Suchergebnisse

Part I Introduction: Theorizing the Resilience of Hybrid Bodies -- 1. Rematerializing the Cyborg: Understanding the Agency of People Living with Technologies inside Their Bodies -- 2. On Vulnerable Bodies, Transformative Technologies, and Resilient Cyborgs -- Part II Technogeographies of Resilience -- 3. Creating Material-Resilient Cyborgs: Sensing and Tuning Agencies of Pacemakers and Defibrillators -- 4. Passive Victims of Faulty Machines? Anticipating and Taming ICD Shocks -- 5. Wired-Heart Cyborgs and the Materiality of Everyday Life -- Part III Resilience and Difference -- 6. 'How Did You Get that Scar?': Gender and the Appropriation of Visibly Marked Bodies -- 7. How Age Matters: The Emotional Work of Younger and Older People Living with Defibrillators -- Part IV How Hybrid Bodies Fall Apart -- 8. "Should we turn off the pacemaker?": Trajectories of Dying and Geographies of Rights and Responsibilities -- 9. The Second Life of Pacemakers: Creating Resilient Implants and Infrastructures for Pacemaker Reuse in the Global South -- 10. Conclusions: Towards a Sociology of Resilient Cyborgs -- Index.

This article contributes to Science and Technology Studies on vulnerability by putting cyborgs at center stage. What vulnerabilities emerge when technologies move under the skin? I argue that cyborgs face new forms of vulnerability because they have to live with a continuous, inextricable intertwinement of technologies and their bodies. Inspired by recent feminist studies on the lived intimate relationships between bodies and technologies, I suggest that sensory experiences, material practices, and cartographies of power are important heuristic tools to understand the vulnerabilities of hybrid bodies. Based on an analysis of how patients in the Netherlands and the United States cope with appropriate and inappropriate implantable cardioverter defibrillator shocks, I describe how defibrillators introduce two new kinds of vulnerabilities: vulnerability as an internal rather than an external threat, and as harm you may try to anticipate but can never escape. Despite these vulnerabilities, some heart patients don't position themselves as passive victims of faulty machines. They actively engage in material practices of resilience by using magnets to stop inappropriate shocks. I conclude that anticipating and taming the improper working of technologies inside bodies constitutes a new form of invisible labor that is crucial to diminishing the existential uncertainties of cyborgs.

Recently there has been a renewed interest in cyborgs, and particularly in new and emerging fusions of humans and technologies related to the development of human enhancement technologies. These studies reflect a trend to follow new and emerging technologies. In this article, I argue that it is important to study 'older' and more familiar cyborgs as well. Studying 'the old' is important because it enables us to recognize hybrids' embodied experiences. This article addresses two of these older hybrids: pacemakers and implantable cardioverter defibrillators inserted in the bodies of people suffering from heart-rhythm disturbances. My concern with hybrid bodies is that internal devices seem to present a complex and neglected case if we wish to understand human agency. Their 'users' seem to be passive because they cannot exert any direct control over the working of their devices. Technologies inside bodies challenge a longstanding tradition of theorizing human–technology relations only in terms of technologies external to the body. Cyborg theory is problematic as well because most studies tend to conceptualize the cyborg merely as a discursive entity and silence the voices of people living as cyborgs. Inspired by feminist research that foregrounds the materiality of the lived and intimate relations between bodies and technologies, I argue that creating these intimate relations requires patients' active involvement in sustaining their hybrid bodies. Based on observations of these monitoring practices in a Dutch hospital and interviews with patients and technicians, the article shows that heart cyborgs are far from passive. On the contrary, their unique experience in sensing the entangled agencies of technologies and their own heart plays a crucial role in sustaining their hybrid bodies.

Dominant discourses on telecare technologies often celebrate the erasure of distance and place. This paper provides a critical intervention into these discourses by investigating how spaces still matter, despite the move from physical to virtual encounters between healthcare professionals and patients. I argue that science and technology studies (STS) research on telecare, as well as other technologies, can be enriched by including a focus on place to understand the dynamic interactions between people and things. Adopting insights of human geographers, I show how places in which technologies are used affect how technologies enable or constrain human actions and identities. Whereas some spaces may facilitate the incorporation of technologies, others may resist technologies. A focus on how places matter is important for understanding how telecare technologies reorder and redefine healthcare. Although other healthcare technologies are also important actors in transforming healthcare, telecare technologies do this in a very specific way: they redefine the spatial dimensions of healthcare. To capture and further explore this changing spatial configuration of healthcare, I introduce the notion of technogeography of care. This concept provides a useful heuristic to study how places matter in healthcare. Although telecare technologies introduce virtual encounters between healthcare providers and patients, the use of telecare devices still largely depends on locally grounded, situated care acts. Based on interviews with users of several cardiac telecare applications, including healthcare professionals and patients in Germany and the Netherlands, the paper shows how patients' homes and public spaces are important for shaping the implementation and use of telecare technologies, and vice versa. Last, but not least, telecare devices are implicated as well. The paper emphasizes the place-dependency of the use and meaning of technical devices by showing how the same technological device can do and mean different things in different places.

