Although it is now generally acknowledged that new biomedical technologies often produce new definitions and sometimes even new concepts of disease, this observation is rarely used in research that anticipates potential ethical issues in emerging technologies. This article argues that it is useful to start with an analysis of implied concepts of disease when anticipating ethical issues of biomedical technologies. It shows, moreover, that it is possible to do so at an early stage, i.e., when a technology is only just (...) emerging. The specific case analysed here is that of 'molecular medicine'. This group of emerging technologies combines a 'cascade model' of disease processes with a 'personal pattern' model of bodily functioning. Whereas the ethical implications of the first are partly familiar from earlier -- albeit controversial -- forms of preventive and predictive medicine, those of the second are quite novel and potentially far-reaching. (shrink)

This paper praises and criticizes Peter-Paul Verbeek's What Things Do . The four things that Verbeek does well are: remind us of the importance of technological things; bring Karl Jaspers into the conversation on technology; explain how technology "co-shapes" experience by reading Bruno Latour's actor-network theory in light of Don Ihde's post-phenomenology; develop a material aesthetics of design. The three things that Verbeek does not do well are: analyze the material conditions in which things are produced; criticize the social-political design (...) and use context of things; and appreciate how liberal moral-political theory contributes to our evaluation of technology. (shrink)

Public “upstream engagement” and other approaches to the social control of technology are currently receiving international attention in policy discourses around emerging technologies such as nanotechnology. To the extent that such approaches hold implications for research and development (R&D) activities, the distinct participation of scientists and engineers is required. The capacity of technoscientists to broaden the influences on R&D activities, however, implies that they conduct R&D differently. This article discusses the possibility for more reflexive participation by scientists and engineers in (...) the internal governance of technology development. It reviews various historical attempts to govern technoscience and introduces the concept of midstream modulation, through which scientists and engineers, ideally in concert with others, bring societal considerations to bear on their work. (shrink)

This paper praises and criticizes Peter-Paul Verbeek's What Things Do. The four things that Verbeek does well are: remind us of the importance of technological things; bring Karl Jaspers into the conversation on technology; explain how technology "co-shapes" experience by reading Bruno Latour's actor-network theory in light of Don Ihde's post-phenomenology; develop a material aesthetics of design. The three things that Verbeek does not do well are: analyze the material conditions in which things are produced; criticize the social-political design and (...) use context of things; and appreciate how liberal moral-political theory contributes to our evaluation of technology. (shrink)

The Body Multiple is an extraordinary ethnography of an ordinary disease. Drawing on fieldwork in a Dutch university hospital, Annemarie Mol looks at the day-to-day diagnosis and treatment of atherosclerosis. A patient information leaflet might describe atherosclerosis as the gradual obstruction of the arteries, but in hospital practice this one medical condition appears to be many other things. From one moment, place, apparatus, specialty, or treatment, to the next, a slightly different “atherosclerosis” is being discussed, measured, observed, or stripped away. (...) This multiplicity does not imply fragmentation; instead, the disease is made to cohere through a range of tactics including transporting forms and files, making images, holding case conferences, and conducting doctor-patient conversations. The Body Multiple juxtaposes two distinct texts. Alongside Mol’s analysis of her ethnographic material—interviews with doctors and patients and observations of medical examinations, consultations, and operations—runs a parallel text in which she reflects on the relevant literature. Mol draws on medical anthropology, sociology, feminist theory, philosophy, and science and technology studies to reframe such issues as the disease-illness distinction, subject-object relations, boundaries, difference, situatedness, and ontology. In dialogue with one another, Mol’s two texts meditate on the multiplicity of reality-in-practice. Presenting philosophical reflections on the body and medical practice through vivid storytelling, The Body Multiple will be important to those in medical anthropology, philosophy, and the social study of science, technology, and medicine. (shrink)

There might not be a specific nano-ethics, but there definitely is an ethics of new & emerging science and technology (NEST), with characteristic tropes and patterns of moral argumentation. Ethical discussion in and around nanoscience and technology reflects such NEST-ethics. We offer an inventory of the arguments, and show patterns in their evolution, in arenas full of proponents and opponents. We also show that there are some nano-specific issues: in how size matters, and when agency is delegated to smart devices. (...) Our overall approach is a pragmatist ethics, and we conclude that struggle (and learning) might be more productive than models emphasizing consensus. (shrink)

