This paper proposes an ethical reflection on personalized medicine and more precisely on the diagnostic technology underlying it, including nanochips. Our approach is inspired by a combination of two philosophical frames of reference: first, John Dewey’s distinction between intuitive valuation and reflexive evaluation, second, John Rawls’ reflective equilibrium. We aim at what we call a ‘reflexive equilibrium’, a mutual adjustment between on the one hand, the intuitive beliefs scientists have about the ethics of the technologies they work on (...) (‘valuations’ in Dewey’s vocabulary) and, on the other hand, the reflexive ethical assessment of these technologies (‘evaluations’). Our goal, in this paper, is to provide the first step of this process through a philosophical analysis of some valuations on individualized medicine. In order to apprehend the ethical values shaping the development of biochips, we present and analyze qualitative interviews with scientists involved in the conception and the development of biochips involving nanotechnologies. We then propose a critical assessment of the role of ethics in these scientific practices. Last, we suggest two distinct and complementary ways to solve some of the issues brought to light by the interviews, without aiming at any dogmatic or “ready-made” answer. The first of these perspectives gives a central role to the capability individuals could achieve through personalized medicine; the second approach analyses the ethical disruptions entailed by personalized medicine with a special focus on care. (shrink)

Diagnostic frameworks are essential to many scientific and technological activities and clinical practice. This study examines the main fundamental aspects of such frameworks. The three components required for all diagnoses are identified and examined, i.e. their normative dimension, temporal nature and structure, and teleological perspective.The normative dimension of a diagnosis is based on (1) epistemic values when associated with Hempel's inductive risk concerning the balance between false‐positive and false‐negative outcomes, leading to probabilistic judgements; and (2) non‐epistemic values when related (...) to ideas such as well‐being, normality, illness, etc, as idealized norms or ideal points of reference.It should be noted that medical diagnoses match the three necessary components, while some essential diagnostic frameworks – the taxonomies ofGordon andNANDA– in nursing lack some components. The main lack is normative as the most popular frameworks in nursing diagnosis seem to be descriptions of observed reality rather than normative and value‐based judgements in which both epistemic and non‐epistemic values may coexist. (shrink)

The interdisciplinary research area Cognitive Interaction Technology (CIT) aims to understand and support interactions between human users and other elements of socio-technical systems. Important reasons for the new interest in understanding CIT in sport psychology are the impressive development of cognitive robotics and advanced technologies such as virtual or augmented reality systems, cognitive glasses or neurotechnology settings. The present article outlines this area of research, addresses ethical issues, and presents an empirical study in the context of a new measurement (...) and assessment system for training in karate. Recent advances in the field of cognitive assistance systems enabled largely automatized assessments of individual mental representation structures for action sequences, such as choreographed movement patterns in dance or martial arts. Empirical investigations with karate practitioners of different skill levels demonstrate that advanced software-based survey and algorithmic analysis procedures based on cognitive models generate individualized performance predictions for a movement sequence from theKanku-dai kata(a pre-defined karate movement sequence), which correlated significantly not only with formal expertise (kyu/danrank) but also with the actual likelihood of mistakes in action execution. This information could prospectively be used to define individual training goals for deliberate practice and incorporated into cognitive interaction technology to provide appropriate feedback. We argue that the development of cognitive interaction systems for sport should explicitly take ethical issues into consideration and present a particular developed engineering approach. The potential benefits of such an assistance system for intermediate and advanced practitioners include more effective and flexible practice, as well as supportive effects, and more flexible training schedules. Furthermore, we argue that researchers from the field of sport psychology can benefit from advances in technological systems that enhance the understanding of mental and motor control in skilled voluntary action. (shrink)

Diagnostic self-testing devices are being developed for many illnesses, chronic diseases and infections. These will be used in hospitals, at point-of-care facilities and at home. Designed to allow earlier detection of diseases, self-testing diagnostic devices may improve disease prevention, slow the progression of disease and facilitate better treatment outcomes. These devices have the potential to benefit both the individual and society by enabling individuals to take a more proactive role in the maintenance of their health and by helping (...) society improve health and reduce health costs. However, the full implications of future home-based diagnostic technology for individuals and society remain unclear due to their novelty. We argue that the development of diagnostic tools, especially for home use, will heighten a number of ethical challenges. This paper will explore some of the ethical implications of home-based self-testing diagnostic devices for the autonomous and relational dimensions of the person. This will be facilitated by examining the impact of diagnostic devices for individual autonomy, for the delivery of accurate diagnosis and for the personal significance of the information for the user. The latter will be examined using Charles Taylor's view of personhood and his emphasis on human agency and interpretation. While the ethical issues are not necessarily new, the development of home-based self-testing diagnostic devices will make issues regarding autonomy, accuracy of information and personal significance more and more demanding. This will be the case particularly when an individual's autonomous choices come into conflict with the person's relational responsibilities. (shrink)

Prenatal diagnostic technologies have been used for the purpose of detecting sex—leading to abortion of female fetuses—and have posed new challenges to the already difficult question of social justice for women in India. This article reports findings from a case study conducted with 25 women who had used prenatal diagnostic technologies for sex determination.Against the common belief that Indian society is “improving” because of 21st-century medical technology, this case study shows that the social context has given a (...) patriarchal value to such advanced technology in India. Furthermore, it sheds light on why prenatal diagnostic technologies have taken a different route in India.It shows that reasons for accepting the use of prenatal diagnostic technologies for sex determination by women are diverse and complex. (shrink)

ABSTRACTDiagnostic self‐testing devices are being developed for many illnesses, chronic diseases and infections. These will be used in hospitals, at point‐of‐care facilities and at home. Designed to allow earlier detection of diseases, self‐testing diagnostic devices may improve disease prevention, slow the progression of disease and facilitate better treatment outcomes. These devices have the potential to benefit both the individual and society by enabling individuals to take a more proactive role in the maintenance of their health and by helping society (...) improve health and reduce health costs. However, the full implications of future home‐based diagnostic technology for individuals and society remain unclear due to their novelty.We argue that the development of diagnostic tools, especially for home use, will heighten a number of ethical challenges. This paper will explore some of the ethical implications of home‐based self‐testing diagnostic devices for the autonomous and relational dimensions of the person. This will be facilitated by examining the impact of diagnostic devices for individual autonomy, for the delivery of accurate diagnosis and for the personal significance of the information for the user. The latter will be examined using Charles Taylor's view of personhood and his emphasis on human agency and interpretation.While the ethical issues are not necessarily new, the development of home‐based self‐testing diagnostic devices will make issues regarding autonomy, accuracy of information and personal significance more and more demanding. This will be the case particularly when an individual's autonomous choices come into conflict with the person's relational responsibilities. (shrink)

