Paper short abstract:

This paper examines the evolution of key embodiments and representations of the ‘bionic man’ and its body parts to discuss the dynamics of the social worlds and the political economy of medical devices.

Paper long abstract:

This paper examines the evolution of key embodiments and representations of the 'bionic man' and its body parts to discuss the dynamics of the social worlds and the political economy of medical devices.

The long and challenging journey of how to build body parts and devices at the interfaces of bodies, machines, animals and computers - such as prosthetics, implants and artificial organs - to repair, replace and enhance damaged parts of the human body and the full bionic man has received so far limited investigation. Medical devices that initially were considered controversial are now fully accepted and integrated in our bodies and everyday lives, mostly black boxed and taken for granted (e.g. pacemakers and artificial hearts). However, the convergence of info-, bio- and nano-technologies is creating complex configurations of bodies, new and old devices, and data that deserve attention and should be unpacked, as well as the dynamics of their social worlds examined.

In this paper I analyse key embodiments and representations of the bionic man using historical, archival and visual methods. These artefacts are useful sites to study the evolution of temporary actualizations and materializations of medical devices, their social worlds and political economy. This paper contributes to advancing a critical discussion of the ethical, social and legal dimensions and implications of the evolution of smart health technologies and complex configurations of bodies, devices and data.

Paper short abstract:

For some, 'everyday cyborgs,' living with an implantable cardiac device requires acclimatisation to the process of cyborgisation. Partly this is due to the ambiguous nature of embodiment whereby a self is not just a body; but a body has an identity, integrity and image which is in flux.

Paper long abstract:

The cyborg scholar Chris Hables Gray (2012) refers to cyborgisation as a process that shares the variability yet inevitability of death. It is a life that is effected by incorporating different levels of corporeal integration with different types and kinds of materials. Increasing reliance is being made on 'implantable smart technologies' (Haddow et al 2015; Harmon et al. forthcoming) an example is implantable cardiac devices.

These technologies closely fit Haraway's (1991) 'CᶟI' functionality and Clynes and Kline 'homeostatic feedback system' (1960); the ability of the devices to command-control-communication offer an autonomy never previously realised in automation within the body. I want to draw upon interview data that relates the everyday cyborg accounts of 1) the surgical processes necessary to become an everyday cyborg and 2) the consequences of implantation of such an auto-biotechnology can be unexpected, requiring acclimatisation. This research also speaks to an embodiment that is much more ambiguous than self as body/self has body. Rather, the experience of the body is one that has an identity, integrity and image ('Triad of I') none of which is in a fixed state.

Paper short abstract:

Everyday cyborg gives us a way of understanding the different modes in which implanted devices and complex prostheses become incorporated into (the lives of) persons. This paper examines how they transgress and challenge conceptual, ethical, and legal boundaries and dichotomies.

Paper long abstract:

Everyday cyborgs are all around us (Haddow et al 2015). They are persons with replacements and augmentations ranging from the simple to the extraordinarily complex; for example, artificial joint replacements, implanted devices such as pacemakers and the total artificial heart, and limb prostheses. These parts and devices may be completely artificial, biological, or biohybrid in nature (a mixture of biological and synthetic components). Additionally, they may contain mechanical or electronic components and be capable of running software and storing data (Haddow, Harmon, & Gilman, 2015). The idea of the everyday cyborg is not simply an evocative metaphor. Implanted devices and complex prostheses represent occasions where external objects become a part of persons (and their bodies). As such, I make two main arguments in this paper.

First, I argue that the image of the everyday cyborg gives us a way of understanding the different modes in which such devices become incorporated into (the lives of) persons and, in so doing, transgress the usual boundary between subject and object. I identify (at least) four ways in which implanted devices and complex prosthetics become incorporated into (the lives of) persons: (1) physical internalisation, (2) functional integration, (3) psychological constitution, and (4) phenomenological assimilation. Secondly, I outline how the linking of the organic, biological person with synthetic, inorganic parts and devices raises questions which the law is ill-equipped to deal with, arguing that everyday cyborgs prompt a re-analysis of the conceptual and ethical terrain underpinning the law, as well as the law itself.

