Abstract
To understand the merging of humans with technologies, STS and post-phenomenology have developed a rich vocabulary and heuristics, including entanglement, human-machine unions, and incorporation. Although this conceptual vocabulary is very important for understanding how the technologically transformed body comes into being and is enacted in everyday life, technologies inside bodies pose another challenge to theorizing body-technology relations. How are we to understand human-technology relations in which technologies should not entangle with bodies because they serve other purposes? For wired heart cyborgs, activities such as passing security controls at airports, or using electromagnetic machines, electrical domestic appliances and electronic devices, and even intimate contacts with their loved ones, can turn into events where the proper functioning of their devices may be at risk. Moreover, people having tele-defibrillators are at risk of being hacked. Anticipation of potentially harmful events and situations thus becomes an important part of the choreography of everyday life. To capture the active engagement involved in avoiding such intertwinement, I introduce the term ‘disentanglement work,’ that is, work involved to prevent entanglements with objects and people that may inflict harm upon devices implanted in bodies. This chapter explores what forms of disentanglement work are enacted during physical encounters with objects and people and which responsibilities emerge during these interactions.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
https://www.stin.nl, Accessed 3 March 2016; https://stanfordhealthcare.org/medical-treatments/i/icd.html. Accessed 22 November 2015.
- 2.
Four of the patients I interviewed did not have any experiences with passing security gates because they could not afford to travel by airplane or belonged to the generation that did not travel at all.
- 3.
https://www.stin.nl/reizen-met-een-icd/luchthavenbeveiliging.htm. Accessed 30 March 2016.
- 4.
Misfits also occur at hospitals because people living with internal heart devices are not allowed to be diagnosed with MRI scans or treated with surgical electrocautery.
- 5.
- 6.
http://www.amazon.com/Detector-Pacemaker-Health-Alert-Device/dp/B000L0Q2X4. Accessed 30 March 2016.
- 7.
Leaflet ‘Important Safety Instructions’ included in the package of the Bose Soundlink Bluetooth Speaker.
- 8.
www.stin.nl. Accessed 30 March 2016.
- 9.
www.inspire.com/groups/sudden-cardiac-arrest-association/discussions/. ICD response to static. 29 July 2013.
- 10.
See note. 6.
- 11.
www.inspire.com/groups/sudden-cardiac-arrest-association/discussions/. ICD Noise. Posted 24 September 2011. Accessed 29 March 2016.
- 12.
The metal case of pacemakers and ICDs is inserted just beneath the skin in a so-called pocket, a space created between the muscles usually beneath the left collarbone.
- 13.
www.inspire.com/groups/sudden-cardiac-arrest-association/discussions/.Now about our kids. Posted 25 August 2012. Accessed 30 March 2016.
- 14.
www.inspire.com/groups/sudden-cardiac-arrest-association/discussions/.Now about our kids. Posted 28 August 2012. Accessed 30 March 2016.
- 15.
Franceschi-Bicchierai (2017).
- 16.
- 17.
During the patient information meeting I observed at the heart policlinic in Amsterdam, any discussion of the potential risks of hacking was absent as well.
- 18.
The only regulation that seems to be in place in the US is that device manufacturers should include an ‘information security analysis’ when they apply for FDA approval for bringing new pacemakers and ICDs to the market.
- 19.
The FDA had been informed about this risk of hacking by a cybersecurity firm that had previously been involved in a lawsuit with the same manufacturer for disclosing vulnerabilities in the software of pacemakers (Hern 2017).
- 20.
Interview ICD patient 10; interviews pacemaker patients 1, 3, 4, 8, and 11. In a survey conducted among patients of the heart policlinic where I did my fieldwork, 50% of the respondents reported that they did not want to use a remotely monitored ICD (Interview cardiologist 2012).
- 21.
For a similar observation, see Bjorn and Markussen (2013, 26).
- 22.