Diagnostic devices do more than just passively register facts. They intervene in the situations in which they are put to use. The question addressed here is what this general remark may imply in specific cases. To answer this question a specific case is being analysed: that of the blood sugar measurement device that people with diabetes may use to monitor their own blood sugar levels. This device not only allows the patients concerned to better approach normal blood sugar levels, (...) but alters what counts as normal in the first place. Using the device may shift people's attention away from their physical sensations towards the numbers measured, but it may also help them to increase their own physical self-awareness. Self-monitoring finally (something that the devices have made possible) makes patients less dependent on professionals, but it requires them to engage in self-disciplining and binds them to the outcomes of their measurement activities: their own blood sugar levels. (shrink)

The World Health Organisation (WHO) is leading a global effort to deliver improved diagnostic testing to people living in low‐resource settings. A reliance on the healthcare technologies marketplace and industry, shapes many aspects of the WHO project, and in this situation normative guidance comes by way of the ASSURED criteria — Affordable, Sensitive, Specific, User‐friendly, Rapid and robust, Equipment‐free, and Delivered. While generally improving access to diagnostics, I argue that the ASSURED approach to distributive justice — efficiency — and (...) assessment of worth — productivity — may constrain efforts to deliver timely and accurate diagnosis in the developing world equitably by holding back new and innovative diagnostics and indirectly encouraging program and device design that may unfairly discriminate against certain groups. Even as we try to overcome the problem of global healthcare injustice, we may be entrenching disadvantage. I present my critique of ASSURED by 1) referencing Boltanski and Thévenot's theory of orders of worth to highlight the industrial and market foundations of the ASSURED guidelines; 2) comparing ASSURED with other normative guides that elevate the importance of civic responsibility in evaluations of distributive justice; 3) presenting a case study of the failed promise of microfluidic diagnostic devices. I conclude that a new approach to normative guidance is required to assess the value of developing world diagnostics, preferably, one that does not force global public goods into the marketplace. (shrink)

Digital technology has facilitated additional means for human communication, allowing social connections across communities, cultures, and continents. However, little is known about the effect these communication technologies have on the ability to accurately recognize and utilize nonverbal behavior cues. We present two competing theories, which suggest (1) the potential for technology use toenhancenonverbal decoding skill or, (2) the potential for technology use tohindernonverbal decoding skill. We present preliminary results from two studies to test these hypotheses. Study 1 (...) (N= 410) found that global screen time was unrelated to nonverbal decoding skill. However, how participants spent their time using technology mattered. Participants who reported more active technology use (i.e., posting content) self-reported that their nonverbal decoding skill (as measured by the Emotional Sensitivity subscale of the Social Skills Inventory) was superior but performed worse on objective measures of decoding skill (using standardized tests including the Diagnostic Analysis of Nonverbal Accuracy-Adult Faces and the Workplace Interpersonal Perception Skill). By contrast, passive users performed significantly better on objective measures of nonverbal decoding skill; although they did not self-report any difference in their skill compared to less passive users. Study 2 (N= 190), and a mini-meta analysis of both studies, replicated this pattern. These effects suggest a roadmap for understanding the theoretical relationship between technology use and nonverbal communication skills. We also provide recommendations for future research, including the use of experimental designs to determine causal pathways and to advance our conceptual understanding of the relationship between technology use and nonverbal decoding skill. (shrink)

Kairos has been a key concept in medicine for millennia and is frequently understood as “the right time” in relation to treatment. In this study we scrutinize kairos in the context of diagnostics. This has become highly topical as technological developments have caused diagnostics to be performed ever earlier in the disease development. Detecting risk factors, precursors, and predictors of disease (in biomarkers, pre-disease, and pre-pre-disease) has resulted in too early diagnoses, i.e., overdiagnoses. Nonetheless, despite vast advances in science and (...) technology, diagnoses also come too late. Accordingly, timing diagnostics right is crucial. In this article we start with giving a brief overview of the etymology and general use of the concepts of kairos and diagnosis. Then we delimit kairos in diagnostics by analysing “too early” and “too late” diagnosis and by scrutinizing various phases of diagnostics. This leads us to define kairos of diagnostics as the time when there is potential for sufficient information for making a diagnosis that is most helpful for the person. It allows us to conclude that kairos is as important in diagnostics as in therapeutics. (shrink)

The purpose of the study is to determine the personal results of students with disabilities and to identify the necessary conditions for effective work with this category of children in distance learning. The analysis of the results revealed the need for the use of subject-oriented technology in the educational process, which contributes to the formation of the subjective position of students, allowing for the individualization of the educational process, maximally compensating for developmental deficits caused by diseases. As a result, (...) the necessity of organizing purposeful career guidance work with disabled children and educational work with parents was revealed. (shrink)

Contemporary medical diagnostics has a dynamic moral landscape, which includes a variety of agents, factors, and components. A significant part of this landscape is composed of information technologies that play a vital role in doctors’ decision-making. This paper focuses on the so-called Intelligent Decision-Support System that is widely implemented in the domain of contemporary medical diagnosis. The purpose of this article is twofold. First, I will show that the IDSS may be considered a moral agent in the practice of medicine (...) today. To develop this idea I will introduce the approach to artificial agency provided by Luciano Floridi. Simultaneously, I will situate this approach in the context of contemporary discussions regarding the nature of artificial agency. It is argued here that the IDSS possesses a specific sort of agency, includes several agent features (e.g. autonomy, interactivity, adaptability), and hence, performs an autonomous behavior, which may have a substantial moral impact on the patient’s well-being. It follows that, through the technology of artificial neural networks combined with ‘deep learning’ mechanisms, the IDSS tool achieves a specific sort of independence (autonomy) and may possess a certain type of moral agency. Second, I will provide a conceptual framework for the ethical evaluation of the moral impact that the IDSS may have on the doctor’s decision-making and, consequently, on the patient’s wellbeing. This framework is the Object-Oriented Model of Moral Action developed by Luciano Floridi. Although this model appears in many contemporary discussions in the field of information and computer ethics, it has not yet been applied to the medical domain. This paper addresses this gap and seeks to reveal the hidden potentialities of the OOP model for the field of medical diagnosis. (shrink)

