Biomedicine on Display

I’m thrilled by the fact that an historian of medicine (Richard Barnett of the Department of History and Philosophy of Science in Cambridge) will chair a panel debate on health care in the digital age (taking place in Cambridge, UK, on Thursday) — it sustains the tendency that historians of medicine are becoming more engaged in contemporary debates about the health care system; and almost always for the better.

Titled ‘Saved by SMS’, the panel debate is about a worldwide healthcare system in crisis and the future prospects of bringing health care practitioners and patients into the digital information age:

From tracking malaria drugs in the developing world by SMS, sharing information about disease outbreaks via social networking sites, to empowering patients and doctors to share diagnosis and treatment ideas, significant changes to the digital and social infrastructure of the global healthcare system could revolutionise the way we look after own health, and other peoples.

Bertalan Meskó (Science Roll) and others have been instrumental in putting medicine 2.0 on the agenda. Historians of medicine and medical museum could play a much more active role in these crucial discussions. The fact that Richard Barnett will chair the meeting on Thursday is a good sign — hopefully he will also infuse some historical perspective into the discussion.

Recently I announced a quiz to get more information about a historical syringe that a couple of friends had bought for me. This quiz was far from easy since we had no information on the syringe whatsoever. Medical Museion’s guest researcher and former chief physician Sven Erik Hansen was the first to make a suggestion on our Danish blog — he thought it might had been be used to treat haemorrhoids.

Sven Erik’s was a qualified guess, but it seems like the area of expertise that we are dealing with here is rather odontology. Thomas put a query about the syringe on rete, the mailing list for curators, historians, students, collectors, dealers, etc, interested in the history of scientific instruments, and immediately received some very interesting answers. First out was Frank Manasek: 

This type of syringe was common in dentistry or in minor surgery where local anesthetics (such as lidocaine) would be used. Later syringes of this style were designed to use disposable ampoules of anesthetic, and disposable needles. (This one predates both.) The needle on this example is long, suggesting its use in mandibular blocks.

Following Franks lead Alistair Kwan elaborated:

I was just about to write almost the same thing. The last time I asked a dentist about the move away from these, he said that patients are more scared of them because they are big and shiny, and harder to
keep out of sight — convenience and cost of disposables did not play into his decision, though they are primary issues in debates between surgeons, surgical nurses and hospital administrators.

If you compare with today’s common disposables, the plunger design involves a different handhold that increases control through tight spaces and increases pressure on the contents. If you try them out, you can experience how the palm-grip hold is much less subject to little wobbles in the finger and thumb joints. (A high-stability grip for the disposables is to wrap them in all four fingers of a fist, which limits where you can work.)

You can also experience how the palm-grip hold and the lighter two-finger hold are suited to injecting targets at different heights and orientations. You cannot comfortably inject straight down with the
palm grip hold unless you are leaning right over the patient. But your forearm is positioned for easy aiming sideways or forwards or upwards, as into the nerves in the mandibular joint.

For times when you want a pistol or palm grip (e.g. in veterinary medicine), there are handles for disposable syringes. The handles derive from earlier syringes in which they were inbuilt. In recent years (decades?) they have simply had the syringe removed, leaving a hollow or brackets in which to insert a disposable. Similarly with ring grips, now marketed for use by non-medical people with frail hands who need to administer to themselves or family members, and for cake decorating.

Easy disassembly makes cleaning easier but it sometimes owes more to manufacturing processes than concern for scrubbing and autoclaving. A device like this is often cheaper to mass-produce from standard stock than by building all components from scratch. If it goes together easily, it often follows that it comes apart easily as well. Today’s one-way barbed fasteners and sonic welders have of course
cancelled that rule.

