Biomedical Engineering Reference
In-Depth Information
of the individual patient. In this sense, these technologies can be said to be
reordering the relationship between practitioners and patients.
Technologies that can be related to '
new biologies
', for example trans-
species transplantation and various types of gene technology, offer new
possibilities in the prediction and prevention of future disease, but also
generate new risk identities and uncertainties. Another set of technologies
create 'cyborg' hybrids or '
assemblages
' in bringing together machine and
body tissue. One example is 'regenerative medicine' producing artifi cial body
parts and intra-body instruments. These technologies thus raise a series of
'diffi cult and challenging questions concerning the character of our human/
non-human identity' (Brown and Webster 2004: 2).
The consequences of medical technologies for medical practice as well
as for patients can of course be described in different ways depending on
the perspective and purpose of the analysis. Today, there is much debate
about '
new
' medical technology that can generate more paradigmatic shifts
in medicine and in the relationship between professionals and patients
(or patients-to-be). The development of increasingly sophisticated optical
devices (for example the X-ray and ultrasound technology) has opened up
radically new ways to 'look into the body'. The 'new genetics' has created
new possibilities to 'look into the future', as it is used for example in
diagnostic situations. Another aspect of the novelty of medical technology is
that the
role
of technology in medicine can change as development in medical
knowledge and medical training is increasingly defi ned in technical rather
than professional terms - something that in turn may affect the relationship
between expert and lay discourse.
Even if much of the modern medical technology is presented as new, some
technologies can rather be seen as 'more of the same', as applied in new
clinical contexts or as presented as new by those who develop or use the
technology. Also, technology can be combined in 'clusters' that will be new,
including mundane and routine uses of medical technologies (Brown and
Webster 2004). One example is antenatal care where new components of
advanced technology, such as ultrasound screening of the foetus, are added
to a well-established routine health surveillance programme. Furthermore,
medical technologies are found in highly specialized medicine, for example
specialist clinics for genetic counselling or diagnostics, as well as in routine
primary health care, such as the regular Pap-smear screening of all women
above a certain age. In Timmermans and Berg's words, 'medicine forms an
archaeology of layer upon layer of technologies from the most mundane
band-aids and pencils to sophisticated machines such as MRIs and artifi cial
hearts, from virtually neutral infusion pumps to highly symbolic procedures
and devices such as the drug Viagra or genetic tests' (2003: 99).
How are we to make sense of these medical technologies (and the debates
they trigger)? One important point of departure is that medical technology
always appears, and is understood, in a context, and thus cannot 'speak'
entirely for itself. It takes on meaning in the social, cultural and clinical context