The global response to managing the spread of HIV has recently undergone a significant shift with the advent of ‘treatment as prevention’, a strategy which presumes that scaling-up testing and treatment for people living with HIV will produce a broader preventative benefit. Treatment as prevention includes an array of diagnostic, technological and policy developments that are creating new understandings of how HIV circulates in bodies and spaces. Drawing on the work of Michel Foucault, we contextualize these developments by linking (...) them to systems of governance and discursive subjectivation. The goal of this article is to problematize the growing importance of viral suppression in the management of HIV and the use of related surveillance technologies. For people living with HIV, we demonstrate how treatment-as-prevention’s emphasis on individual and collective viral load is transforming the performative dimensions of embodied risk, affect, subjectivity and sex. (shrink)

Digital technologies induce organised immaturity by generating toxic sociotechnical conditions that lead us to delegate autonomous, individual, and responsible thoughts and actions to external technological systems. Aiming to move beyond a diagnostic critical reading of the toxicity of digitalisation, we bring Bernard Stiegler’s pharmacological analysis of technology into dialogue with the ethics of care to speculatively explore how the socially engaged arts—a type of artistic practice emphasising audience co-production and processual collective responses to social challenges—play a care-giving role (...) that helps counter technology-induced organised immaturity. We outline and illustrate two modes by which the socially engaged arts play this role: 1) disorganising immaturity through artivism, most notably anti-surveillance art, that imparts savoir vivre, that is, shared knowledge and meaning to counter the toxic side of technologies while enabling the imagination of alternative worlds in which humans coexist harmoniously with digital technologies, and 2) organising maturity through arts-based hacking that imparts savoir faire, that is, hands-on knowledge for experimental creation and practical enactment of better technological worlds. (shrink)

While the implementation of digital technology in psychiatry appears promising, there is an urgent need to address the implications of the absence of ethical design in the early development of such technologies. Some authors have noted the gap between technology development and ethical analysis and have called for an upstream examination of the ethical issues raised by digital technologies. In this paper, we address this suggestion, particularly in relation to digital healthcare technologies for patients with schizophrenia spectrum disorders. (...) The introduction of digital technologies in psychiatry offers a broad spectrum of diagnostic and treatment options tailored to the health needs and goals of patients’ care. These technologies include wearable devices, smartphone applications for high-immersive virtual realities, smart homes, telepsychiatry and messaging systems for patients in rural areas. The availability of these technologies could increase access to mental health services and improve the diagnostics of mental disorders.Additional Instruction AbstractIn this descriptive review, we systematize ethical concerns about digital technologies for mental health with a particular focus on individuals suffering from schizophrenia. There are many unsolved dilemmas and conflicts of interest in the implementation of these technologies, such as (1) the lack of evidence on efficacy and impact on self-perception; (2) the lack of clear standards for the safety of their daily implementation; (3) unclear roles of technology and a shift in the responsibilities of all parties; (4) no guarantee of data confidentiality; and (5) the lack of a user-centered design that meets the particular needs of patients with schizophrenia. mHealth can improve care in psychiatry and make mental healthcare services more efficient and personalized while destigmatizing mental health disorders. To ensure that these technologies will benefit people with mental health disorders, we need to heighten sensitivity to ethical issues among mental healthcare specialists, health policy makers, software developers, patients themselves and their proxies. Additionally, we need to develop frameworks for furthering sustainable development in the digital technologies industry and for the responsible usage of such technologies for patients with schizophrenia in the clinical setting. We suggest that digital technology in psychiatry, particularly for schizophrenia and other serious mental health disorders, should be integrated into treatment with professional supervision rather than as a self-treatment tool. (shrink)

According to a chorus of authors, the human life-world is currently invaded by an avalanche of high-tech devices referred to as “emerging,” ”intimate,” or ”NBIC” technologies: a new type of contrivances or gadgets designed to optimize cognitive or sensory performance and / or to enable mood management. Rather than manipulating objects in the outside world, they are designed to influence human bodies and brains more directly, and on a molecular scale. In this paper, these devices will be framed as ‘extimate’ (...) technologies (both intimate and external; both embedded and foreign; both life-enhancing and intrusive), a concept borrowed from Jacques Lacan. Although Lacan is not commonly regarded as a philosopher of technology, the dialectical relationship between human desire and technological artefacts runs as an important thread through his work. Moreover, he was remarkably prescient concerning the blending of life science and computer science, which is such a distinctive feature of the current techno-scientific turn. Building on a series of Lacanian concepts, my aim is to develop a psychoanalytical diagnostic of the technological present. Finally, I will indicate how such an analysis may inform our understanding of human life and embodiment as such. (shrink)

Small, mundane technologies, such as stethoscopes, medicinal bottles, labels, cleaning and dispensing equipment, are integral to the practice of western herbal medicine in the UK. A focus on such technologies reveals the dynamic character and porousness of medical systems and allows us to identify cultural interactions. In this photo essay, based on long-term anthropological research, I explore an assemblage of everyday technologies used by WHM practitioners and the ways in which these technologies contribute to shaping diagnostic stories, to performing (...) medical legitimacy and invoking herbal traditions. The biomedical, herbal and domestic technologies-in-use come into view as vibrant and dynamic objects with highly contingent meanings and identities. Their absorption into this non-biomedical therapy supports the performance of medical legitimacy, authority, tradition and professionalism, while the use of everyday domestic objects may signal female-coded practices of care. This demonstrates the adaptability of a medical practice situated at the margin of mainstream healthcare and subject to ongoing technological and ideological influence. The strategic integration of this assemblage of everyday technologies into WHM contributes, I suggest, to evoking a competent, trustworthy and time-honoured medical practice, which is simultaneously inscribed with multiple tensions, ambiguities and contestations. (shrink)

The paper deals with the introduction of nanotechnology in biochips. Based on interviews and theoretical reflections, it explores blind spots left by technology assessment and ethical investigations. These have focused on possible consequences of increased diffusability of a diagnostic device, neglecting both the context of research as well as increased accuracy, despite it being a more essential feature of nanobiochip projects. Also, rather than one of many parallel aspects in innovation processes, ethics is considered here as a ubiquitous (...) system of choices between sometimes antagonistic values. Thus, the paper investigates what is at stake when accuracy is balanced with other practical values in different contexts. Dramatic nanotechnological increase of accuracy in biochips can raise ethical issues, since it is at odds with other values such as diffusability and reliability. But those issues will not be as revolutionary as is often claimed: neither in diagnostics, because accuracy of measurements is not accuracy of diagnostics; nor in research, because a boost in measurement accuracy is not sufficient to overcome significance-chasing malpractices. The conclusion extends to methodological recommendations. (shrink)