Pacemakers and defibrillators run on so-called proprietary, or closed-source, software for which the device manufacturers retain intellectual property rights (Wikipedia. Source code. Accessed 19 February 2019).
- 23.
People living with pacemakers and ICDs are not allowed to engage in full contact sports such as boxing, and deep-sea diving is also not allowed, while those with defibrillators are forbidden to work as professional taxi drivers, driving instructors, or couriers (Anonymous 2013).
Bibliography
Adams, V., Murphy, M., & Clarke, A. (2009). Anticipation: Technoscience, life, affect, temporality. Subjectivity, 28, 246–265.
Anderson, G. (2010). Chronic conditions: Making the case for ongoing care. Chronic care in America: A 21st century challenge. Robert Wood Johnson Foundation & Partnership for Solutions: Johns Hopkins University, Baltimore. http://www.rwjf.org/en/library/research/2010/01/chronic-care.html. Accessed 8 May 2017.
Anonymous. (2013). Code 1010 en de bedoeling van de wetgever. STIN Journaal, 1, 33.
Arndt, R. Z. (2017). Abbott recall signals new era in medical-device cybersecurity. http://www.modernhealthcare.com/article/20170901/NEWS/1709009986. Accessed 5 Sept 2017.
Baglieri, S., & Shapiro, A. (2012). Disability studies and the inclusive classroom: Critical practices for creating least restrictive attitude. London/New York: Routledge.
Bates, D. (2006). Could hackers attack the newest heart monitors? http://www.defibrillator-help.com/pl/hackers.htm. Accessed 13 Feb 2012.
Bjorn, P., & Markussen, R. (2013). Cyborg heart: The affective apparatus of bodily production of ICD patients. Science and Technology Studies, 26(2), 14–28.
Blume, S. (2010). The artificial ear: Cochlear implants and the culture of deafness. New Brunswick: Rutgers University Press.
Brown, N., & Webster, A. (2004). New medical technologies and society: Reordering life. Cambridge/Malden: Polity Press.
Brune, J., & Wilson, D. J. (Eds.). (2013). Disability and passing. Philadelphia: Temple University Press.
Casper, M. J., & Morrison, D. R. (2010). Medical sociology and technology: Critical engagements. Journal of Health and Social Behavior, 51(S), 120–132.
Clarke, A. E., Shim, J. K., Mamo, L., Fosket, J. R., & Fishman, J. R. (2003). Biomedicalization: Technoscientific transformations of health, illness, and U.S. biomedicine. American Sociological Review, 68(2), 161–194.
Dalibert, L. (2014). Posthumanism and somatechnologies: Exploring the intimate relations between humans and technologies. PhD thesis, University of Enschede, Enschede.
Dalibert, L. (2016). Living with spinal cord stimulation: Doing embodiment and incorporation. Science, Technology & Human Values, 41(4), 635–659.
de Cock, C., et al. (2010). Remote monitoring and follow-up of cardiovascular implantable electric devices in the Netherlands: An expert consensus report of the Netherlands society of cardiology. Netherlands Heart Journal, 20(2), 53–65.
Dubin, A. M., Batsford, W. P., & Lewis, R. J. (1996). Quality of life in patients receiving implantable cardioverter defibrillators at or before age 40. Pacing Clinical Electrophysiology, 19, 1555–1559.
FDA. (2017). Class 2 device recall accent family of pacemakers. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRes/res.cfm?ID=158779. Accessed 5 Sept 2017.
Fox, N. J. (2012). The body. Cambridge/Oxford/Boston/New York: Polity Press.
Franceschi-Bicchierai, L. (2017). Why we should worry about hackable hearts. https://motherboard.vice.com/En-US/article/why-we-should-worry-about-hackable-hearts. Accessed 3 Apr 2017.
Garland-Thomson, R. (2011). Misfits: A feminist materialist disability concept. Hypatia, A Journal of Feminist Philosophy, 26(3), 591–609.