Now what began as an artefact without a history suddenly had spawned a fascinating insight into the world of dentistry. Peter Morris continued (still on the rete list):

These syringes are still in very common use by dentists in the UK. I don’t recognise the disposables mentioned by Alistair. Personally I always try to avoid the jab if I can which provokes friction between me and the dentist. I would say the needle is a little bit thicker than it appears in the photograph, but it may just be a matter of the scale of the photograph (and the psychological effect of it going into your mouth). A quick look on the web throws up JS Dental Manufacturing Inc of Ridgefield Connecticut. I cannot find out how long it has been in business but it seems well established.

And back to Alistair:

I should clarify a bit though: the common disposables are less stable than the big dental model when used in the mouth owing to how they  have to be held. What I originally wrote (in a low-energy moment at the end of work yesterday) was unclear, though I’m sure that your exhibit writers will have no trouble doing better. (I’m now at the start of the day so am more critical of what I write!)

And that critical attitude might be what made Alistair return with one last comment:

It might also be worth indicating that some anaesthesia techniques begin with aspirating by withdrawing the plunger to suck a little on the tissue that the needle has entered. This tests whether you are in the right place: the colour of the liquid obtained indicates the extent of blood supply. If you get blood, you know to withdraw the needle and start again. (I find needle-guiding techniques very clever. Other common rules are to locate external markers for guidance, and to hit bone or a sudden resistance change as an indicator for depth. Some markers for mandibular anaesthesia are in the ear which is why the dentist puts his finger there — as target to aim for — while inserting the needle.)

Aspiration is reflected in some plunger handles: they have a ring for the thumb.

It’s more difficult to aspirate with pistol-grip and palm-grip syringes because pulling and pushing require different holds. That may entail having an assistant steady the patient’s head.

Following Peter’s post, I had a quick look at some on-line catalogues and saw that both metal and disposable plastic syringes are sold by dental equipment suppliers.

So thanks to our fellow histrorians and curators on the rete list, we’ve been able to construct a much more detailed curatorial story about the syringe than I ever imagined when I first posted the original quiz.

And so we need a winner. The stern panel of judges (who will remain anonymous) has decided to a name Alistair Kwan the winner. So Alistair, whenever you come to Copenhagen, please visit us here at Medical Museion and claim your prize.

As I’ve written about before, we have a small but excellent (and recently restored) collection of moulages here at Medical Museion. Like they have many places in Europe.

Which made me quite excited to read Jim Edmonson’s travel report from Paris and the Musée des moulages de l’hôpital Saint-Louis on Avenue Claude-Vellefaux:

Read more here.

A few months ago, I advertised the meeting ‘KörperGegenwart, neue Technologien, neue Sammlungen’ to be held at the Deutsches Hygiene-Museum in Dresden, 22-24 April.

Now the program has been finalised — and it looks very good! After a plenary discussion on ‘Schauplätze der Schönheit: Klinik, Kunst, Medien und Museen’ on Thursday evening, there follows two days of presentations, most of which seem to be very relevant for the future of medical and science museums:

