Robotic surgery, human fallibility, and the politics of care.

摘要

"Robotic Surgery, Human Fallibility, and the Politics of Care" leverages the methods and theoretical paradigms of performance, visual, and new media studies to explore the contradictions, aspirations, and failures of modern technologized medicine. In particular, I consider the use of robots in the operating rooms of a large research hospital. "University Hospital" illuminates a contemporary articulation of human bodies and robotic technology that focuses and amplifies existing and emergent tensions and contradictions in modern medicine's investment in providing both care and cure. Intuitive Surgical, Inc.'s da Vinci Surgical System provides a "platform" for this exploration, both as a concrete, material, and particular assemblage of hardware, software and human wetware, and as a technology that offers a specific and perhaps more productive vantage point---a modest step stool---for understanding the contemporary politics of surgical pedagogy and practice. I locate the dVSS in a broader context of ambivalence that surgeons experience with regard to the manual practices of their craft, an ambivalence amplified by the increasing sophistication and automation of surgical tools and the changing ontologies of surgical practice. The surgical interface of the dVSS prosthetically enhances---as well as displaces and replaces---embodied surgical skill. At a time when all facets of medical care grapple with the problem of medical error, I outline an emergent sensibility of machinic virtuosity, articulated to both human and robotic surgical practice alike, geared toward addressing and overcoming the perceived pitfalls of human fallibility. Rather than simply enacting a technological dehumanization of medicine, robotic surgery suggests a more complicated terrain where the nature of the human and the machine bleed into each other. What I term the "becoming machine" of the surgeon and the "becoming surgeon" of the medical device occurs on the cutting edge of the robot-surgeon interface. The implications of this emergent medical sensibility are far from clear or unilateral. In closing, I reflect on the uncertain impact of the ideal of machinic virtuosity on the politics of care. This reflection considers software and machine ethics alongside medicine's aspiration to manage contingency according to the "procedurality" of medical and surgical protocols.