Introduction
Social Studies of Medical Technology
there aren’t many which address the issues of technology
The Routinization of Technology Use
new therapy is novel--upsets the ruitine at first, front page news--causes a social change as it becomes accepted
A Case Study of Therpautic Plasma Exchange (TPE)
vast increase in use occured before any evidence of its effectiveness--
Contasting Views: "Experimental" vs. "Routine" Treatment Setttings
physicians like new toys
rutine stuff is dramatically less interesting--the physicians don’t even bother with it--but just because it is rutine does not mean it’s perfect
role of paitents/nurses/phsyicains changes durring the transition from experimental to rutine
The Development of Ward Rituals
rituals for begining, ending, middle are all different for different places--not strictly dependent on the technicalities
rituals disguise the uncertainties about the saftey and outcome of the treatment--create an atmosphere of "normal" operations
Physicians and TPE: Research or Therapy?
nurses--treatment; physicians--research
the data becomes the meaningful reality to the physician, not the outcome
A Moral Imperative for Treatment
moral imperative to provide the rutine treatment overrides concerns about safety and efficacy
Implications: Technology in Health Policy and Bioethics
routinization speeds the "percived meaning of a new therapy from expierimental to standard"
more scientific evaluations do not appropriately asses the strenght of this technological imperitive
reports of initial sucess are very influential
cost
patient’s voice