• ‘Körperspuren im Deutschen Hygiene-Museum. Strategien und Objekte’ (Susanne Roeßiger, Deutsches Hygiene-Museum, Dresden)
• ‘Auf Biegen und Brechen. Zur (In)Formierung des Körpers’ (Stefan Rieger, Ruhr-Universität Bochum)
• ‘Der Körper und seine Teile. Vom Präparat zum transplantierten Organ’ (Katrin Solhdju, Zentrum für Literatur- und Kulturforschung, Berlin)
• ‘Vom Körper zum Maß. Zur Geschichte der Konfektionsgrößen’ (Daniela Döring, Humboldt-Universität zu Berlin)
• Vermessene Menschen. Vom Fingerabdruck bis zum Ganzkörperscan’ (Erika Feyerabend, BioSkop-Forum zur Beobachtung der Biowissenschaften e.V.)
• ‘Prothesen exponieren. Sichtbarkeiten neuer Technologien’ (Karin Harrasse, Kunsthochschule für Medien Köln)
• ‘Design in der Orthetik. Innovative Prinzipien der Körperanformung’ (Andreas Mühlenberend, resolutdesign; Hochschule Magdeburg-Stendal)
• ‘Wie sieht der bionische Mensch aus?’ (Friedrich Ditsch, Technische Universität Dresden)
• ‘”It’s a Material World”´: Situiertheit, Verkörperung und Materialität in der neueren Robotik’ (Jutta Weber, Universität Bielefeld)
• ‘Von der Nasen- zur Gesichtstransplantation: Zur Geschichte und Zukunft der kosmetischen Chirurgie’ (Sander L. Gilman, Emory University, Atlanta)
• ‘Science Fashion´: TechnoNaturen und deren alltagskulturellen Umdeutungen im System der Mode’ (Elke Gaugel, Akademie der Bildenden Künste, Wien)
• ‘Wie kommt die Seele ins Museum? Medizinische Museen und das Transzendentale’ (Robert Bud, Science Museum, London)
• ‘Den biomedizinischen Apparat ausstellen: Materialität und Digitalität in “Split + Splice” (Kopenhagen)’ (Susanne Bauer, Humboldt-Universität zu Berlin)
• ‘Die Schärfung des Blicks. Kunstinterventionen in anatomischen Sammlungen’ (Ingeborg Reichle, Berlin-Brandenburgische Akademie der Wissenschaften)
• ‘Körperwissen in der Kunst’ (Ute Meta Bauer, Massachusetts Institute of Technology, Boston)

As you can see, all presentations are in German — so the germanophilically challenged may have problems.

More here and here.

Sanjoy Bhattacharya (Reader at the Wellcome Trust Centre for the History of Medicine at UCL) invites us all to participate in a webinar organised in connection with the first event of the 2010 series of the World Health Organization Global Health Histories Seminars (you can see the full list of seminars here).

The topic of the webinar is ‘SARS: Learning from an epidemic of fear’, and it takes place this upcoming Wednesday 17 February, 12:30-2:30 pm (Central European Time):

The 2003 outbreak of SARS, a deadly new infectious disease, sparked worldwide alarm. It caused more than 8 000 cases and almost 800 deaths in at least 25 countries. Its spread was halted only by emergency international action.

In the opening presentation of this new seminar series, health psychologist Professor George Bishop describes his studies of how ordinary people respond to illness threats. He focuses particularly on the impact of SARS in Singapore, public responses to the epidemic, and the lessons learned.

Dr Cathy Roth, a WHO expert on the disease, explains the role of WHO in leading the struggle to contain this unprecedented threat.

The WHO’s webinar system only allows up to a thousand users logged-on simultaneously, so you’d better reserve access now — register here. After registering you will receive a confirmation email containing information about how to join.

Since the snow descended upon Copenhagen a month ago everybody has been walking around wrapped up in scarfs and woollen clothing, trying to avoid the snowdrifts. Personally, my thoughts wander off to a warmer place — more specifically Southern France, where I took some needed holiday last summer and visited, among other things, the two medical museums in Toulouse.

Being a foreigner in France is not easy. The lingua franca in France is French which can be quite a challenge if one is far from a native French speaker. Not many people in the region speak English, and all signs (even in museums) are written in the native tongue. That’s a shame — there is a fascinating culture and history to be told, but unfortunately much of this history is missed if one does not speak or read the language.