Diagnostic devices do more than just passively register facts. They intervene in the situations in which they are put to use. The question addressed here is what this general remark may imply in specific cases. To answer this question a specific case is being analysed: that of the blood sugar measurement device that people with diabetes may use to monitor their own blood sugar levels. This device not only allows the patients concerned to better approach normal blood sugar levels, but (...) alters what counts as normal in the first place. Using the device may shift people's attention away from their physical sensations towards the numbers measured, but it may also help them to increase their own physical self-awareness. Self-monitoring finally (something that the devices have made possible) makes patients less dependent on professionals, but it requires them to engage in self-disciplining and binds them to the outcomes of their measurement activities: their own blood sugar levels. (shrink)

Most known technology serves to ingeniously adapt the world to the physical and mental limitations of human beings. Humankind has acquired awesome power with its rather limited means. Nanotechnological capabilities further this power. On some accounts, however, nanotechnological research will contribute to a rather different kind of technological development, namely one that changes human beings so as to remove or reduce their physical and mental limitations. The prospect of this technological development has inspired a fair amount of ethical debate. Here, (...) proponents and opponents of such visions of human enhancement are criticized alike for engaging in speculative ethics. This critique exposes a general pattern that extends to other nano-, bio-, or neuroethical debates. While it does not apply to all discussions of “enhancement technologies” it does apply to all ethical discourse that constructs and validates an incredible future which it only then proceeds to endorse or critique. This discourse violates conditions of intelligibility, squanders the scarce and valuable resource of ethical concern, and misleads by casting remote possibilities or philosophical thought-experiments as foresight about likely technical developments. In effect, it deflects consideration from the transformative technologies of the present. (shrink)

This article offers a contrast between European and US-American approaches to the convergence of enabling technologies and to associated issues. It identifies an apparently paradoxical situation in which regional differences produce conflicting claims to universality, each telling us what can and will happen to the benefit of humanity. Those who might mediate and negotiate these competing claims are themselves entangled in the various positions. A possible solution is offered, namely a universalizable strategy that aims to disentangle premature claims to unity (...) and universality as in the case of the greater "efficiency" of nanomedicine. This is the strategy by which Science and Technologies Studies (STS) can analytically tease apart what it has helped produce and sustain in the first place. The virtues and limits of this strategy are briefly presented, deliberation and decision-making under conditions of productive disillusionment recommended. (shrink)

In the wake of the emergence and rapid development of nanoethics there swiftly followed fundamental criticism: nanoethics was said to have become much too involved with speculative developments and was concerning itself too little with actually pending questions of nanotechnology design and applications. If this diagnosis is true, then large parts of nanoethics are misguided. Such fundamental criticism must surely either result in a radical reorientation of nanoethics or be refuted for good reasons. In this paper, I will examine the (...) critics’ central arguments and, building on this scrutiny, formulate an answer to these alternatives. The results lead to conclusions which allow explaining and unfolding the thesis of this paper that instead of speculative nanoethics we should better speak of and develop explorative philosophy of nanotechnology. (shrink)

Although it is now generally acknowledged that new biomedical technologies often produce new definitions and sometimes even new concepts of disease, this observation is rarely used in research that anticipates potential ethical issues in emerging technologies. This article argues that it is useful to start with an analysis of implied concepts of disease when anticipating ethical issues of biomedical technologies. It shows, moreover, that it is possible to do so at an early stage, i.e. when a technology is only just (...) emerging. The specific case analysed here is that of ‘molecular medicine’. This group of emerging technologies combines a ‘cascade model’ of disease processes with a ‘personal pattern’ model of bodily functioning. Whereas the ethical implications of the first are partly familiar from earlier—albeit controversial—forms of preventive and predictive medicine, those of the second are quite novel and potentially far-reaching. (shrink)

In this article we briefly summarize how converging technologies challenge elements of the existing symbolic order, as shown in the contributions to this special issue. We then identify the vision of ‘life as a do it yourself kit’ as a common denominator in the various forms of convergence and proceed to show how this vision provokes unrest and debate about existing moral frameworks and taboos. We conclude that, just as the problems of the industrial revolution sparked off the now broadly (...) established ideal of sustainability the converging technologies should be governed by the ideal of ‘human sustainability’. The essence of this ideal is formed by the ongoing discussion about the extent to which we may, or should want to, ‘make’ our environment and ourselves, and when it is better to simply accept what is given and what happens to us. (shrink)