Engineering flesh : towards professional responsibility for 'lived bodies' in tissue engineering

Abstract

Engineering Flesh. Towards professional responsibility for ‘lived bodies’ in Tissue Engineering This study analyses the work of biomedical engineers as normative work that affects people’s daily lives as bodies. In biomedical engineering, engineers study bodies as machine-like objects and develop technologies from such a perspective. However, in daily life patients live their bodies not as machine-like but as themselves. Biomedical engineering can be said to involve normative work because it affects the way people experience and live their bodies. For example, imaging technologies used to follow the development of a foetus during pregnancy stimulate the perception of the foetus as an individual human being and change the related conceptions of good professional care and responsible parenthood. In this light, I raise the question as to how biomedical engineers can take and shape professional responsibility for this kind of normative work with respect to bodies. To study normative work in biomedical engineering, I have analysed the practice of tissue engineering (TE). In this practice, engineers rather literally make human body parts: TE has as objective to create living body part substitutes (e.g. skin, heart valves and bladders) by using cells. In the tradition of Science and Technology Studies (STS) I have studied normative work in TE empirically by following a specific TE project: namely, a TE heart valve project through participant observations, interviews and other fieldwork approaches. To be able to analyse how the practice of TE affects lived bodies I draw on work in the philosophical tradition of phenomenology. This tradition has as central concept ‘the lived body’ rather than the body as object. In this book I show how TE implies normative work for engineers: in the presentation of their work in terms of ‘mimicking nature’; in making standards for TE heart valves; and in developing networks to stimulate the further development of TE and to enable the implementation of TE. It becomes clear these activities are no neutral, technical activities but affect the opportunities for people as lived bodies in specific ways. Based on these findings, I conclude that professional responsibility for normative work in TE should not be limited to issues of functionality and safety of TE body parts, but should also be taken for the way TE affects how people might experience and live their bodies. To take this responsibility seriously, engineers should systematically learn about the effects of their normative work on lived bodies. To that purpose they should be in touch - not only with the results of experiments with bodies as machines, but also- with the results of their work for lived bodies. I end with the suggestion that a pragmatic model of ‘social learning’ offers opportunities to combine taking responsibility for engineering as normative work and learning about the effects of it for lived bodies.