Using my terrible French with a lot of pardon and merci I finally made it to Le musée des instruments de médecine des Hôpitaux de Toulouse and Le musée d’histoire de la médecine de Toulouse. Both museums are situated right on the edge of the beautiful Pont Neuf bridge and the exhibition rooms are situated in the old hospital building, l’Hôtel-Dieu. When searching for travel directions I had stumbled on the Hôtel-Dieu but I did not understand exactly what it meant. Two quotes:

The common phrase necator pauperum or ‘assassin of the poor’ was used for those who neglected their duty to succour those in need and guilty prelates could lose their status as a result. The bishops therefore built xenodochia near their cathedrals, of hospitaliae at the entrance to the cities. The former gave shelter to the poor and the sick of the town, who were known as the matricularii and were registered and maintained by the church. The hospitaliae, also called ‘maison—Dieu’ or ‘hôtel-Dieu’ flourished during the Carolingian Renaissance and took in mainly pilgrims and travellers.

and:

Most of the present-day Hôtel-Dieu hospitals originate in the episcopal domus Dei or the domus pauperum.

(both from Frexinos 2001, p. 19; see reference below)

Why place a hospital in Toulouse? Well, the city is one the road to the famous pilgrimage site Santiago de Compostela. The pilgrims came from all over Europe to pray at the tomb of St. James, and for the keen observer the St. James’ shell (seen in the centre of the picture below) is a dead give away.

Here’s the old hospital of Toulouse. The museums are located in the left part of the building. In the centre of the picture one sees the St. James’ shell:

The two museums have slightly different focus. One is about medical history in general. When you enter the building you step into a general reception area, where posters give a general introduction to the history of the museum (at least I believe they do; no signs in English!). One thing that really speaks in favour of the museum is the friendly staff. Even though the receptionist didn’t speak a word of English she was very friendly and we did manage to communicate. At least our conversation went so well that I was handed a brief description of the collections in English. It reminded of how important a museum reception staff is; they make the first impression so it has to be a good one.

The museum basically consists of three showrooms. The first, and smallest one, is on pharmaceutical history. From a museological point of view it is not impressive. The objects are placed in their display cases with a short description of their use, but there is very little context to be found.

In the next showroom the objects are roughly divided into different specialities, such as surgery and obstetrics. This part of the museum is definitely the best. It’s quite small though. Some of these instruments are quite impressive and even though I had seen most of them before there was one that stood out — the tobacco cloister seen in the picture below. Sure I had seen cloisters before (we have some here at Medical Museion) but this type was new to me. I have told so many visitors in Copenhagen about how the cloister was used to rid the body of black gall, but this one was different. Normally you would have needed another person to use it, but this one was designed so that it could be self-administered. The patient simply straddled over the cloister, activated the pump and let the tobacco smoke act as a laxative:

I also fell very much in love with the beautiful object below (for more on Theriac see here):

The third part of the museum is situated in the basement, and I had a hard time figuring out exactly what the organising principle was. There was a microscope and some x-ray equipment but exactly what the connection was escaped me — maybe becuase I didn’t know the language well enough.

The other museum — Le musée des instruments de médecine des Hôpitaux de Toulouse — is placed in the same building and right next to the one on the medical history of Toulouse. It is disappointingly small: only one single room and a couple of podiums outside. The custodian was extremely nice, however, and between her English and my horrible French we did manage to get a conversation going.

The best part of the experience was the moulages:

Below is a selection of some of the other objects displayed:

Drills used to perform trepanation:

Pacemakers:

And an instrument used to perform an abortion (Thomas actually wrote about these kind of instruments a year ago):

Both museums were indeed interesting and there was a great feeling in the old historical buildings. One of the best things about my visit though was that I bought a book by Jacques Frexinos entitled The Hospitals of Toulouse. A Thousand Years of History (2001), an excellent introduction to the topic of hospital history. I strongly recommend you to get a copy before visiting the Toulouse museums (the French version can be bought here.)

Toulouse is a beautiful city and if one is interested in medical history I would recommend a visit. Not so much for the museological experience, but the objects in themselves are interesting.

At the picture above you can see the Pont Neuf and in the background the old hospital buildings that house the museums.

Last September, we announced the call for an upcoming meeting on digestive history in Dublin 30 April–1 May.

