Introduction

The history of technology1 has usually been transmitted in Europe and North America as an heroic tale about the conquest of the enemy, whether this be aspects of the human or natural worlds—a narrative of progress, and of the betterment of social life in general. This has been characterized as the Standard View of technology (Pfaffenbergger, 1992), one which assumes that necessity is the mother of invention, causing humans to produce tools, devices, and artifacts that permit us, we believe, increasingly rational, autonomous, and prosperous lives, liberated from the constraints imposed by individual biology, oppressive human enemies, and the environment.

It has been suggested that inherent to the Standard View are two sets of tacit meanings that at first glance appear to be contradictory. The first assumes that the relationship of humans to technology is too obvious to need examination. Organizations, industries, technicians, craftspeople, and so on simply make things that are in themselves neither good nor bad. The second approach, one of technological determinism, conceives of technology as a powerful and autonomous agent, inherent to progress, and therefore by definition an unquestionable good, but that inevitably dictates the form to be followed by human social life (see, for example, Heilbroner, 1967).

Marshall Sahlins (1976) takes a very different approach. For him neither technologies nor the human t Lock

"needs" they are devised to alleviate should be conceptualized as autonomous, but must inevitably be understood as embedded in cultures and histories. Cultural analyses of technology are concerned with the attribution of meaning to technologies and their application, and hence with "entrenched moral imperatives" (Pfaffenberger, 1992, p. 506). The politics of national, community, and individual identity making is intimately associated with the development, global transfer, and implementation of socio-technical artifacts and systems. Pfaffenberger concludes that "when we examine the 'impact' of technology on society, we are talking today about the impact of one kind of social behavior on another" (Pfaffenberger, 1988). For him technology is "humanized nature," and inseparable from both political relationships and the culturally informed meanings associated with it.

It has been shown repeatedly that artifacts, including biomedical technologies, can be introduced successfully to new cultural settings without a simultaneous adoption of the logical use originally associated with them (Lock & Kaufert, 1998; Van Der Geest & Reynolds Whyte, 1988). New meanings and social relations coalesce around transported artifacts, whatever the direction of their travel.2 This is not an argument for the autonomy of artifacts (or for that matter for the autonomy of culture), but rather for their inherent heterogeneity as social objects. Alternatively, some artifacts and technologies, notably when they threaten entrenched values, are actively rejected, or after attempted adoption fail to take root or their use is severely restricted.

Disputes among politicians, scientists, clinicians, and activists within any given location often take place over access to and distribution of technologies. Breast cancer activists have, for example, lobbied hard for increased research and technological developments in connection with this disease, forcing the hand of politicians (Kaufert, 1998). The governments of many countries with few economic resources, often to the consternation of Western trained physicians and the World Health Organization (WHO), encourage pharmacologists, traditional practitioners, or even itinerant vendors of medicine, to diagnose diseases and prescribe medicine, thereby economizing dramatically on health care expenditure (Van Der Geest & Reynolds Whyte, 1988). Several of the best documented examples of cultural dissonance in connection with biotechnology transfer have to do with contraceptive and reproductive technologies, and with AIDS prevention (Epstein, 1996; Ginsberg & Rapp, 1995; Lock & Kaufert, 1998). For example, the technology that identifies the sex of a fetus has been applied in some locations to systematically practice selective abortion of female fetuses.

For anthropologists, it is technologies in practice— their differential development, transfer, and application, relationship to politics and economics, national interests, and dominant values, and their impact on individuals, communities, and societies at large—that is of over-riding concern. Also of considerable interest is the relationship of the technologies of biomedicine to indigenous technologies. Inevitably the ethnographic approach is central to such research; further more, the culture concept is almost without exception drawn on either explicitly, or else is implicitly assumed to be an influential force in individual and community responses to technologies, both indigenous and those that are imported. This entry will be confined largely to such research.

It is not possible to make a comprehensive coverage of the anthropology of biomedical technologies, as even a cursory glance at journals such as Medical Anthropological Quarterly will show. Notably absent is recent research into new techno/visual representations of the body, including the emerging field of telemedicine (Csordas, 2000; Sinha, 2000; Taylor, 2000). Nor does space permit an evaluation of how politics and values are implicated in the development and application of specific biomedical technologies while others are never supported.

Coverage of the rich literature produced by sociologists of science that has direct relevance to the conceptualization and development of technologies and their implementation is also absent (see, for example, Berg, 1997; Berg & Mol, 1998; Cambrosio & Keating, 1995; Latour, 1999; Timmermans, 1999).

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