Simon Dawes: You demonstrate in your article how bioengineers focus on the practicalities of their research and the prototype as the object of that research, and how they leave ethics and patients to surgeons, but you also emphasise the sense of ‘sociomoral’ responsibility that they share. Could you tell us about this, and explain how you see the difference between morals and bioethics among surgeons and bioengineers?
Lesley Sharp: Within contemporary clinical medicine—as practiced in the U.S., U.K., and elsewhere—the ethics of care are central to day-to-day practices (and professional training). For one, physicians often cite the importance to “do no harm” in the context of clinical care; when dilemmas arise, they may consult staff bioethicists. Within research contexts IRBs provide, again, standardized ways in which to think about the ethics of care (and experimentation, be it with human or animal subjects). The sociomoral responsibilities borne by bioengineers, however, are far less pronounced or even present. (Here within the U.S., for instance, it is a relatively new development to teach courses in the “ethics of engineering,” for example.) Engineers often understand their field as concerned primarily with substances and objects of human design; when “interfaced” with living, breathing subjects, the ethics of care—or the sociomoral consequences of their work—are understood as domains overseen by those who supervise patient care.
SD: Would you say that there has there been a shift from mechanical to computational terminology in the history of prostheses, and is there a metaphorical distinction between the way that prosthetic limbs (external devices) and organs (internal devices) are presented by the professionals who work with them? And how prevalent are military metaphors in such presentations?
LS: An interesting question. Within the context of my own research I most frequently encounter mechanical and not computational terminology, although this may spring from the fact that it is what most interests me. As for metaphorical thinking, I’m trained to assume that human bodies are never “mere” objects or things, but, rather, embody deeply embedded and sophisticated systems of symbolic thought. A well known aphorism within my discipline (derived from Mary Douglas) is that the body is a natural symbol.
SD: You point out that there is a tendency to represent recipients of prostheses as muscular, militarised (and male) bodies. To what extent can this be explained by the importance of Powerpoint in the presentation of contemporary conference papers, and the incursion of promotional logic and aesthetics into research and development?
LS: This tendency is especially pronounced within the U.S. (a nation whose history is dominated by involvement in wars and armed conflicts). I don’t think that the parameters of Powerpoint have any effect on this.
SD: The main focus of your article is on the absence of women in visualisations of heart devices among biomechanical engineering professionals, and you emphasise the limited number of women bioengineers as one of the reasons for this. Could it also have something to do with earlier assumptions about heart disease being a male problem? And is there a link between the invisible women in this professional discourse, and the invisible men in advertising and educational literature on illnesses such as cancer (where breast cancer is well illustrated but testicular cancer is not)? And what about race – are the recipients of heart devices represented as white males globally or just in the US?
LS: Actually, what I have sought to illustrate is that the absence of women in engineering is too simple an argument for explaining the absence of female bodies in the realm of artificial heart design; these two gendered developments are, however, entangled in a dialectic of sorts. Most certainly earlier assumptions of heart disease being primarily a male affliction has skewed engineers’ interests, yet one must ask why male bodies still proliferate in this domain when it’s well known that women, too, suffer heart disease and failure and when cardiologists clamour for devices suitable to women’s bodies. As for race—this is indeed a very complicated issue (and would probably require a second article). There is a very complex history in the U.S. involving exploitative renderings of nude bodies of people of color; more significantly, however, I think, is that access to cutting-edge health care is most frequently denied to the poor (and, at times by extension) people of color. This picture can shift, however, when experimental subjects are sought.
SD: You’ve written extensively on human organ transplants. How do you think the field has developed in recent years, and what do you think have been the most influential texts to have come out of it? Finally, could you also tell us a little about what you’re currently working on?
LS: This question would require a very lengthy answer—perhaps the best response would be the friendly suggestion that readers take a look at my book entitled Strange Harvest. My current research involves a comparative study of xenotransplantation and artificial heart design.
Lesley A. Sharp is Professor in Anthropology at BarnardCollege, and Senior Research Scientist in Sociomedical Sciences at the Mailman School of Public Health, ColumbiaUniversity. She is the author of Strange Harvest: Organ Transplants, Denatured Bodies and the Transformed Self (California, 2006) and Bodies, Commodities, and Biotechnologies: Death, Mourning and Scientific Desire in the Realm of Human Organ Transfer (Columbia, 2007). [email: firstname.lastname@example.org]
Simon Dawes is the Editor of the TCS Website and Editorial Assistant of Theory, Culture & Society and Body & Society