Now it has materialised with a programme. As expected most talks are about 19th and early 20th century, with one exception — Katherine Angel (Warwick University) who will speak about “A Very Simple Answer: Causal Reasoning in the Last Twenty Five Years of Peptic Ulcer”.

For more information or to register, contact michael.liffey@ucd.ie.

As mentioned in a previous blogpost, I’m currently doing a ph.d.-project here at Medical Museion concerning the history of the concept of successful aging in neuroscience and its relation to ideas on cognitive enhancement.

Part of my work, therefore, is going to conferences like this one, held in Copenhagen last week:

The conference was arranged by the Danish research center GNOSIS, and featured both neuroscientists and philosophers – as an attempt to bridge the disciplinary boundaries and maybe produce some kind of synergy.

The first day especially had that feeling. Themed under the headline ‘Brain Plasticity’ and featuring, among others, the English philosophical-minded neuroscientist Steven Rose, German phenomenological philosopher and psychiatrist Thomas Fuchs, and Danish biologist and anthropologist Andreas Roepstorff, there was a real feel of cross-disciplinary science communication. A science communication which was also a communication of the immense complexity of the brain and of the production of knowledge concerning it.

As Steven Rose pointed out, neuroscience is ‘data rich, but theory poor’, needing some theorizing on how best to manage the complexities of the huge amount of collected data. One common perspective to most of the talks at the conference were that the brain’s workings can best be understood viewed as a complex, irreducible and indeterminate, continuously developing process. This was conceptualized from both phenomenology, developmental systems theory (or autopoiesis, as Rose termed it), and biosemiotics – all in one way or the other emphasizing the brain as embodied (or the body as ‘embrained’, as someone smartly put it), and emphasizing the body’s embeddedness in the world (emworlded). Dichotomies and dualisms, determinacy and reductionism were (with maybe one exception) not only forcibly opposed, they were long left behind, it seemed.

But still there was a sense that, despite agreement on the general perspective, this did not solve the concrete methodological challenge of, for instance, going from correlates to causality, inducing from the particular to the common, or explaining the relationship between brain and mind/consciousness/awareness/attention etc. Neuroscience, it seems, brings new attention to a lot of old philosophical problems. The multidisciplinary collaborations within the field of neuroscience, and the demand for new theoretical developments and new conceptualizations, may not find a solution to these problems, but it sure sets the stage for interesting theoretical developments in the years to come.

As for the link to my project on successful aging, this development in neuroscience seems to run almost parallel to the overall development of the field of gerontology and aging research in the last couple of decades from around the time that the concept of successful aging was introduced. Many of the same philosophical problems are also seen in other parts of aging research than the parts including the neurosciences.

Aging research (as well as maybe most other fields in the health sciences?) is becoming a multidisciplinary field where dichotomies and dualisms between brain-mind, body-world, and individual-society are being tested and challenged.

Medical museums are usually full with old and new medical science instruments. But they tend to be kept in storage because it is difficult to display them in a meaningful way. It’s much easier to put moulages, pickled organs and surgical instruments on show. Medical science instruments usually need truckloads of description and contextualisaton to make sense in museum displays. (Probably because they don’t ‘talk’, some people would say :-)

Neither do many museum curators give much thought to the historicity of their display techniques. How have display practices changed over time and how do these practices reflect museum culture, politics and technologies?

Such question wil hopefully be discussed at the 29th symposium of the Scientific Instrument Commission, which will be held in Firenze, 4-9 October 2010 on the theme ‘Instruments on display’, i.e., how instruments have been presented in scientific collections, museums and permanent and temporary exhibitions throughout modern history up to the present:

Did didactic, scientific, celebrative, propagandistic and rhetorical considerations significantly influence the manner of displaying instruments? How were instruments presented in a Wunderkammer of the Renaissance, in a 18th-century cabinet or in a 19th-century exhibition? How and why are they shown in contemporary science museums?

