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. 2023 Apr;23(4):9-23.
doi: 10.1080/15265161.2022.2044543. Epub 2022 Mar 9.

Materialized Oppression in Medical Tools and Technologies

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Materialized Oppression in Medical Tools and Technologies

Shen-Yi Liao et al. Am J Bioeth. 2023 Apr.

Abstract

It is well-known that racism is encoded into the social practices and institutions of medicine. Less well-known is that racism is encoded into the material artifacts of medicine. We argue that many medical devices are not merely biased, but materialize oppression. An oppressive device exhibits a harmful bias that reflects and perpetuates unjust power relations. Using pulse oximeters and spirometers as case studies, we show how medical devices can materialize oppression along various axes of social difference, including race, gender, class, and ability. Our account uses political philosophy and cognitive science to give a theoretical basis for understanding materialized oppression, explaining how artifacts encode and carry oppressive ideas from the past to the present and future. Oppressive medical devices present a moral aggregation problem. To remedy this problem, we suggest redundantly layered solutions that are coordinated to disrupt reciprocal causal connections between the attitudes, practices, and artifacts of oppressive systems.

Keywords: Philosophy; biotechnology; gender/sexuality; health policy; race and culture/ethnicity; regulatory issues.

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