Some critiques of cybermedicine claim that it is problematic because it fails to create physician–patient relationships. But, electronically mediated encounters do create such relationships. The issue is the nature and quality of those relationships and whether they are conducive to good patient care and meet the ethical ideals and standards of medicine. In this paper, I argue that effective communication and compassion are, in most cases, necessary for the establishment of trusting and morally appropriate physician–patient relationships. The creation of these (...) relationships requires patients and physicians to take psychological and emotional risks and to make commitments to each other. The problem is that by altering the form and content of verbal and non-verbal behaviors and by limiting the kinds of interactions that can take place, cybermedicine makes risk-free interactions easier and more commonplace and retards the development of physician compassion and patient trust. In doing so, cybermedicine encourages morally inappropriate physician–patient relationships. I argue that Merleau-Ponty''s notion of embodiment and Kierkegaard''s criticisms of disinterested reflection help us to understand how cybermedicine can undermine patient health and well being and why it should be seen as a possible threat to the moral integrity of physician–patient relationships. (shrink)

Focusing on the interactions between people suffering from neuromuscular diseases and their wheelchairs, the author raises the question of action: how is action made possible for people suffering from neuromuscular diseases? Starting with actor-network theory, the author shows that action not only results from distribution and delegation to heterogeneous entities but emerges from hard and lengthy work that makes the relation between them possible and transforms the entities involved. The author describes this work, called the process of adjustment, as work (...) on the links making a person, his or her body, and his or her world. Through this work, new possibilities of action emerge for the person, but also new abilities; the person’s identity is transformed and shaped. This analysis leads to a particular conception of the person as made up through his or her relations to other entities. (shrink)

This article argues that autistic people occasionally experience greater comfort from imposed routines than from a yielding form of love and understanding, which I will call naive humanism. Collins's theory of action, with its attention toward the achievements residing in a reductionist approach, can help to point out the flaws of a naive humanistic stance. It would, however, be a mistake to stop at this point and remain satisfied with the problem-solving capacity of such a reductionist stance. In a ward (...) for autistic youths, the risk of cruelty resides in a purely mechanistic stance as much as in a naive humanistic approach. Thus, the social context of care of autistic people urges us to question the scope of a traditional scheme of thought, which cherishes a deep distinction between humans and machines. (shrink)

According to policy makers, telemedicine offers “huge opportunities to improve the quality and accessibility of health services.” It is defined as diagnosis, treatment, and monitoring, with doctors and patients separated by space but mediated through information and communication technologies. This mediation is explored through an ethnography of a U.K. teledermatology clinic. Diagnostic image transfer enables medicine at a distance, as patients are removed from knowledge generation by concentrating their identities into images. Yet that form of identity allows images and the (...) expert gaze to be brought into potentially lifesaving proximity. Following Latour’s thread, images must be captured and then mobilized to the knowledge base, where they must be stabilized into standard diagnoses, then combined with different images, waiting lists, skin lesions, dermatologists, paper records, and beds, so that ultimately, outcomes are produced. This huge task requires new knowledges and a widening of agency that, if unacknowledged, may see telemedicine projects continue to founder. (shrink)