This year’s symposium is sponsored and organized by Istituto e Museo di Storia della Scienza (Museo Galileo) and Fondazione Scienza e Tecnica. The meeting is open to “anyone interested in the history, preservation, documentation of use of scientific instruments”, whether academic scholars, curators, collectors or students.

Send abstract before 1 June, 2010 by filling in this template.
More info on the symposium website.

Speaking about Jim Edmonson and the Dittrick Museum (i.e., the medical museum at Case Western Reserve University in Cleveland), I’ve forgotten to tell you that they have just launched an institutional blog called — ‘Dittrick Museum’. Follow it here. Welcome to the medical museum blog sector!

The 23rd Nordic Medical History Congress will be held in Oslo, 25-27 May 2011. Contact Olav Hamran, Norwegian National Medical Museum (medisin@tekniskmuseum.no) for more info.

Just saw the early spring Monday seminar program at UCL’s STS department. I like the nice British analytical touch to it. Much more interesting than the usual fashionable Latouresque ANTsemiotics and other STS’ese sociolects. For example:

• Jeremy Howick, ‘When can we trust the experts? Defending the Evidence Based Medicine stance’, 25 January
• David Healy, ‘They used to call it Medicine’, 1 February
• Sam Schweber, ‘Writing the Biography of Hans Bethe’, 8 February
• Jane Gregory, ‘Producing the post-Fordist public, or: What is Science Communication for in a post-industrial society?’, 22 February
• Helena Sheehan, ‘What (if anything) has Marxism to contribute to science studies?’, 8 March
• Jeff Hughes, ‘Before the bomb: on writing the history of unclear physics’, 22 March

Wish I were in London more often, would love to discuss production of a post-Fordic public or hear Jeff unfold his ideas about ’unclear physics’ (no typo, it’s an intended joke, says Jon Agar, who sent the programme around).

This is the last part of my project description for the Ph.D.-project called “A genealogical study of the concept of ’successful aging’ and its relation to the idea of ‘human enhancement”. See the first two parts here and here.

 ’Successful aging’ in the neurosciences and the link to ‘cognitive enhancement’
In order to narrow the problem field, the project will look closely at how the notion of ‘successful aging’ has been understood and defined in the field of neuroscience in the last decades, and how ‘successful cognitive aging’ has played together with discussions — both in the scientific literature, in science policy documents and in general public discourse — about the possibility for so called ‘cognitive enhancement’ (‘neuro-enhancement’) [12][13][14][17]. Both in the scientific literature and in policy documents on ‘successful aging’ and ‘human enhancement’, the neurosciences are considered as the primary field of research; neuroscience also figures prominently in the corresponding public discourse [7][21][23], cf. [25]. The brain and cognition are ascribed significant cultural value in the emerging ‘knowledge society’; healthy cognitive abilities are considered necessary for a life-long contribution to the labour market and for well-being in everyday life, and not surprisingly some of the exponents for the notion of ‘knowledge society’ are also exponents for ‘converging technologies’ [17][21].

Current developments in the field of aging research also have strong discursive links to cognitive enhancement. As the aforementioned EU parliament study argues: “The growing problem of neurodegenerative diseases in ageing societies has turned research and development in therapeutic cognitive enhancers into a very dynamic field with significant resources” [21:26]. Likewise, in enhancement discussions special attention is being ascribed to cognitive enhancement: “’neuro/ brain enhancement’ as a research field stands at the centre of the CT [converging technologies] debate. It attracts the largest share of attention due to its plans to simulate and manipulate brain processes, which – if realized successfully – could directly affect our concepts of the human self and identity” [17:382], cf. [21][23][25]. Also here there may be a significant aspect of user-driven innovation: medications developed in research into age related diseases like Alzheimer’s disease is already being used by young, healthy individuals to (presumably) enhance their cognitive abilities [14][17][21], and, conversely, one could therefore expect that the market for cognitive enhancement may stimulate research in the prevention and treatment of age-related neurodegenerative diseases.

