October 1972: Clare College welcomed its first women students, but men and their gadgets were very much in evidence. Chuck Berry sat at Number 1 with My Ding-a-Ling. Allan Alcorn had just released the world’s first video game (Pong). Thanks to Thomas Whitney, the world’s first scientific calculator had, overnight, rendered the slide-rule obsolete. Meanwhile, in healthcare, mainframe computers were just beginning to take up space in the accounts departments of hospitals, so around this time the first of many NHS chief executives must have made a claim he would later regret—that the latest technology would inevitably increase efficiency and save money. Fast-forward 50 years and we are living in a world of ubiquitous technologies. Most of us are naked without our smart phones. Technologies sometimes make us sick—but health technologies of various kinds also help diagnose us, monitor us, treat us, store and share our health data, connect us to our clinicians or our loved ones, prompt us to take our medication or complete our daily 10,000 steps, guide our doctors to manage our illness in evidence-based ways, enable medical research to be conducted on us, and much much more.
The aim of this lecture is not to gallop the audience through an eclectic timeline of technologies introduced in the healthcare sector over the last half-century. Rather, I want to talk about how technologies in healthcare have been theorised. In particular, I will show how the work of scholars—many but by no means all of them women—who have drawn on feminist theories (and the critical social sciences more generally) have built an interdisciplinary field of scholarship that explicitly decentres technologies in favour of a focus on such things as socio-technical systems and the technology-assisted lived body. These critical perspectives reject deterministic, technology-as-superhero discourses which depict particular new technologies as causing particular benefits (for patients, for clincians, for the health service) in a politically and morally neutral way. But they also reject the Luddite ‘cold technology/ warm care’ dualism which depicts an inevitable trade-off between good care and technological progress, making us set in our ways and fearful of innovation. Using a range of empirical examples, I will show how such perspectives take us infinitely farther than a technology-on v technology-off randomised controlled trial.
Trish Greenhalgh OBE, a medical doctor, is Professor of Primary Care Health Sciences and Director of the Interdisciplinary Research In Health Sciences research group at the University of Oxford. Her 35-year academic career was kick-started when she transferred temporarily from Medical Sciences to Social and Political Sciences as a Clare undergraduate in the late 1970s. She now leads a programme of research at the interface between social sciences and medicine, with a particular focus on innovation and new technologies. She is the author of over 400 peer-reviewed academic papers and 16 books, sits on numerous advisory groups in UK and internationally, and is a member of Independent SAGE.