This paper examines the sociotechnical practice of robotic prostate surgery. It analyzes how an affective metric—"patient regret"-—is utilized to evaluate the outcomes of robotic surgery for prostate cancer and configures bioethical structures of responsibility.
Long abstract:
This paper examines how robotic surgery for prostate cancer is epistemically and ethically evaluated in the governance of healthcare technologies. The prostate is deeply imbued with notions of gender, sexuality, and race (Johnson, 2021; Wailoo, 2012), and the surgical suite is an affectively charged space (Prentice, 2012). Prostate cancer care has undergone significant sociotechnical changes in the twenty-first century. In contemporary high-technology healthcare settings, robotic surgery has been one response to expanding biomedical markets for prostate intervention. Affective metrics, especially the presence or absence of patient regret, are mobilized in the post-operative evaluation of robotic prostatectomies to compare outcomes of operations performed by surgeons unaided by robotics and the algorithms that run these human-machine hybrid systems. Rates of regret are used as proxies to establish patient satisfaction in consumer-driven models of healthcare efficacy. The paper argues that this is further structured by bioethical notions of responsibility that place the greatest emphasis on logics of choice (Mol, 2008) and considers how responsibility is configured when algorithms are driving surgical intervention.