According to an editor of The Economist, the world produced, in the years since World War II, seven times more goods than throughout all history. This is well appreciated by lay people, but has hardly affected social scientists. They do not have the conceptual apparatus for understanding accelerated material-technical change and its meaning for people's personal lives, for their ways of relating to them-selves and to the outside world. Of course, a great deal of speculation about emerging life forms in (...) industrialised societies exists and social scientists with a futuristic bend have projected their diverse visions upon public debates, ranging from thc Efficient Hedonism of "post-industrialist' society a la Daniel Bell to the “Responsible Convivialism” of 'post-materialist" critics such as Fritz Schumacher. Competing images of the coming "services society" or "self-service society" share a central concern: the ongoing relation between tile spheres of large organisations and personal lifestyles, between salaried work arid private consumption. They also share a eel-tau' implausibility: few people recognize themselves in either projection. And they sham ubiquitous reference to "technology", without accounting for it in real terms. A good diagnostic of what is actually happening seems to me to be Jonathan Gershuny, who sees a drift toward a particular type of self-service economy: a quite radical shift in the mode of provision of social services, as he calls it, based on new kinds of consumer technologies. Industrialization used to be partial, but is becoming total fast. This process obviously has many facets, the one I am interested in here is the intrusion of modern technology into spheres of life which in the past have been relatively little dependent on it. (shrink)

The paper examines the ethical dimensions of Michel Houellebecq’s works of fiction. On the basis of keen diagnostics of contemporary Western culture, this world-renowned French writer predicts the destructive social consequences of ultra-liberalism and enters into an argument with transhumanist theories. His writings, depicting the misery of contemporary man and imagining a new human species enhanced by technologies, show that neither the so-called neo-humans nor the “last man” of liberal democracies can reach happiness. The latter can only be achieved if (...) humanist values, shared by previous generations and promoted by the great 19th-century authors (Balzac, Flaubert), are reinvented. (shrink)

Autism is a neurodevelopmental disorder typically assessed and diagnosed through observational analysis of behavior. Assessment exclusively based on behavioral observation sessions requires a lot of time for the diagnosis. In recent years, there is a growing need to make assessment processes more motivating and capable to provide objective measures of the disorder. New evidence showed that motor abnormalities may underpin the disorder and provide a computational marker to enhance assessment and diagnostic processes. Thus, a measure of motor patterns could (...) provide a means to assess young children with autism and a new starting point for rehabilitation treatments. In this study, we propose to use a software tool that through a smart tablet device and touch screen sensor technologies could be able to capture detailed information about children’s motor patterns. We compared movement trajectories of autistic children and typically developing children, with the aim to identify autism motor signatures analyzing their coordinates of movements. We used a smart tablet device to record coordinates of dragging movements carried out by 60 children during a cognitive task. Machine learning analysis of children’s motor patterns identified autism with 93% accuracy, demonstrating that autism can be computationally identified. The analysis of the features that most affect the prediction reveals and describes the differences between the groups, confirming that motor abnormalities are a core feature of autism. (shrink)

This article presents a case study of a recent controversy over the use of computed tomography as a diagnostic technology in South Korean hospitals. The controversy occurred in the wake of a series of conflicts in the late twentieth century over the legitimate placement of healing practices, medicinal substances, and medical technologies within Korea’s separate “Western Medicine” and “Korean Medicine” systems of health care and pharmaceutical distribution. The controversy concerned an attempt to use hi-tech imaging technology—the epitome (...) of modern medicine—in a clinic that maintains a strong ideological attachment to Korean healing traditions. A close study of this dispute, based on interviews, participant observation, and documentary analysis, showed that discursive positions taken about the translatability of medical technologies changed with the context of dispute, and did not reflect a stable epistemic boundary between rival medical paradigms. (shrink)

Life sciences and emerging technologies raise a plethora of issues. Besides practical, bioethical and policy issues, they have broader, cultural implications as well, affecting and reflecting our zeitgeist and world-view, challenging our understanding of life, nature and ourselves as human beings, and reframing the human condition on a planetary scale. In accordance with the aims and scope of the journal, LSSP aims to foster engaged scholarship into the societal dimensions of emerging life sciences (Chadwick and Zwart 2013) and via this (...) thematic series, the journal provides a podium for authors who intend to address concrete issues from a ‘continental philosophical’ perspective, which may in- clude (post)phenomenology, hermeneutics, dialectics, (post)structuralism, psychoanalysis, critical theory and similar approaches. The series aims to contribute to a diagnostics of the present and a prognostics of the future, focusing on critical normative challenges (such as embodiment, intimate technologies, social justice, biopower, nanomedicine, human enhancement and the anthropocene) and building on the work of key authors such as Hegel (1830), Heidegger (1953, 1953/1954), Bachelard (1938), Canguilhem (1975), Lacan (1966, 1969-1970/1991), Habermas (1968), Serres (1972), Foucault (1969), Žižek (2006/2009), Stiegler (2010), Sloterdijk (2001, 2009) and others, but targeting con- crete up-to-date events and case studies against the backdrop of broader developments within the techno-scientific culture. (shrink)

This article explores the profound impact of visualism and visual perception in the context of medical imaging diagnostics. It emphasizes the intricate interplay among vision, embodiment, subjectivity, language, and historicity within the realm of medical science and technology, with a specific focus on image consciousness. The study delves into the role of subjectivity in perception, facilitating the communication of opacity and historicity to the perceiving individual. Additionally, it scrutinizes the image interpretation process, drawing parallels to text interpretation and highlighting (...) the influence of personal biases and individuality in medical practice. By revisiting Husserl’s conceptualization of “image consciousness” and introducing the notion of “image theme”, the paper seeks to establish a theoretical framework for making sense of images within the context of technological interpretation. A key objective is to enhance the phenomenology of technology through a systematic analysis of medical imaging diagnosis, contributing to an expanded epistemological foundation for medical practice. The article recognizes that the construction of medical knowledge incorporates subjective elements, especially within a historical context. The interpretation of images involves both instrumental and expert interpretation, with human subjectivity playing a crucial role. The article asserts that human creativity and conscious engagement are indispensable in interpreting all medical images. (shrink)

