Liao and Carbonell argue that medical devices are often not merely biased, but rather materialize oppression through the perpetuation of oppression into the present and future (Liao and Carbonell 2...

The purpose of cultural competence education for medical professionals is to ensure respectful care and reduce health disparities. Yet as Berger and Miller (2021) show, the cultural competence framework is dated, confused, and self-defeating. They argue that the framework ignores the primary driver of health disparities—systemic racism—and is apt to exacerbate rather than mitigate bias and ethnocentrism. They propose replacing cultural competence with a framework that attends to two social aspects of structural inequality: health and social policy, and institutional-system activity; (...) and two psychological aspects of structural inequality: the clinical encounter, and the epistemic. -/- We agree with the structural approach. To that end, we think it would be fruitful to include attention to physical contributors to structural inequality, namely the material artifacts used in medicine. Devices, tools, and technologies can materialize biases, perpetuate oppression, and contribute to health disparities. Granted, not everything that interests philosophers can be squeezed into medical education. Nevertheless, there are compelling reasons for including the study of material artifacts in education designed to reduce health disparities. First, devices and tools often carry forward biases from the past, and keep biases hidden from plain sight. Second, by studying these artifacts, future clinicians can begin to see themselves as part of a larger sociotechnical system. Finally, as medicine becomes increasingly tech-laden, it’s important for clinicians to see how material artifacts (including algorithms) connect individuals to structures. This will help to undermine oversimplified narratives according to which objective tools and technologies can correct for the bias and subjectivity of flawed human beings. (shrink)

Shen-yi Liao and Vanessa Cabonell’s “Materialized Oppression in Medical Tools and Technologies,” joins the long list of groundbreaking papers whose importance is obscured by an innocuous title. Som...

Liao and Carbonell discuss the role of (supposed) racial differences and racism in two medical devices: pulse oximeters and spirometers. They show that what might seem like cases of mere bias, are...

Biomedical practice can encode and perpetuate oppressive ideologies. This encoding and perpetuation, scholars like Liao and Carbonell (2023) convincingly argue, can occur not only via social practi...

Many digital technologies, designed and controlled by intensive data-driven corporate platforms, have become ubiquitous for many of our daily activities. This has raised political and ethical concerns over how they might be threatening our personal autonomy. However, not much philosophical attention has been paid to the specific role that their hyper-designed (sensorimotor) interfaces play in this regard. In this paper, we aim to offer a novel framework that can ground personal autonomy on sensorimotor interaction and, from there, directly address how (...) technological design affects personal autonomy. To do this, we will draw from enactive sensorimotor approaches to cognition, focusing on the central notion of habits, understood as sensorimotor schemes that, in networked relations, give rise to sensorimotor agency. Starting from sensorimotor agency as a basis for more complex forms of personal autonomy, our approach gives us grounds to analyse our relationship with technology (in general) and to distinguish between autonomy-enhancing and autonomy-diminishing technologies. We argue that, by favouring/obstructing the enactment of certain (networks of) habits over others, technologies can directly act upon our personal autonomy, locally and globally. With this in mind, we then discuss how current digital technologies are often being designed to be autonomy-diminishing (as is the case of “dark patterns” in design), and sketch some ideas on how to build more autonomy-enhancing digital technologies. (shrink)

Medical devices with built-in bias can both result from, and contribute to, harmful systemic racial oppression—a point that Liao and Carbonell (2023) argue convincingly in the target article of thi...

Often a physician’s first introduction to a patient is not a physical encounter but a review of their chart. A glaring “violence risk” flag in an Electronic Medical Record (EMR) is often noticeable...

Liao and Carbonell explore how oppressive medical technologies constitute materiality insofar as they reflect past oppression, embody oppression in the present day, and carry oppression into the fu...

Liao and Carbonell point out that much of the danger embedded in “materialized oppression” derives from the fact that the essence of that marginalized oppression may not be overt. It can often rece...

Liao and Carbonell’s (2023) article, “Materialized Oppression in Medical Tools and Technologies” directs our attention, not to new cutting edge medical technologies, but to the pulse oximeter and t...

Berger and Miller argue that contemporary medical education directed toward “cultural competency” fails to address the structural inequities and systemic racism underpinning health dispariti...