These interconnected arenas of aging research, enhancement discourse and general ideas about successful aging will be the focus point of this project. The point of departure is that the connection between the discussion about successful aging and the discussion about human enhancement has been overlooked in the scientific literature and that the two discourses are more closely related than usually presumed. Shedding light on the historical relation between the two notions both in the scientific and popular discourses will potentially have significant consequences for future research, for research politics and for the public understanding of successful aging.

References:
7. Kirk, H. (2008). Med hjernen i behold – Kognition, træning og seniorkompetencer. København: Akademisk Forlag.
12. Balling, G. (2002) (ed.). Homo Sapiens 2.0. Når teknologien kryber ind under huden. København: Gads Forlag.
13. Balling, G og Lippert-Rasmussen, K. (2006). Det menneskelige eksperiment. København: Museum Tusculanums Forlag.
14. Greely et al. (2008). Towards responsible use of cognitive-enhancing drugs by the healthy. Nature, 456, 702-705.
17. Beckert, B., Blümel, C and Friedewald, M (2007). Visions and realities in converging technologies. Innovation: The European Journal of Social Science Research, 20(4), 375-395.
21. European Parliament Science and Technology Options Assessment (2009). Human Enhancement Study. Awailable at http://www.europarl.europa.eu/stoa/publications/studies/stoa2007-13_en.pdf (14.08.09)
23. http://www.humanityplus.org/read/2009/07/human-enhancement-what-should-be-permitted-geneva-october-20-21-2009/ (14.08.09)
25. Dumit, Joseph (2004). Picturing Personhood. Brain Scans and Biomedical Identity. Princeton: Princeton University Press

This is the second part of my project description for the Ph.D.-project called ‘A genealogical study of the concept of ’successful aging’ and its relation to the idea of ‘human enhancement’. See the first part here.

The relation between ’successful aging’ and ‘human enhancement’
The project will particularly focus on an analysis of the possible connection between ideas about the prevention and treatment of age-related diseases, on the one hand, and the current merging discourse on ‘human enhancement’, on the other. Like ‘successful aging’, the notion of ‘human enhancement’ — including a large variety of different ideas about the future possibilities for technological improvements of human bodies — became widely spread in the 1980’s and 1990’s [11][12][13][14].

A preliminary survey of the literature indicates that the notions of ‘successful aging’ and ‘human enhancement’ often seem to appear together in the scientific literature and in medical and health policy documents. For example both the European Union (EU) and the National Science Foundation (NSF) have published reports that deal with so called ‘converging technologies’, usually defined as a convergence of nano-, bio-, info-, and cogno-sciences and technologies (NBIC). In such reports, the notion of ‘human enhancement’ is a central concept, around which the discussion of the aging population in the developed countries revolves [15][16][21], cf. also [17][18][19][20]. As a study commissioned by the EU Parliament says, “it is safe to say that a side effect of the fast-growing research and development into pharmaceuticals for age-related neurodegenerative diseases will be a number of new drugs which can be used for the enhancement of performance of young, healthy people.” [21:7]

Similarly, in a large number of websites and blogs published by organisations and individuals that support and promote the notion of ‘human enhancement’, the possibility for using such technologies as life extension devices and for delaying age-related physical and/or cognitive decline constitutes one of the central arguments for developing enhancement technologies [11][22]. Websites that express the opinions of the so called transhumanist (posthumanist) movement is one of the most vociferous exponents of this argument. Both these pro-enhancement advocates and science policy reports (like the EU parliament study and the NSF reports) emphasize the fact that the biomedical sciences, biotechnologies and medicotechnical technologies are increasingly producing new technologies capable of simultaneously enhancing the capacities of healthy people and treating diseases, especially age-related diseases [16][21][23]. Thus the discourse about ‘human enhancement’ and ‘successful aging’ are discursively intimately connected.