Livestock production has been confronted with several epidemics over the last decades. The morality of common animal disease strategies—stamping out and vaccination—is being debated and provokes controversies among farmers, authorities and the broader public. Given the complexity and controversy of choosing an appropriate control strategy, this article explores the potential of nano-enabled diagnostics in future livestock production. At first glance, these applications offer promising opportunities for better animal disease surveillance. By significantly shortening the reaction time from diagnosis to appropriate control, (...) they could complement the current disease management strategies. Although nano-enabled diagnostics will not make livestock disease eradication strategies redundant or completely free of the culling of infected animals, these diagnostics could significantly reduce the number of culled animals and animal suffering. This article aims to demonstrate that the ethical assessment of advanced diagnostics can build on the experiences with decision making in biomedical ethics where nonmaleficence, beneficence, autonomy and justice serve as important benchmarks. Nano-enabled diagnostics may be an ethically sound solution if it can resolve the dilemma between stamping out and vaccination in favor of the latter and if it can balance the autonomy–paternalism dilemma between farmers and authorities. The technology should allow to be switched on and off by farmers, whilst simultaneously allowing for a weak paternalism on behalf of authorities in order to benefit the farmer and broader society and to protect them from harm. (shrink)

Trust relations in the health services have changed from asymmetrical paternalism to symmetrical autonomy-based participation, according to a common account. The promises of personalized medicine emphasizing empowerment of the individual through active participation in managing her health, disease and well-being, is characteristic of symmetrical trust. In the influential Kantian account of autonomy, active participation in management of own health is not only an opportunity, but an obligation. Personalized medicine is made possible by the digitalization of medicine with an ensuing increased (...) tailoring of diagnostics, treatment and prevention to the individual. The ideal is to increase wellness by minimizing the layer of interpretation and translation between relevant health information and the patient or user. Arguably, this opens for a new level of autonomy through increased participation in treatment and prevention, and by that, increased empowerment of the individual. However, the empirical realities reveal a more complicated landscape disturbed by information ‘noise’ and involving a number of complementary areas of expertise and technologies, hiding the source and logic of data interpretation. This has lead to calls for a return to a mild form of paternalism, allowing expertise coaching of patients and even withholding information, with patients escaping responsibility through blind or lazy trust. This is morally unacceptable, according to Kant’s ideal of enlightenment, as we have a duty to take responsibility by trusting others reflexively, even as patients. Realizing the promises of personalized medicine requires a system of institutional controls of information and diagnostics, accessible for non-specialists, supported by medical expertise that can function as the accountable gate-keeper taking moral responsibility required for an active, reflexive trust. (shrink)

In its first part, this paper seeks to make plausible (a) that molecular genetic diagnostics differs in ethically relevant ways from traditional types of medical diagnostics and (b) that the consequences of introducing this technology in broad screening-programs to detect widespread genetic diseases in a population which is not at high risk may change our understanding of health and disease in a problematic way. In its second part, the paper discusses some aspects of public control of scientific and technological (...) innovations in the field of molecular genetic diagnostics. (shrink)

Information and computer technology has come to play an increasingly important role in medicine, to the extent that e-health has been described as a disruptive innovation or revolution in healthcare. The attention is very much focused on the technology itself, and advances that have been made in genetics and biology. This leads to the question: What is changing in medicine today concerning e-health? To what degree could these changes be characterized as a ‘revolution’? We will apply the work (...) of Thomas Kuhn, Larry Laudan, Michel Foucault and other philosophers—which offers an alternative understanding of progress and revolution in medicine to the classic discovery-oriented approach—to our analysis. Nowadays, the long-standing curative or reactive paradigm in medicine is facing a crisis due to an aging population, a significant increase in chronic diseases and the development of more expensive diagnostic tools and therapies. This promotes the evolution towards a new paradigm with an emphasis on preventive medicine. E-health constitutes an essential part of this new paradigm that seeks to solve the challenges presented by an aging population, skyrocketing costs and so forth. Our approach changes the focus from the technology itself toward the underlying paradigm shift in medicine. We will discuss the relevance of this approach by applying it to the surge in digital self-tracking through health apps and wearables: the recognition of the underlying paradigm shift leads to a more comprehensive understanding of self-tracking than a solely discovery-oriented or technology-focused view can provide. (shrink)

Background While integrating genomic sequencing into clinical care carries clear medical benefits, it also raises difficult ethical questions. Compared to traditional sequencing technologies, genomic sequencing and analysis is more likely to identify unsolicited findings (UF) and variants that cannot be classified as benign or disease-causing (variants of uncertain significance; VUS). UF and VUS pose new challenges for genetic health professionals (GHPs) who are obtaining informed consent for genomic sequencing from patients.Methods We conducted semi-structured interviews with 31 GHPs across Europe, Australia (...) and Canada to identify some of these challenges.Results Our results show that GHPs find it difficult to prepare patients to receive results because a vast amount of information is required to fully inform patients about VUS and UF. GHPs also struggle to engage patients – many of whom may be focused on ending their ‘diagnostic odyssey’ – in the informed consent process in a meaningful way. Thus, some questioned how ‘informed’ patients actually are when they agree to undergo clinical genomic sequencing.Conclusions These findings suggest a tension remains between sufficient information provision at the risk of overwhelming the patient and imparting less information at the risk of uninformed decision-making. We suggest that a shift away from ‘fully informed consent’ toward an approach aimed at realizing, as far as possible, the underlying goals that informed consent is meant to promote. (shrink)

Background While integrating genomic sequencing into clinical care carries clear medical benefits, it also raises difficult ethical questions. Compared to traditional sequencing technologies, genomic sequencing and analysis is more likely to identify unsolicited findings (UF) and variants that cannot be classified as benign or disease-causing (variants of uncertain significance; VUS). UF and VUS pose new challenges for genetic health professionals (GHPs) who are obtaining informed consent for genomic sequencing from patients.Methods We conducted semi-structured interviews with 31 GHPs across Europe, Australia (...) and Canada to identify some of these challenges.Results Our results show that GHPs find it difficult to prepare patients to receive results because a vast amount of information is required to fully inform patients about VUS and UF. GHPs also struggle to engage patients – many of whom may be focused on ending their ‘diagnostic odyssey’ – in the informed consent process in a meaningful way. Thus, some questioned how ‘informed’ patients actually are when they agree to undergo clinical genomic sequencing.Conclusions These findings suggest a tension remains between sufficient information provision at the risk of overwhelming the patient and imparting less information at the risk of uninformed decision-making. We suggest that a shift away from ‘fully informed consent’ toward an approach aimed at realizing, as far as possible, the underlying goals that informed consent is meant to promote. (shrink)

