Technology and Medical Practice: Blood, Guts and Machines (review)

Ericka Johnson and Boel Berner’s edited volume provides a critical examination of the relationship of medical practices to medical technologies. All of the authors in this text attempt to use feminist science studies coupled with science and technology studies to unpack the role of new medical technologies in social, cultural, political, and economic relationships; they problematize the notion that medical technologies can be used universally across all bodies and the belief that practitioners and bodies (sometimes as patients, sometimes as representations of patients) can be passive actors in the construction of these medical technologies.

The book is divided into three parts: in “Judging Bodies” the authors look at how medical practices and technologies interact to create certainty/ uncertainty about the human body and its (ab)normal function(s); “Simulating Bodies” focuses on the development of patient substitutes—simulators—that are meant to teach medical students and practitioners the feel of the human body through various synthetic means; and in “Linking Bodies and Machines” human-machine hybrids and ideas about human-ness and machine-ness are situated within localized networks of artifacts, patients, and professional medical practices. Using different methodologies (ethnography, discourse analysis, etc.), the authors disassemble the thoughts, actions, techniques, and beliefs built into medical technologies and practices.

Though the sites of study are quite diverse, at its core, this edited volume cohesively develops important perspectives on the ways in which to study medicine as it is practiced with new technologies and as its practitioners negotiate their relationships with medical devices. For example, part 2, “Simulating Bodies,” opens with Rachel Prentice’s ethnographic research at a medical informatics laboratory that was building a gynecological surgical simulator. Her work provides a lens through which to better understand “the construction of surgical knowledge by following how researchers construct a digitally and mechanically mediated relationship between hands and patient” (p. 80). Her study of the creation of haptically enabled machines—those that try to mimic the feel of surgery, the pressure needed to puncture skin with a scalpel, or the different resistances of various tissues—demonstrates the complexities encountered when trying to translate physical sensations into mathematically modeled and responsive computer systems. More important, though, it gives an intimate sense of the surgical experience and the dynamic and multifaceted relationships that surgeons have with machines that are meant to function as extensions of their bodies, of their skills. Prentice, like the rest of the authors, is pushing beyond the confines of current scholarship in order to create a much more nuanced account of technological experiences in the frame of medical practices.

The degree to which the authors bring together feminist science studies and science and technology studies varies. Jenny Sundén’s analysis of a simulated, parturient body is much more of a feminist critique of technology, of technological systems, and of analytical categories (the editors call her piece a “feminist intervention” [p. 76]) than it is a study of the utility of using the two theoretical frameworks at the core of this volume in conjunction. Ericka Johnson’s piece, which looks at the “validation” of a gynecological exam simulator in one country (the United States) and its virtual rejection in another (Sweden), merges ideas about agential reality with a deconstruction of the different styles of a supposedly “universal” gynecological examination in different national contexts, employing both theoretical frameworks. On the whole, most authors, like Johnson, are able to integrate feminist science studies and science and technology studies seamlessly in their analyses, demonstrating the power of such a theoretical composite.

As Lucy Suchman notes in her epilogue, “in the case of modern biomedicine, the legibility and accessibility of the body are mediated through the machine” (p. 203) and a closer examination of the relationship between machines and bodies in contemporary biomedicine is essential for patients and practitioners to negotiate modern medical practice. Johnson and Berner’s edited volume is, overall, an insightful exploration of issues at the interface of...