Paper short abstract:

This paper foregrounds the specific kinds of data generated by the artificial pancreas, a set of interlinked, body-mounted devices for users with Type 1 diabetes, and explores their implications for epistemological and metaphysical transformations on the part of artificial pancreas users.

Paper long abstract:

Many personal medical devices (PMDs) generate data about people's movements, activities, and bodily status, in many cases offering users granular knowledge about hitherto unknown aspects of their own bodies. This paper foregrounds and explores the specific kinds of data generated by the artificial pancreas, a set of interlinked, body-mounted devices that sense and respond to varying blood sugar levels in users with Type 1 diabetes. This intervention generates large amounts of data regarding insulin dosage and (especially) blood sugar levels, providing significantly greater detail regarding the latter than is available using standard monitoring methods. Through analysis of interviews conducted with participants in a recent overnight study of the artificial pancreas in pregnant women, this paper draws on Weickian theories of 'sensemaking' to explore how data can reconstitute micro-scale attitudes to the self and technology. These transformations can occur at the epistemological level (e.g. through the revelation of unsuspected micro-scale blood sugar fluctuations) as well as at the metaphysical level, e.g. through the experience of living as the subject of automated, algorithm-driven treatment enacted through wearable devices. Moreover, these transformations can be both empowering and oppressive in different ways, offering new potential for action and improved self-care at the same time as generating new kinds of challenges and problems to be overcome. Consequently, this chapter demonstrates the multiple and complex ways in which data - a somewhat intangible resource, yet also a ubiquitous and personal one - increasingly plays important roles in technology-mediated experiences of health and illness.

Paper short abstract:

Based on semi-structured interviews, this paper critically examines the use of senses in diagnostic work, and problematizes new modes of healthcare such as telemedicine that compromise sensory judgments.

Paper long abstract:

The physical exam is the cornerstone of the medical encounter, yet this aspect of medical practice is being reconfigured in response to shifts in medical regulation and governance, developments in diagnostic testing, digital health technologies for self-monitoring and self-care, new modes of health care such as telemedicine and the techno-utopian discourses that surround them. Critical sociological scholarship highlights that in focusing on explicit medical knowledge and disembodied data we take for granted aspects of healthcare work, such as the ways in which health and illness is sensed. Sensing has always been a part of the skilled work of medical practice, to the extent that the mediated hearing of auscultation contributed to the establishment of medicine as a profession. However, recent research has captured practices such as dual use of the senses and tests. In telemedicine, sensory work is delegated, often to the patient, because this healthcare environment does not facilitate sensing directly. Based on semi-structured interviews, this paper examines the diverse ways doctors rely on their senses in diagnostic work, as well as the translations and transferences inherent in this sensing (sensing via a patient's sense, sensing via technology). It also problematizes new modes of healthcare such as telemedicine that compromise sensory judgments, and the extent to which they can transform health and care. I argue that the sensory work of diagnosis is vital, but it is left out of mainstream conversations about 'good' medicine and healthcare futures.

Paper short abstract:

This paper examines the biological variant of the recent trend towards 3D printing, small scale manufacturing of computer-designed objects from organic material. Looking at the architecture of this new field, its fabric and future, I show how bioprinting matters from a social scientist perspective.

Paper long abstract:

Recent media headlines suggest that scientists will have the ability to create or 'biofabricate' personalised organs such as livers and hearts. While 3D printers and printing have proven successful, are now widely used and commercially available, bio-printing is far more complex, working through the successive layering of organic materials. Bioinks - such as differentiated-, human embryonic-, or induced pluripotent stem-cells - are used to create structures approximating body parts. It is argued that these new forms of printing will have the same revolutionary and democratising effect as book printing, applicable to regenerative medicine and industry. It is not texts that will become broadly available, but individually designed biological structures or body parts.

The emerging field of biofabrication can be located at the crossroad of biology and engineering. Scientists trace back the start of bioprinting to well over three decades ago, with the appearance of articles that started to explore the possibilities to organise cells spatially into structures that closely mimic the native tissue architecture. Looking at the architecture of this new field, its fabric and potential, this paper explores how bioprinting matters from a social scientist perspective. How are new epistemic and material configurations created? How does this new type of bio-object shift social and economic relations, especially in the context of organ replacement? And how can social scientists imprint on current developments in a multi-dimensional way?