Our lives are dominated by technology. We live with and through the achievements of technology. What is true of the rest of life is of course true of medicine. Many of us owe our existence and our continued vigour to some achievement of medical technology. And what is true in a major way of general medicine is to a significant degree true of psychiatry. Prozac has long since arrived, and in its wake an ever-growing armamentarium of new (...) psychotropics; beyond that, neuroscience promises ever more technological advances for the field. -/- However, the effect of technology on the field of psychiatry remains highly ambiguous. On the one hand there are the achievements, both in the science and practice of psychiatry; on the other hand technology's influence on the field threatens its identity as a humanistic practice. In this ambiguity psychiatry is not unique - major thinkers have for a long time been highly ambivalent and concerned about the technological order that now defines modern society. For the future, the danger is that the psychiatrically real becomes that which can be seen, the symptom, and especially that which can be measured. Disorders and treatments might become reduced to what can be defined by diagnostic criteria and what can be mapped out on a scale. -/- This book exams how technology has come to influence and drive psychiatry forward, and considers at just what cost these developments have been made. It includes a range of stimulating and thought-provoking chapters from a range of psychiatrists and philosophers. (shrink)

The introduction of recombinant DNA technology into the field of genetics has led to a rapid advancement of our knowledge of genes and genome structure. Such technology, applied to the human genome, has provided valuable information concerning the nature and possible treatment of inherited disorders. The possibility that this knowledge will pave the way for the correction of at least some of these disorders has captured the imagination of the informed public. In this review we look at the (...) accomplishments of molecular pathologists to date and how new techniques are being applied to the study of inherited disease. (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)

Current advances in connectivity, sensor technology, computing power and the development of complex algorithms for processing health-related data are paving the way for the delivery of innovative long-term health care services in the future. Such technological developments will, in particular, assist the elderly and infirm to live independently, at home, for much longer periods. The home is, in fact, becoming a locus for health care innovation that may in the future compete with the hospital. However, along with these advances (...) come valid privacy and security questions arising from the fact that the data collected and transmitted through these technologies could also allow for individual monitoring as well as unauthorized access to critical diagnostic and other health data. (shrink)

Somatic cell count is a diagnostic test of milk for mastitis in cows. Its specificity and sensitivity are less than 1.0, making test results uncertain. I discuss epistemological problems of the test such as underdetermination, undercalibration and underdiscrimination, in the solution of which biomedical and economic factors may play a role. Diagnostics of the SCC should be considered as an epistemological network, functioning in a network in which farmers, veterinarians, epidemiologists and milk industry shift their position following biomedical, technological (...) and economic changes, which is described as an actor-network to understand how human and non-human agents in mastitis may be associated. (shrink)

The introduction of the modern diagnostic and therapeutic procedures to the medical practice provided a new challenge for the medicine. The art of medicine, with its default purpose of acting for the benefit of health, is therefore required to derive from technological progress effectively and rationally. As a result, the medical ethics has been engaged with the rules of economy and management of deficit medical procedures as well as their rational and fair distribution. The above suggests, that medics, given (...) these recourses, should approach each patient with a consideration to their therapeutic rights. However, the physicians cannot just concentrate on the good of one particular patient, but must take into account joint responsibility for the good of a potential patient. This makes medical ethical dilemmas similar to the ethical issues of business. The notion of responsibility is the key for discriminating these two kinds of ethics. (shrink)

Synthetic biology is often seen as the engineering turn in biology. Philosophically speaking, entities created by synthetic biology, from synthetic cells to xenobots, challenge the ontological divide between the organic and inorganic, as well as between the natural and the artificial. Entities such as synthetic cells can be seen as hybrid or transitory objects, or neo–things. However, what has remained philosophically underexplored so far is the impact these hybrid neo–things will have on (our phenomenological experience of) the living world. By (...) extrapolating from Walter Benjamin’s account of how technological reproducibility affects the aura of art, we embark upon an exploratory inquiry that seeks to fathom how the technological reproducibility of life itself may influence our experience and understanding of the living. We conclude that, much as technologies that enabled reproduction corroded the aura of original artworks (as Benjamin argued), so too will the aura of life be under siege in the era of synthetic lifeforms. This article zooms in on a specific case study, namely the research project Building a Synthetic Cell (BaSyC) and its mission to create a synthetic cell–like entity, as autonomous as possible, focusing on the properties that differentiate organic from synthetic cells. (shrink)

Central to Watts and Newson’s argument in their seminal paper ‘ Is there a duty to routinely reinterpret genomic variant classifications? ’ is that diagnostic laboratories are not morally obligated to actively reinterpret variants of uncertain significance (VUS) due to the superior outcomes offered by next-generation sequencing (NGS) compared with traditional methods.1 NGS technologies can identify, analyse and interpret millions of genetic variations at once. For example, ‘the use of conventional molecular assays in clinical contexts could require doing a (...) lot of assays for various mutations. Using these different assays, more tissue may be required. These targets can accurately be questioned using NGS technology in a single test.’2 If NGS-based genomic sequencing is reliable and its output outweighs the potential harm of uncertainties, then, it is plausible to say that those test providers cannot incur a moral duty to actively reinterpret VUS because there won’t be any need to do so.1 Despite its seeming reliability, diagnostic laboratories face enormous challenges in implementing NGS-based …. (shrink)

Prominent tuberculosis (TB) actors are invoking solidarity to motivate and justify collective action to address TB, including through intensified development and implementation (D&I) of technologies such as drugs and diagnostics. We characterize the ethical challenges associated with D&I of new TB technologies by drawing on stakeholder perspectives from 23 key informant interviews and we articulate the ethical implications of solidarity for TB technology D&I. The fundamental ethical issue facing TB technological D&I is a failure within and beyond the TB (...) community to stand in solidarity with persons with TB in addressing the complex sociopolitical contexts of technological D&I. The failure in solidarity relates to two further ethical challenges raised by respondents: skewed power dynamics that hinder D&I and uncertainties around weighing risks and benefits associated with new technologies. Respondents identified advocacy and participatory research practices as necessary to address such challenges and to motivate sustained collective action to accelerate toward TB elimination. We present the first empirical examination of bioethical accounts of solidarity in public and global health. Our study suggests that solidarity allows us better to understand and address the ethical challenges that arrest the D&I of new TB technologies. Solidarity lends credence to policies and practices that address the relational nature of illness and health through collective action. (shrink)

