This thesis examines the practice of haemodialysis and kidney transplantation, the two medical therapies available for persons with kidney failure, from a phenomenological perspective. A basic assumption made in the thesis is that contemporary biomedicine is deeply embedded in the cultural, historical, economic, and political circumstances provided by the particular local, national, and transnational contexts in which it is practiced. The aim of the thesis is twofold. On the one hand, the aim is to examine the forms of person- and (...) patienthood enacted and negotiated in haemodialysis and kidney transplantation care and in the daily lives of persons with kidney failure. On the other hand, the aim is to investigate the ways in which the enacted and negotiated forms of person- and patienthood are culturally embedded and normatively charged. In order to examine and investigate this twofold aim, an empirical material has been gathered that comprises observations and in-depth interviews with patients and caregivers at four haemodialysis units, one in Riga, Latvia, and three in Stockholm, Sweden. The theoretical approach and methodology of the study is cultural and phenomenological in character, drawing on an ethnological and anthropological understanding of culture as processual and relational, and on a phenomenological understanding of personhood as embodied and intertwined with the surrounding world. The thesis shows that patients’ encounters and attempts to deal with the diagnoses and treatments associated with kidney failure are complex and often misalign them with the normatively charged orientations enacted and recommended by medicine. The complex situation that emerges when they undergo transplantation, for example, stands in stark contrast to the widespread official view of organ transplantation as a self-evidently health-bringing and normalising therapy. Through their repeated and extensive experiences of undergoing haemodialysis and living with the disease, patients eventually become able to create a synthesis between their lived experiences of their own body and their body as a medical object – what in the thesis is called a ‘sick body’ – a synthesis that allows them to reorient themselves in life and experience a sense of direction. This process relies, to a large extent, on the temporal structure that haemodialysis affords life; it is by repeatedly undergoing the treatment that patients become able to create a sick body. Even so, many of them find this temporal structure problematic; they experience it as disruptive of their control and future-orientedness and as causing an existentially difficult-to-handle boredom. The thesis also shows that the political developments and the norms prevalent in the two national contexts studied greatly affect the orientations of the treatment practices and the participants’ lives. In both Riga and Stockholm, ideals of freedom, activity, control, and self-actualisation influence what forms of patienthood and personhood are enacted. The study indicates that persons who fall ill with a serious and chronic disease only gradually become able to understand and actively cope with their differently embodied circumstances of life. This suggests that medical professionals should not too hastily enlist their patients as experts on their own bodies, but rather provide them with the time and support necessary for making repeated attempts at creating and maintaining a life with a sick body. (shrink)

Modern technology has enabled the use of new forms of information in the care of critically ill patients. In intensive care units (ICUs), technology can simultaneously reduce the lived experience of illness and magnify the objective dimensions of patient care. The aim of this study, based upon two empirical studies, is to find from a philosophical point of view a more comprehensive understanding for the dominance of technology within intensive care. Along with caring for critically ill patients, technology is part (...) of the ICU staff's everyday life. Both technology and caring relationships are of indispensable value. Tools are useful, but technology can never replace the closeness and empathy of the human touch. It is a question of harmonizing the demands of subjectivity with objective signs. The challenge for caregivers in ICU is to know when to heighten the importance of the objective and measurable dimensions provided by technology and when to magnify the patients’ lived experiences, and to live and deal with the ambiguity of the technical dimension of care and the human side of nursing. (shrink)

Technology is a specific form of human agency that yields to (an imperfect) realization of human control over a technological situation-that is, a situation not governed to an end by natural constraints but by specific human aims. In this view, technology can be considered the only way of producing artificial beings. However, all technology is finite by nature, which means that sooner or later, all technology will fail, break down, and go wrong. The fate of all technologies and artificial beings (...) produced by technologies is finitude. Human beings are artificial beings, in this way human existence is also finite. (shrink)

Three philosophical perspectives on the relation between technology and society are distinguished and discussed: 1) technology as an autonomous force that determines society; 2) technology as a human construct that can be shaped by human values, and 3) a co-evolutionary perspective on technology and society where neither of them determines the other. The historical evolution of the three perspectives is discussed and it is argued that all three are still present in current debates about technological change and how it may (...) affect society. This is illustrated for the case of Artificial Intelligence (AI). It is argued that each of the three perspectives contributes to the debate of AI but that the third has the strongest potential to uncover blind spots in the current debate. (shrink)