Garland-Thomson, R. (2014). The story of my work: How I became disabled. Disability Studies Quarterly, 34(2), n.p.
Goodwin, D. (2008). Refashioning bodies, reshaping agency. Science, Technology & Human Values, 33(3), 345–363.
Haddow, G., King, E., Kunkler, I., & McLaren, D. (2015). Cyborgs in the everyday: Masculinity and biosensing prostate cancer. Science as Culture, 24(4), 484–506.
Haraway, D. (1985). Manifesto for cyborgs: Science, technology and socialist feminism in the 1980s. Socialist Review, 80, 65–108.
Haraway, D. (1991). Simians, cyborgs and women: The reinvention of nature. London: Free Association Books.
Haraway, D. (2008). When species meet. Minneapolis: University of Minnesota Press.
Hazelton, A., et al. (2009). Coping with my partners’ ICD and cardiac disease. Circulation: American Heart Association, 120, e73–e76.
Helmreich, S. (2013). Potential energy and the body electric: Cardiac waves, brain waves and the making of quantities into qualities. Cultural Anthropology, 54(7), 139–148.
Hern, A. (2017). Hacking risk leads to recall of 500,000 pacemakers due to patient death fears. https://www.theguardian.com/technology/2017/aug/31/hacking-risk-recall-pacemakers-patient-death-fears-fda-firmware-update. Accessed 5 Sept 2017.
Ihde, D. (1990). Technology and the lifeworld: From garden to earth. Bloomington: Indiana University Press.
Jacob, S., et al. (2011). Clinical applications of magnets on cardiac rhythm management devices. EP Eurospace, 13(9), 1222–1230.
Kaiser, K., et al. (2007). Cancer as a ‘we-disease’: Examining the process of coping from a relational perspective. Families, Systems & Health, 25(4), 4004–4018.
Khandelwal, S. (2017). Over 8,600 vulnerabilities found in pacemakers. http://thehackernews.com/2017/06/pacemaker-vulnerability.html. Posted at June 5, 2017. Accessed 5 Sept 2017.
Kolota, G. (2013, October 29). The implant was fatal, at least on TV. New York Times, p. 5.
Latour, B. (1993). We have never been modern. Cambridge, MA: Harvard University Press.
Lehoux, P. (2006). The problem of health technology: Policy implications for modern health care systems. New York/London: Routledge/Taylor & Francis.
Lettow, S. (2011). Somatechnologies: Rethinking the body in philosophy of technology. Techne, 15(2), 110–117.
Mabo, P., Victor, F., Bazin, P., et al. (2012). A randomized trial of long-term remote monitoring of pacemaker recipients (the COMPAS trial). The European Heart Journal, 33(9), 1105–1111.
Machulis, K. (2011). Hacking into my heart’s device’s data. http://icdusergroup.blogspot.nl. Accessed 8 Apr 2014.
Makaryus, J. N., et al. (2014). Inappropriate implantable cardioverter-defibrillator shocks attributed to alternating-current leak in a swimming pool. Texas Heart Institute Journal, 41(1), 61–63.
Marsman, D. (2014). We gaan op reis en nemen mee. STIN Journaal, 2, 15.
Mauldin, L. (2016). Made to hear: Cochlear implants and raising deaf children. Minneapolis: University of Minnesota Press.
Moe, M. (2016a). Go ahead hackers. Break my heart. https://www.wired.com/2016/go-ahead-hackers-break-heart/. Accessed 3 Apr 2017.
Moe, M. (2016b). I want to know what code is running inside my body. https://backchannel.com/i-want-to-know-what-code-is-running-inside-my-body-ff9a159da34b. Accessed 3 Apr 2017.
Mol, F. (2014). Mag ik dit; mag ik dat? Technici geven antwoord op uw vragen. STIN Journaal, 3, 27.
Morrison, D. R., & Bliton, M. J. (2011). Exploring layers of meaning with deep brain stimulation patients. Journal AJOB Neuroscience, 2(1), 26–28.
