well as the socio-cultural environment interacting with it (Ward et al. TOPOI 36:365–375, 2017), of which technologies are a part. Yet, smart machines are advancing on human abilities to perceive and interpret concerning the accuracy, quantity, and quality of the data processed. Machines process and categorize images, perform classification tasks, they calculate and perform pattern analysis, all (...) machine learning processes are task-specific. Machine learning processes resemble human interpretative processes; however, these are two very different ways of “dealing with something,” although both can be said to be hermeneutical, one enactive, the other material; the first is a meaning-generating interpretative process, the second a statistics-based information output. The information extracted from all the data fed into the computer is the end-product of machine learning, whereas human interpretative enactments are continuous and necessary for any application of the information output. (shrink)

This paper examines the development of medical technology in terms of Max Weber's theory of rationalization. It argues that medical technology is a part of the general process of social, political and economic changes in modern Western societies. Medical technology today keeps many people alive who, in the past, would have died from their illness. In recent years, burgeoning technological achievements in medicine have been regarded as a threat to the individual's freedom to die. (...) Many people believe that the prolongation of life only adds to the suffering of the patient and to the emotional distress of the family. They argue that a quiet death is preferable to the indignities inflicted by mechanical life support. This paper addresses these issues in light of Weber's theoretical arguments. (shrink)

When people get ill, they naturally want to restore health through medical interventions. Here I model a situation in which individuals can psychologically entertain multiple potential treatments at once: when illness occurs, individuals would attempt one treatment first, and if it fails to produce an observable effect within a particular time period, a second treatment is attempted, and the eventual recovery is attributed to the treatment that is temporally closer. This creates population dynamics wherein the therapeutic power of the (...) superior/effective medical treatments is misattributed to inferior/ineffective treatments. Through both analytic formulation and agent-based simulation, I show that the equilibrium frequencies of different treatment variants depend on their natural variability in the effect timing, the level of individual patience, and the number of cultural models sampled by the naive individual. Both ineffective and effective medical treatments may stably coexist in the population under a range of parameter settings. (shrink)

The diffusion of technology in the US has taken place in an environment of both regulation and free enterprise. Each has been subject to manipulation by doctors and medical administrators that has fostered unprecedented ethical dilemmas and legal challenges. Understanding these developments and historical precedents may allow a more rational diffusion policy for medical technology in the future.

Examines some of the ethical questions raised by the capabilities of modern medicine.

Development-oriented funding schemes such as the UK Global Challenges Research Fund (GCRF) have opened up opportunities for collaborations between low-middle income countries (LMICs) and high-income country (HIC) researchers. In particular, funding for medical technology research has seen a rise in previously under-represented disciplines such as physics and engineering. These collaborations have considerable potential to advance healthcare in LMICs, yet can pose challenges experienced to researchers undertaking these collaborations. Key challenges include a lack of tradition of HIC/LMIC collaborations within (...) participating departments, lack of experience with development agendas, designing contextually-appropriate technologies and ensuring long-term viability of research outputs. This paper reflects on these key challenges, using the experiences of the authors on the Open Laboratory Instrumentation (OLI) project as a focalizing lens. This project was a GCRF-funded collaboration between physicists in the UK and engineers in Tanzania to develop an open-source, 3D-printed, fully-automated laboratory microscope. The paper highlights key ethics lessons learnt. (shrink)

Development-oriented funding schemes such as the UK Global Challenges Research Fund (GCRF) have opened up opportunities for collaborations between low-middle income countries (LMICs) and high-income country (HIC) researchers. In particular, funding for medical technology research has seen a rise in previously under-represented disciplines such as physics and engineering. These collaborations have considerable potential to advance healthcare in LMICs, yet can pose challenges experienced to researchers undertaking these collaborations. Key challenges include a lack of tradition of HIC/LMIC collaborations within (...) participating departments, lack of experience with development agendas, designing contextually-appropriate technologies and ensuring long-term viability of research outputs. This paper reflects on these key challenges, using the experiences of the authors on the Open Laboratory Instrumentation (OLI) project as a focalizing lens. This project was a GCRF-funded collaboration between physicists in the UK and engineers in Tanzania to develop an open-source, 3D-printed, fully-automated laboratory microscope. The paper highlights key ethics lessons learnt. (shrink)

Development-oriented funding schemes such as the UK Global Challenges Research Fund (GCRF) have opened up opportunities for collaborations between low-middle income countries (LMICs) and high-income country (HIC) researchers. In particular, funding for medical technology research has seen a rise in previously under-represented disciplines such as physics and engineering. These collaborations have considerable potential to advance healthcare in LMICs, yet can pose challenges experienced to researchers undertaking these collaborations. Key challenges include a lack of tradition of HIC/LMIC collaborations within (...) participating departments, lack of experience with development agendas, designing contextually-appropriate technologies and ensuring long-term viability of research outputs. This paper reflects on these key challenges, using the experiences of the authors on the Open Laboratory Instrumentation (OLI) project as a focalizing lens. This project was a GCRF-funded collaboration between physicists in the UK and engineers in Tanzania to develop an open-source, 3D-printed, fully-automated laboratory microscope. The paper highlights key ethics lessons learnt. (shrink)

Medical technology assessment deals with the evaluation of novel or existing health care procedures. This paper addresses the interdependence between factual and normative issues, using the controversies about acceptability and desirability of reduced-size liver transplantations with living donors as example.