Praised as a panacea for resolving all societal issues, and self-evidently presupposed as technological innovation, the concept of innovation has become the emblem of our age. This is especially reflected in the context of the European Union, where it is considered to play a central role in both strengthening the economy and confronting the current environmental crisis. The pressing question is how technological innovation can be steered into the right direction. To this end, recent frameworks of Responsible Innovation focus on (...) how to enable outcomes of innovation processes to become societally desirable and ethically acceptable. However, questions with regard to the technological nature of these innovation processes are rarely raised. For this reason, this paper raises the following research question: To what extent is RI possible in the current age, where the concept of innovation is predominantly presupposed as technological innovation? On the one hand, we depart from a post-phenomenological perspective to evaluate the possibility of RI in relation to the particular technological innovations discussed in the RI literature. On the other hand, we emphasize the central role innovation plays in the current age, and suggest that the presupposed concept of innovation projects a techno-economic paradigm. In doing so, we ultimately argue that in the attempt to steer innovation, frameworks of RI are in fact steered by the techno-economic paradigm inherent in the presupposed concept of innovation. Finally, we account for what implications this has for the societal purpose of RI. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

Don Ihde is one of the world's foremost thinkers on the place of technologies in our lives. Over the course of a long career, he has built a unique and useful perspective by expanding on phenomenological and American pragmatist philosophy and has developed wide-ranging insights and conceptual tools for describing the details of our experience across the various areas of human activity, including scientific practice, anthropological history, computer interface, design, art history, and the technologies of everyday life. The Critical Ihde (...) brings together many of Ihde's most influential writings, as well as a number of under-recognized gems. Across these works are examples of his influential contributions to the phenomenology of human auditory and visual experience, his foundational work on the phenomenology of technology, and his thoughts on the technologies of scientific practice, including laboratory and medical imaging. Further, these chapters reveal the development of "postphenomenology," Ihde's original philosophical perspective, one that continues to flourish today across the work of a growing interdisciplinary and international collective of scholars. (shrink)

This article presents the framework Capability Sensitive Design (CSD), which consists of merging the design methodology Value Sensitive Design (VSD) with Martha Nussbaum's capability theory. CSD aims to normatively assess technology design in general, and technology design for health and wellbeing in particular. Unique to CSD is its ability to account for human diversity and to counter (structural) injustices that manifest in technology design. The basic framework of CSD is demonstrated by applying it to the hypothetical design case of a (...) therapy chatbot for mental health. By applying CSD to a design case, the merits of this new framework over the standard VSD approach become apparent. Also, the application demonstrates what a technology design would look like when attention is paid to capabilities right from the start of the design process. (shrink)

This paper presents a Heideggerian phenomenological analysis of screens. In a world and an epoch where screens pervade a great many aspects of human experience, we submit that phenomenology, much in a traditional methodological form, can provide an interesting and novel basis for our understanding of screens. We ground our analysis in the ontology of Martin Heidegger's Being and Time [1927/1962], claiming that screens will only show themselves as they are if taken as screens-in-the-world. Thus, the phenomenon of screen is (...) not investigated in its empirical form or conceptually. It is rather taken as a grounding intentional orientation that conditions our engagement with certain surfaces as we comport ourselves towards them “as screens.” In doing this we claim to have opened up the phenomenon of screen in a new and meaningful way. (shrink)

Traditional human–computer interaction (HCI) allowed researchers and practitioners to share and rely on the ‘five E’s’ of usability, the principle that interactive systems should be designed to be effective, efficient, engaging, error tolerant, and easy to learn. A recent trend in HCI, however, is that academic researchers as well as practitioners are becoming increasingly interested in user experiences, i.e., understanding and designing for relationships between users and artifacts that are for instance affective, engaging, fun, playable, sociable, creative, involving, meaningful, exciting, (...) ambiguous, and curious. In this paper, it is argued that built into this shift in perspective there is a concurrent shift in accountability that is drawing attention to a number of ethical, moral, social, cultural, and political issues that have been traditionally de-emphasized in a field of research guided by usability concerns. Not surprisingly, this shift in accountability has also received scarce attention in HCI. To be able to find any answers to the question of what makes a good user experience, the field of HCI needs to develop a philosophy of technology. One building block for such a philosophy of technology in HCI is presented. Albert Borgmann argues that we need to be cautious and rethink the relationship as well as the often-assumed correspondence between what we consider useful and what we think of as good in technology. This junction—that some technologies may be both useful and good, while some technologies that are useful for some purposes might also be harmful, less good, in a broader context—is at the heart of Borgmann’s understanding of technology. Borgmann’s notion of the device paradigm is a valuable contribution to HCI as it points out that we are increasingly experiencing the world with, through, and by information technologies and that most of these technologies tend to be designed to provide commodities that effortlessly grant our wishes without demanding anything in return, such as patience, skills, or effort. This paper argues that Borgmann’s work is relevant and makes a valuable contribution to HCI in at least two ways: first, as a different way of seeing that raises important social, cultural, ethical, and moral issues from which contemporary HCI cannot escape; and second, as providing guidance as to how specific values might be incorporated into the design of interactive systems that foster engagement with reality. (shrink)