Mulcahy, M. (2009). Wireless pacemaker talks to cardiac specialist via Internet. www.gizmag.com/wireless-pacemaker-internet-monitoring/12549/picture/90493/. Accessed 13 Feb 2012.
Nederlandse Hartstichting. (2012). Pacemaker. Brochure voor patiënten.
Pollock, A. (2008). The internal cardiac defibrillator. In S. Turkle (Ed.), The inner history of devices (pp. 98–110). Cambridge, MA: MIT Press.
Rose, N., & Novas, C. (2003). Biological citizenship. In A. Ong & S. Collier (Eds.), Blackwell companion to global anthropology (pp. 439–463). Oxford: Blackwell.
Shuren, J. (2011). A town hall meeting with the FDA: Democracy at work. http://icdusergroup.blogspot.nl. Accessed 8 Apr 2014.
Siebers, T. (2008). Disability and the theory of complex embodiment – For identity politics on a new register. In T. Siebers (Ed.), Disability theory (pp. 278–297). Ann Arbor: The University of Chicago Press.
Slatman, J. (2012). Phenomenology of bodily integrity in disfiguring breast cancer. Hypatia, A Journal of Feminist Philosophy, 27(2), 281–300.
Slatman, J., & Widdershoven, G. (2010). Hand transplants and bodily integrety. Body & Society, 16(3), 69–92.
Sobchack, V. (2004). Carnal thoughts: Embodiment and moving image culture. Berkeley: University of California Press.
Split, R. (2013). Voorwoord. STIN Journaal, 4, 3.
Standen, A. (2012). Patients crusade for access to their medical device data. https://www.npr.org/sections/health-shots/2012/05/28/153706099/patients-crusade-for-access-to-their-medical-device-data?t=1551099734168. Accessed 13 Feb 2012.
Vallance, C. (2015, December 3). Could hackers break my heart via my pacemaker? BBC Radio 4 News. http://www.bbc.com/news/technology-34899713. Accessed 5 Sept 2017.
van Harten, V. (2013). Zijn medische implantaten hackbaar? STIN Journaal, 1, 8.
van Noort, W. (2017). Half miljoen pacemakers blijken kwetsbaar voor hackers. Ook in Nederland moeten patiënten terug naar het ziekenhuis voor een update van hun pacemaker. www.NRC.nl. Accessed 5 Sept 2017.
Vazquez, L. D., et al. (2010). Sexual health for patients with an implantable cardioverter defibrillator. Circulation, 122, e465–e467.
Verbeek, P.-P. (2008). Intentionality: Rethinking the phenomenology of human-technology relation. Phenomenology and the Cognitive Sciences, 7(3), 387–395.
Webster, A. (2007). Health, technology & society. A sociological critique. Houndmills/Basingstoke/Hampshire: Palgrave Macmillan.
Westerhof, P. (2006). Mijn vliegreis zonder problemen. STIN website. Rubriek Reizen. Subsectie Reiservaringen. http://www.stin.nl. Accessed 8 May 2015.
Winance, M. (2010). Care and disability. Practices of experimenting, tinkering with, and arranging people and technological aids. In A. Mol, I. Moser, & J. Pols (Eds.), Care in practice: On tinkering in clinics, homes and farms (pp. 93–119). Bielefeld: Transcript Verlag.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2020 The Author(s)
About this chapter
Cite this chapter
Oudshoorn, N. (2020). Wired Heart Cyborgs and the Materiality of Everyday Life. In: Resilient Cyborgs. Health, Technology and Society. Palgrave Macmillan, Singapore. https://doi.org/10.1007/978-981-15-2529-2_5
Download citation
DOI: https://doi.org/10.1007/978-981-15-2529-2_5
Published:
Publisher Name: Palgrave Macmillan, Singapore
Print ISBN: 978-981-15-2528-5
Online ISBN: 978-981-15-2529-2
eBook Packages: Social SciencesSocial Sciences (R0)