This paper approaches the interaction of a health professional with an AI system for diagnostic purposes as a hybrid decision making process and conceptualizes epistemo-ethical constraints on this process. We argue for the importance of the understanding of the underlying machine epistemology in order to raise awareness of and facilitate realistic expectations from AI as a decision support system, both among healthcare professionals and the potential benefiters. Understanding the epistemic abilities and limitations of such systems is essential if we (...) are to integrate AI into the decision making processes in a way that takes into account its applicability boundaries. This will help to mitigate potential harm due to misjudgments and, as a result, to raise the trust—understood here as a belief in reliability of—in the AI system. We aim at a minimal requirement for AI meta-explanation which should distinguish machine epistemic processes from similar processes in human epistemology in order to avoid confusion and error in judgment and application. An informed approach to the integration of AI systems into the decision making for diagnostic purposes is crucial given its high impact on health and well-being of patients. (shrink)

Le mouvement posthumaniste, autre nom et radicalisation du transhumanisme, qui projette un homme dépassant sa condition corporelle par son hybridation aux machines, va bien avec notre temps. Ses partisans le conjuguent au futur : ils nous annoncent ce que l'avenir sera, sans s'embarrasser du moindre conditionnel hypothétique. Par leur assurance prophétique, ils veulent nous aspirer dans la spirale du temps technologique, renforçant ainsi la tyrannie du mode de vie que nous imposent déjà jour après jour les entrepreneurs du numérique, les (...) rois du silicium. Ce livre s'en prend d'abord aux deux arguments-phares du posthumanisme, celui de la liberté de "s'augmenter", de poursuivre le projet d'un homme émancipé de ses faiblesses naturelles, et celui des bienfaits de l'amélioration par les techniques. Il réfute sur leur propre terrain les fausses évidences sur lesquelles ces deux argumentaires reposent. Mais surtout, il élargit le débat à la question de l'emprise technologique sur nos sociétés, mettant en évidence le rôle de complice objective que joue à cet égard ce que l'auteur appelle la "Petite éthique", à savoir l'éthique libérale des droits individuels. Ainsi, le posthumanisme nous lance un défi démocratique : celui de se réapproprier notre avenir, c'est-à-dire de faire en sorte qu'il se conjugue non plus au futur obligé, mais au conditionnel politique. (shrink)

Modern health care is inextricably bound up with technologically mediated knowledge and practice. It is vital to investigate its use and role in different clinical contexts characterized, on one hand, by face to face practitioner and patient encounters (where technology may be conceptualised as hindering therapeutic relations) and, on the other hand, by practitioners’ encounter with bodily parts in laboratories (where conceiving of patients may be thought of as confounding objectivity). To contribute to the latter, I offer an ethnographic (...) analysis of cytology laboratory practitioners’ work and microscopic assessment of normal and abnormal cells. First, I discuss the biomedical literature on cytology and the quest for a non-variational bodiless vision. Second, I discuss the concept of multistability, first developed by philosopher of technology Don Ihde, here used to analyse technologically mediated perception and how practitioners interact with technology. Combined with long term ethnographic fieldwork it enables access to, and analysis and articulation of the implicit multifaceted practitioner–technology–cell interface embedded in clinical practice and diagnostic processes. I will also address some implications of my analysis for clinical cytology. (shrink)

Nowadays, the development of human society and daily life are inseparable from the power supply. Therefore, people also put forward higher requirements for the reliability of distribution network, but power companies can only passively deal with distribution network failures, which is a bottleneck for the improvement of distribution network reliability. The Internet of Things is the best solution for online equipment status monitoring and basic data sharing for large, widely distributed, relatively fixed, and large numbers of equipment. The construction of (...) the IoT for power distribution equipment faces many important problems, including the selection of networking, equipment selection, and interaction standards. When researching the implementation plan, research on the distribution of IoT market was carried out. Based on the grid, the idea of optimizing the investment selection plan of the power distribution using IoT was discussed, and a result verification model was established. After the completion of the theoretical part, a case study of medium-voltage distribution grid equipment management and medium-voltage distribution network equipment management based on the grid was carried out by taking a real enterprise application situation as an example. Realizing fault diagnosis of distribution network will not only provide decision support for operation and maintenance of distribution network for power companies, but also have great economic and social benefits. Aiming at the shortcomings of single data mining method in distribution network fault diagnosis, hybrid data mining method is proposed. First, rough set theory is used to reduce the original fault data and form a simplified rule set. Because of the non-linearity of distribution network fault and the strong learning ability, adaptability, and robustness of Bayesian network, Bayesian network can be used to classify distribution network faults. Therefore, a simplified fault diagnosis system is established in this paper, and its correctness is confirmed. Then, the learning and training are carried out by using Bayesian network to call the simplest rule set, which has the characteristics of short learning and training time and high diagnostic accuracy. (shrink)

Should we be allowed to refuse any involvement of artificial intelligence technology in diagnosis and treatment planning? This is the relevant question posed by Ploug and Holm in a recent article in Medicine, Health Care and Philosophy. In this article, I adhere to their conclusions, but not necessarily to the rationale that supports them. First, I argue that the idea that we should recognize this right on the basis of a rational interest defence is not plausible, unless we are (...) willing to judge each patient’s ideology or religion. Instead, I consider that the right must be recognized by virtue of values such as social pluralism or individual autonomy. Second, I point out that the scope of such a right should be limited at least under three circumstances: if it is against a physician’s obligation to not cause unnecessary harm to a patient or to not provide futile treatment, in cases where the costs of implementing this right are too high, or if recognizing the right would deprive other patients of their own rights to adequate health care. (shrink)

ObjectiveTo identify the ethical challenges associated with the development and implementation of new tuberculosis drugs and diagnostics.MethodsTwenty-three semi-structured qualitative interviews conducted between December 2015 and September 2016 with programme administrators, healthcare workers, advocates, policymakers, and funders based in the Americas, Europe, and Africa. Interviews were analysed using thematic analysis.ResultsDivergent interests and responsibilities, coupled with power imbalances, are a primary source of ethical challenges; the uncertain risk profiles of new drugs present an additional one. Although this challenge can be partially mitigated (...) through stringent pharmacovigilance, respondents highlighted that high-burden countries tend to lack the resources to facilitate safe implementation. Increased advocacy and community engagement are considered an ethical imperative for future TB development and implementation.ConclusionsThis project helps identify some of the ethical challenges of new TB technologies. It demonstrates that investigating ethical challenges through qualitative research is one way to apprehend the difficulty of implementing new TB technologies. Addressing this difficulty will require that those in positions of power reconsider their interests in relation to disempowered communities.Policy implicationsEfforts to build consensus regarding what values should underpin the global governance of TB research, prevention, and care are essential to facilitate the ethical implementation of new TB technologies. (shrink)