The purpose of this essay is to: (1) detail how recent trends in philosophical theory have made it possible for philosophers of technology to critically discuss technology transfer; (2) demonstrate that economic standards of assessment are conducive to obscuring the hidden tradeoffs that technological practices, such as mobile phone use in Bangladesh, can engender; and (3) provide the basis of an alternative model that can reflexively addresses dimensions of technology transfer that neo-classical economic accounts occlude.

This article offers a discussion of the connection between technology and values and, specifically, I take a closer look at ethically sound design. In order to bring the discussion into a concrete context, the theory of Value Sensitive Design (VSD) will be the focus point. To illustrate my argument concerning design ethics, the discussion involves a case study of an augmented window, designed by the VSD Research Lab, which has turned out to be a potentially surveillance-enabling technology. I call attention (...) to a “positivist problem” that has to do with the connection between the design context and the use context, which VSD seems to presuppose, and I argue that it is necessary to clearly distinguish between the two, since the designers’ intentions do not always correspond with the users’ practice; in fact, the relation between design and use is very complex and principally unpredictable. Thus, a design theory must accept that foresight is limited to anticipation rather than prediction. To overcome the positivist problem, I suggest a phenomenological approach to technology inspired by Don Ihde’s concept of multistability. This argument, which is general in nature and thus applies to any theory of design ethics, is intended as a constructive criticism, which can hopefully contribute to the further development of design ethics. (shrink)

The purpose of this article is a critical reflection on the field of educational administration and its varied and often conflicting epistemologies. It is argued that the field of educational administration is a community of diverse epistemologies. Although epistemological heterogeneity has been persistently vilified by both theorists and pragmatists with their own discursive agendas, it is this precise environment of critical dialogue and diversity that is conducive to new frontiers in the field. A phenomenology of recognition is thus presented as (...) a showcase for the possibility of approaching and expanding the field topically rather than treatise-like generalizations at the macro level, which are mostly dated discussions on philosophy of science. The principal value of the article is showing alternative pathways—not limited to the discussions about theory of recognition—to new frontiers in educational administration by demonstrating the possibility of thematic theory developments in the field and defending the diversity of existing epistemologies in the field as an asset rather than a liability for further development in the field. (shrink)

This paper outlines the background and significance of philosophy of technology as a focus of inquiry emerging within nursing scholarship and research. The thesis of the paper is that philosophy of technology and nursing is fundamental to discipline development and our role in enhancing health care. It is argued that we must further our responsibility and interest in critiquing current and future health care systems through philosophical inquiry into the experience, meaning and implications of technology. This paper locates nurses as (...) important contributors to the use and integration of health care technology and identifies nursing as a discipline that can provide specific insights into the health experience of individuals, cultures and societies. Nurses are encouraged to undertake further examination of epistemological, ontological and ethical challenges to arise from technology as a focus of philosophical inquiry. The advancement of philosophy of technology and nursing will make a profound contribution to inquiry into the experience of technology, the needs of humanity and the development of appropriate health care. (shrink)

In this paper, I argue that AI-powered voice assistants, just as all technologies, actively mediate our interpretative structures, including values. I show this by explaining the productive role of technologies in the way people make sense of themselves and those around them. More specifically, I rely on the hermeneutics of Gadamer and the material hermeneutics of Ihde to develop a hermeneutic lemniscate as a principle of technologically mediated sense-making. The lemniscate principle links people, technologies and the sociocultural world in the (...) joint production of meaning and explicates the feedback channels between the three counterparts. When people make sense of technologies, they necessarily engage their moral histories to comprehend new technologies and fit them in daily practices. As such, the lemniscate principle offers a chance to explore the moral dynamics taking place during technological appropriation. Using digital voice assistants as an example, I show how these AI-guided devices mediate our moral inclinations, decisions and even our values, while in parallel suggesting how to use and design them in an informed and critical way. (shrink)