Since the 1960s, the predominance of modern contraceptive drugs for women has disciplined men and women to delegate responsibilities for contraception largely to women. Consequently, contraceptive use came to be excluded from hegemonic masculinity. The weak alignment of contraceptive technologies and hegemonic masculinities constitutes a major barrier for technological innovation in contraceptives for men. Based on an analysis of two large-scale clinical trials of hormonal contraceptives for men organized by the World Health Organization (WHO) in the late 1980s and early 1990s, the article shows how the development of new contraceptives for men requires a renegotiation of masculine identities. Technological innovation in contraceptive technology is, thus, not only a story about the making of a new technology, it is also a story about constructing masculine identities.

In the last fifteen years, testing has attracted much attention in science and technology studies. Most researchers have focused almost exclusively on testing in the laboratory, specifically designed test locations, and, for medical technologies, the clinic. What counts as testing has largely been described in terms of the activities of scientific experts. This is not to say that science and technology studies have completely neglected other institutional discourses. Journalistic texts have been a favorite research site for scholars in science and technology studies, particularly those seeking to understand the dynamics of public controversies on science and technology. Although most constructivist studies of science and media relations have treated journalistic texts as secondary to scientific texts, other scholars have dismissed this hierarchy. In this article, scientific texts and journalistic texts are considered equally important locations in which to analyze the testing of technologies. Based on a case study on the testing of a new contraceptive technology for men, the article shows that what counts as successful testing is not solely in the hands of scientific experts. In the case of male contraceptive technologies, journalists have contested the claims of scientific experts, particularly their claims about the cultural feasibility of the new technology.

Il est difficile aujourd'hui de concevoir un univers sans hormones. Il nous faut remonter le temps pour trouver des mondes auxquels elles soient inconnues. Imaginons un paisible dimanche après-midi, à la fin du 19e siècle. Des femmes sont en train de commenter les derniers événements marquants. Si nous pouvions surprendre leur conversation, nous aurions un aperçu détaillé, intime, de la manière dont elles affrontaient la vie de tous les jours. Peut-être aurions-nous la chance de saisir des confidences sur leurs grossesses, leurs accouchements. Nous ne saurons jamais quels mots précis elles employaient alors, mais une chose est sûre : elles ne parlaient pas d'hormones pour expliquer leur existence car le terme n'existait pas. Le concept d'hormone fut forgé en 1905 et ce n'est qu'une vingtaine d'années plus tard que l'industrie pharmaceutique se lança dans la production massive de ces substances. De nos jours, des millions de femmes suivent des traitements hormonaux et bien des gens se réfèrent au modèle hormonal pour expliquer la physiologie et le comportement féminins. Actuellement, des hormones comme les oestrogènes et la progestérone sont les médicaments les plus utilisés de toute l'histoire de la médecine (Wolffers et al., 1989).

Studies of laboratory work have rarely focused on the role of intermediary organizations in developing R&D activities. Most studies focus on a single university-based research laboratory or an industrial R&D unit. Moreover, the rejection by social constructivist scholars of universalistic, deterministic explanations of the development of science and technology has led to an overemphasis on the local features of scientific and technological work. Based on a case study of the role of the World Health Organization (WHO) in contraceptive R&D, this paper suggests that an analysis of the role of intermediary organizations enables us to go beyond a too-narrow focus on the micro-sociological dynamics of laboratory work, to include the macro-and meso-sociological dimensions of science and technology. First, a focus on intermediary organizations enables us to learn more about the manner in which locally specific laboratory cultures are transformed into translocal research practices. This paper shows how literary technologies, and to an even greater extent material technologies, are important tools in accomplishing standardization of local laboratory cultures. Second, a focus on intermediary organizations enables us to study how concerns that go beyond the laboratory - in this case, population control policies and the agenda of the WHO - help to shape laboratory practices.

Studies of drug development have described the role of clinical trials in the selection of drug profiles. This article presents a case study of the development of hormonal drugs in the 1920s and 1930s to illustrate that clinical trials have a more extensive role than is assumed. Clinical trials are instrumental in mediating the relationships between the pharmaceutical industry, the laboratory, and the clinic, resulting in a network of actors collectively creating medical knowledge, drugs, and markets for these drugs.