The field of medicine is generally greeted with great enthusiasm. This can be witnessed in the immense support for medical progress, which is widely hoped to lead to a realization of idealized goals. Indeed, with the help of medicine the human body would be controllable and constructible, human nature perfectible. However, enthusiasm in favor of medical progress is first and foremost a sentiment and, like all sentiments, not necessarily a product of rational contemplation. People are capable of enthusing (...) about the realization of utopian notions, such as life without disease or with the perfect body, without requiring any concrete arguments to back them up. Enthusiasm alone is not a guarantee of ethical desirability, however. Hence, this book takes a closer look at four research fields often referred to in medical utopian literature: 'tissue engineering', 'bioelectronics', 'germ line genome modification' and 'interventions in the biological aging process'. They serve as a basis for analyzing whether ethical arguments can be found to support the euphoric advocacy of the further development of these fields. (shrink)

This paper examines medicine’s use of technology in a manner from a standpoint inspired by Heidegger’s thinking on technology. In the first part of the paper, I shall suggest an interpretation of Heidegger’s thinking on the topic, and attempt to show why he associates modern technology with danger. However, I shall also claim that there is little evidence that medicine’s appropriation of modern technology is dangerous in Heidegger’s sense, although there is no prima facie reason why (...) it mightn’t be. The explanation for this, I claim, is ethical. There is an initial attraction to the thought that Heidegger’s thought echoes Kantian moral thinking, but I shall dismiss this. Instead, I shall suggest that the considerations that make modern technology dangerous for Heidegger are simply not in the character — the ethos — of medicine properly understood. This is because there is a distinction to be drawn between chronological and historical modernity, and that even up-to-date medicine, empowered by technology, retains in its ethos crucial aspects of a historically pre-modern understanding of technology. A large part of the latter half of the paper will be concerned with explaining the difference. (shrink)

Digital twinning in medicine refers to the idea of simulating a person’s organs, muscles or perhaps their entire body, in order to arrive more effectively at accurate diagnoses, to make treatment recommendations that reflect chances of success and possible side-effects, and to better understand the long-term trajectory of an individual’s overall condition. Digital twins, in these ways, build on the recent movement toward personalised medicine,1 and they undoubtedly present us with exciting opportunities to advance our health. Of course, the opportunities (...) are accompanied by newfound challenges—a common refrain in discussions surrounding emerging technologies. In a recent article, Matthias Braun surveys numerous problems, including the precision of simulations, ownership and consent to the use of digital models, and issues of justice in assuring equitable access to novel medical systems.2 In particular, he places special emphasis on the notion of representation. According to Braun, proper representation naturally calls for correspondence—namely a precise model offering dynamic, real-time feedback as well as transparency, both for the patient and the practitioner, in terms of the data being employed. While technical challenges remain, these goals are quite clear and relatively uncontroversial. Where a host of questions arise, however, is in the discussion on the interaction between the represented persons and their simulations. Alongside questions regarding ownership of one’s digital twin, Braun raises the concern that ‘giving …. (shrink)

FEX A, FLENSNER G, EK A‐C and SÖDERHAMN O. Nursing Inquiry 2011; 18: 336–347 Living with an adult family member using advanced medical technology at homeAn increased number of chronically ill adults perform self‐care while using different sorts of advanced medical technology at home. This hermeneutical study aimed to gain a deeper understanding of the meaning of living with an adult family member using advanced medical technology at home. Eleven next of kin to adults (...) performing self‐care at home, either using long‐term oxygen from a cylinder or ventilator, or performing peritoneal or haemodialysis, were interviewed. The qualitative interviews were analysed using a Gadamerian methodology. The main interpretation explained the meaning as rhythmical patterns of connectedness versus separation, and of sorrow versus reconciliation. Dependence on others was shown in the need for support from healthcare professionals and significant others. In conclusion, next of kin took considerable responsibility for dependent‐care. All next of kin were positive to the idea of bringing the technology home, even though their own needs receded into the background, while focusing on the best for the patient. The results were discussed in relation to dependent‐care and transition, which may have an influence on the self‐care of next of kin and patients. The study revealed a need for further nursing attention to next of kin in this context. (shrink)