Contemporary privacy debates regarding new technologies often define privacy in terms of control over personal information such that the privacy “problem” is a lack of control and the privacy “solution” is increased control. This article questions the control-paradigm by pointing to its parallels with earlier debates in the philosophy of technology regarding technology that was out-of-control. What first-generation philosophers of technology understood was that at the root of the questioning of technology lay a need to question the modern self itself. (...) Legal debates regarding privacy renew the importance of this question, for the control-paradigm perpetuates a view of the self as an individual with an inner core transparent to itself on solitary introspection and revealed to others through self-conscious acts of disclosure. Increasingly, this model fails to account for the challenges raised by new technologies and calls for rethinking. (shrink)

The integration of technology in care is core business in nursing and this role requires that we must understand and use technology informed by evidence that goes much deeper and broader than actions and behaviours. We need to delve more deeply into its complexity because there is nothing minor or insignificant about technology as a major influence in healthcare outcomes and experiences. Evidence is needed that addresses technology and nursing from perspectives that examine the effects of technology, especially related to (...) increasing demands for efficiency, the relationship of technology to nursing and caring, and a range of philosophical questions associated with empowering people in their healthcare choices. Specifically, there is a need to confront in practice the ways technique influences care. Technique is the creation of a kind of thinking that is necessary for contemporary healthcare technology to develop and be applied in an efficient and rational manner. Technique is not an entity or specific thing, but rather a way of thinking that seeks to shape and organize nursing activity, and manage efficiently individual difference(s) in care. It emphasizes predetermined causal relationships, conformity, and sameness of product, process, and thought. In response is needed a radical vision of nursing that attempts in a real sense to ensure we meet the needs of individuals and their community. Activism and advocacy are needed, and a willingness to create a certain detachment from the imperatives that technique demands. It is argued that our responsibility as nurses is to respond in practice to the errors, advantages, difficulties, and temptations of technology for the benefit of those who most need our assistance and care. (shrink)

Based on a survey of some popularintroductory anthologies and texts, I arguefrom my experience as a philosopher oftechnology that environmental philosophy mightbe conceived by some researchers in the fieldin terms of an overly narrow theoreticalfoundation. Many of the key figures in thefield take as a basic assumption that theenvironmental crisis is fundamentally bestexplained in terms of some failing in themetaphysical outlooks of most people. However,philosophers of technology typically present atleast two additional types of generalexplanation of the crisis. Environmentalethicists might benefit (...) from consideration ofthese alternative ways of explaining the rootcauses of the ecological crisis. (shrink)