The Papanicolaou (Pap) smear, also called the Pap test, cyto test, cervical smear or cervical cytology, has been described as the most widely used and established cancer-screening technology in the world. It has also been described as a very simple technology including a brush, a microscope slide, fi xative and cervical cells from women. In 1928, George N. Papanicolaou, a Medical Doctor, investigator, PhD in zoology and Aureli Babes (1928/1967), a Romanian pathologist, each independently claimed to have found (...) a ‘very simple’ technique, which provided a new possibility for early diagnostics of cancer/malignant tumours in the female genital tract/uterine cervix. The technique was subsequently named after Papanicolaou who, according to Wied (1964: 174), was more successful than Babes in ‘stimulating the introduction of mass screening projects which are the actual benefi t of the method’. (shrink)

Sweetpotato-pig production is an important system that generates income, utilizes unmarketable crops, and provides manure for soil fertility maintenance. This system is widely practiced from Asia to Africa, with many local variations. Within this system, pigs are generally fed a low nutrient-dense diet, yielding low growth rates and low economic efficiency. Our project in Vietnam went through a process of situation analysis, participatory technology development (PTD), and scaling up over a seven-year period to improve sweetpotato-pig production and to disseminate (...) developed technologies. The situation analysis included a series of pig production assessments in several provinces in northern and southern Vietnam, and pig supply-market chain identification was conducted in 13 provinces. The analysis of these studies informed the project of the following: (1) appropriate locations for our activities; (2) seasonal available feedstuff and farmers’ feeding practices; (3) market fluctuation and requirements; and (4) feeding and management improvement needs based on which the subsequent phase of PTD was designed. The PTD involved a limited number of farmers participating in sweetpotato varietal selection, sweetpotato root and vine silage processing, seasonal feeding combination, and pig feeding with balanced crop-feed diet and silage. Six years of multi-location and multi-season sweetpotato selection resulted in a few promising varieties that yielded up to 75% more dry matter and have since been formally released. The most significant results of silage processing and feeding trials include improved growth, higher feeding efficiency, increased year-round local feedstuff, and considerable labor reduction from eliminated cooking and vine cutting. Once these technologies were developed, a farmer-to-farmer training model was designed for scaling up the adoption and impact. Farmer trainers from seven communes in seven provinces received training in these technologies. In turn, they undertook the responsibility of training other farmers on sweetpotato selection, processing, and feeding. An impact study was also administered to monitor and evaluate (M&E) the dissemination process and to document the impact of the new technologies and farmer-to-farmer training model on pig growth and farmer income generation. The results showed that both participating and non-participating farmers have taken up the technologies, although the former demonstrates higher rates of adoption than the latter. The participants also generated more income and saved more labor from the adoption of the technologies. While the scaling up and M&E activities are on-going, the project has since broadened from a sweetpotato-pig system perspective to a pig-cropfeed system perspective based on farmers’ needs. It has included other crop feeds such as cassava and peanut stems in the research portfolio. New technologies based on on-going PTD will continuously be incorporated into the future training curriculum. (shrink)

This study examines recent French bioethics laws governing the uses of new reproductive and genetic technologies (NRGTs)—including in-vitro fertilization, surrogate motherhood, prenatal diagnostics, sex selection, and cloning—in light of feminist claims to women's rights, especially a woman's right to reproductive freedom. To this end, the study explores two interrelated questions: First, to what extent have French feminists supported NRGT development and treatment? Second, to what extent do French national bioethics debates, laws, and policies reflect feminist reactions to NRGTs? The investigation (...) of these questions is informed by recent theories of state feminism that show how national policy debates are gendered by particular sets of feminist ideas, and how policy choices resulting from these debates turn some of these ideas into law (McBride Stetson and Mazur 1995). Some of the most pressing feminist concerns in this area include women's loss of control over their bodies and fertility, women's exploitation and commercialization of their bodies, and women's health risks from NRGTs. The analysis of pronouncements by French feminist writers, researchers, and policy-makers reveals a multiplicity of feminist stances on NRGTs, showing keenly how feminists contest what constitutes effective feminist public policies to illuminate the fact that these policies are subject to shifting political contestations, rather than the reflection of a fixed set of feminist ideas. While contemporary French feminists grapple with the potential merits and dangers of NRGTS, the study shows that feminists generally seem to support NRGTs, as long as French law protects women's reproductive autonomy. Seen in this light, France's strong sense of the right to procreate through facilitation of access to NRGTs is not a contradiction of France's strong social and legal support for women's reproductive freedom, but rather enables French lawmakers to regulate NRGTs more effectively. (shrink)

This study examines recent French bioethics laws governing the uses of new reproductive and genetic technologies —including in-vitro fertilization, surrogate motherhood, prenatal diagnostics, sex selection, and cloning—in light of feminist claims to women’s rights, especially a woman’s right to reproductive freedom. To this end, the study explores two interrelated questions: First, to what extent have French feminists supported NRGT development and treatment? Second, to what extent do French national bioethics debates, laws, and policies reflect feminist reactions to NRGTs? The investigation (...) of these questions is informed by recent theories of state feminism that show how national policy debates are gendered by particular sets of feminist ideas, and how policy choices resulting from these debates turn some of these ideas into law. Some of the most pressing feminist concerns in this area include women’s loss of control over their bodies and fertility, women’s exploitation and commercialization of their bodies, and women’s health risks from NRGTs. The analysis of pronouncements by French feminist writers, researchers, and policy-makers reveals a multiplicity of feminist stances on NRGTs, showing keenly how feminists contest what constitutes effective feminist public policies to illuminate the fact that these policies are subject to shifting political contestations, rather than the reflection of a fixed set of feminist ideas. While contemporary French feminists grapple with the potential merits and dangers of NRGTS, the study shows that feminists generally seem to support NRGTs, as long as French law protects women’s reproductive autonomy. Seen in this light, France’s strong sense of the right to procreate through facilitation of access to NRGTs is not a contradiction of France’s strong social and legal support for women’s reproductive freedom, but rather enables French lawmakers to regulate NRGTs more effectively. (shrink)