The concept of innovation defines our age. It fuels the global economy, promises a sustainable future, and stands at the heart of our interconnected society. On the one hand, the concept of innovation is widely presupposed in terms of the commercial value it generates. As claimed in the tradition of economic analysis, innovation is characterized by its competitive dynamics and primarily directed at developing marketable products and services. On the other hand, the reality of today’s global issues, such as climate (...) change and food security, urges innovation to generate societal value beyond mainstream economic incentive. To this end, the EU policy discourse has paved the way for Responsible Innovation. The core idea here is to steer innovation processes towards societally desirable outcomes, specifically in response to the ‘grand challenges’ of our time. Under the sway of ‘science with and for society’, the hypothesis is that innovation can only respond to the needs and ambitions of society by including all its actors throughout the process. However, while much effort is dedicated to governing innovation, little thought goes to what innovation itself means conceptually. What understanding of innovation underpins the framework of RI? What implications, if any, does this have for the ambition to achieve RI? These are important questions to raise as they enable critical reflection on the relation between responsibility and innovation, broadly speaking. Does the ‘R’ in RI entail an application of ethical keys to an already existing concept of innovation, or does it require us to rethink the concept of innovation altogether? After providing a general introduction in chapter 1 on the context of the dissertation and its main research objectives, chapter 2 shows how RI emerged from a longer history of efforts to incorporate ethical dimensions in new and emerging technologies, such as Technology Assessment and Science and Technology Studies. While similar to its precursors in prioritizing ethical concerns, RI clearly distinguishes itself by shifting from an ethics of constraints to an ethics of construction. The chapter continues to show that such an approach comes with an epistemic challenge, a political challenge, and a conceptual challenge. Through an extensive analysis of policy documents and academic literature, chapter 3 breaks open the concept of innovation in the RI discourse. Firstly, it demonstrates that the RI discourse tends to presuppose a techno-economic concept of innovation, as coined by the terms ‘technological innovation’ and ‘commercialized innovation’. Secondly, it provides a historical analysis to show that the concept of innovation was originally politically oriented and had little to do with the way in which it is commonly understood today. Thirdly, it discusses the implications of a techno-economic concept of innovation for achieving the ideal of RI and brings into question whether the political origins of innovation may inspire an alternative route. Chapter 4 engages with the philosophy of technology to assess the feasibility of RI at both an ontic and ontological level. While innovation at the ontic level refers to concrete innovative artefacts, innovation at the ontological level refers to the mode through which these artefacts are seen, understood, and created. At the ontic level, RI is shown to play a significant role in steering emerging technologies towards societally desirable outcomes. Even so, at the ontological level, the question is whether the ideal of RI is feasible insofar its scope is limited to governing a techno-economic concept of innovation. Parallel to Martin Heidegger’s view of technology as Enframing, this chapter denotes that in trying to govern a techno-economic concept of innovation, the RI discourse remains subject to its dominance. This in turn explains why, at the operational level, RI is often employed for mere strategic and instrumental purposes, while falling short on its promoted ambitions. Chapter 5 articulates an orientation shift from a techno-economic concept of innovation towards a political concept of innovation in the RI discourse. To this end, the chapter distinguishes between weak RI, which seeks to govern a techno-economic concept of innovation through an applied set of ethical dimensions; and strong RI, which seeks to conceive a political concept of innovation beyond techno-economic ideology and practice. Inspired by the work of Hannah Arendt, the chapter establishes a political concept of innovation that actualizes the human capacity for speech and action, inspires radical novelty, and empowers the public sphere. In doing so, the chapter concludes that strong RI is principally a plural undertaking which guards individual opinion from collective opinion; enables a physical and symbolic openness that genuinely activates citizenry; and stimulates performative speech. The final chapter, chapter 6, briefly recaps the main research objectives and takes stock of the insights gained. It concludes that the contribution of this dissertation does not reside in the concern with the techno-economic ideology of innovation as such – a concern which RI in fact already expressed when it first emerged – but more so in the ontological critique to the idea that this ideology can somehow be overpowered through governance and regulation. The rehabilitation of an ontological dimension in RI in turn provides a new perspective to the philosophy of technology, which over the years has taken a course away from ontological viewpoints. Moreover, the chapter elaborates on how a political concept of innovation adds depth to the foundational claims of RI. Based on these conclusions, the chapter reflects on a range of broader insights, particularly in relation to the philosophy of innovation and the ethics of socially disruptive technologies. In sum, this dissertation politicizes the RI discourse precisely in the way it was originally envisioned, that is, through conceptualizing innovation as a fundamentally political matter. In this view, politics is not merely an extension of RI but is itself the condition of RI; it is what enables innovation to genuinely serve the public good. (shrink)

Research Question: What are patients’ experiences of technology in adult intensive care? Research Objectives: -To explore patients’ perceptions of receiving care in a technological environment -To explore patients’ perceptions of how technology has influenced their experience of care Background: Technology is fundamental to the physical recovery of critically ill patients in intensive care (ICU), however, there is a suggestion in the literature that its presence may dehumanise patient care and distract the nurse from attending to patients’ psychosocial needs. Little attention (...) has been paid to patients’ perceptions of receiving care in a technological environment. The purpose of this research, therefore, was to explore patients’ experiences of technology and care within ICU. Methods: This study was informed by Heideggerian phenomenology. The research took place in a university hospital in England. Nineteen participants who had been a patient in ICU were interviewed using a semi-structured approach. Interviews were transcribed verbatim and analysed utilising Van Manen’s framework. Findings: Resulting themes were ‘My Useless Body’ which describes how participants experienced their body as dysfunctional, disconnected and invaded by technology, ‘Making Sense of It’, which describes how participants rationalised their experiences by constructing a story, and ‘Technology and Care’, which describes how and why participants endured technologies in ICU. Conclusions: The disintegrated body is central to the critically ill’s experiences in ICU. Families play an important role in helping patients make sense of their experiences by filling in gaps in memory and helping them to sort the real from unreal memories. Families therefore require support and information resources in fulfilling this role. Patients experience technology and care as a series of paradoxical relationships: alienating yet reassuring, uncomfortable yet comforting, impersonal yet personal. Nurses maintaining a close and supportive presence and providing personal comfort and care may minimise the invasive and isolating potential of technology. (shrink)