In addition, this integration of the ‘human enhancement’ and ‘successful aging’ discourses seem to have a strong element of user involvement. The strong ideological commitment to the integration between the two notions among individuals that view themselves as members of a loose ‘transhumanist’ intellectual movement is probably the best example of user involvement. It is unclear, however, to what extent the scientific community, the ‘transhumanist’ intellectual movement and the public at large differ with respect to an active commitment to integrating the two notions. However, I will suggest that the increasing use of performance-enhancing drugs in the general population (especially among young people) and the increasing dissemination of pro-enhancement policies and visions that challenge traditional views of the use of medicine both work in favour of a similar integration between the two notions.

Furthermore one might expect that the general and widely spread popular attitude to performance-enhancing drugs in Western cultures is an underlying Zeitgeist which supports the current political, scientific (and ethical) discussions about the integration of the two notions in the ‘transhumanist’ movement and among scientists. Finally, one might also expect that such popular attitudes will effect strategic market evaluations in the pharmaceutical industry and thus spill over to strategies for future drug pipelines. In all these respects, the integration of the notions of ‘human enhancement’ and ‘successful ageing’ may well be framed with reference to broader user involvement and user driven innovation (cf. [14][15][16][21][24]). These are preliminary hypotheses only, however, which need further empirical substantiation.

References:
11. Bostrom, N. (2005). A History of Transhumanist Thought. Journal of Evolution and Technology, 14(1).
12. Balling, G. (2002) (ed.). Homo Sapiens 2.0. Når teknologien kryber ind under huden. København: Gads Forlag.
13. Balling, G og Lippert-Rasmussen, K. (2006). Det menneskelige eksperiment. København: Museum Tusculanums Forlag.
14. Greely et al. (2008). Towards responsible use of cognitive-enhancing drugs by the healthy. Nature, 456, 702-705.
15. Roco, M and Bainbridge, W (2002) (eds.). Converging Technologies for Improving Human Performance. NSF/DOC-sponsored report. Awailable at http://www.wtec.org/ConvergingTechnologies/Report/NBIC_report.pdf. (29.05.2009)
16. Innovation: The European Journal of Social Science Research, 20(4) (December 2007). Special Issue: Converging Science and Technologies: Research Trajectories and Institutional Settings.
17. Beckert, B., Blümel, C and Friedewald, M (2007). Visions and realities in converging technologies. Innovation: The European Journal of Social Science Research, 20(4), 375-395.
18. Det Strategiske Forskningsråd (2006). Det aldrende samfund 2030 – Rapport fra Styregruppen for det strategiske fremsyn om det aldrende samfund 2030. Awailable at http://fi.dk/publikationer/2006/det-aldrende-samfund-2030-rapport-fra-styregruppen/det-aldrende-samfund-2030.pdf (29.05.2009)
19. Murphy, T. F.(1986). A cure for aging? The Journal of Medicine and Philosophy, 11(3): 237-255
20. Veatch, R.M. (1979). Life Span: the Hastings Center report on values and life-extending technologies. New York: Harper and Row.
21. European Parliament Science and Technology Options Assessment (2009). Human Enhancement Study. Awailable at http://www.europarl.europa.eu/stoa/publications/studies/stoa2007-13_en.pdf (14.08.09)
22. http://www.humanityplus.org/learn/philosophy/transhumanist-values (14.08.09)
23. http://www.humanityplus.org/read/2009/07/human-enhancement-what-should-be-permitted-geneva-october-20-21-2009/ (14.08.09)
24. Maher, Brendan (2008). Poll results: Look who’s doping. Nature, 452, 674-675

I’ve just begun my ph.d.-project here at Medical Museion. Titled ”A genealogical study of the concept of successful aging and its relation to the idea of human enhancement”, the project is financed by the new Center for Healthy Aging at the Faculty of Health Sciences.

Below is the first part of the project description concerning the notion of successful aging. In two following parts I will first introduce the possible relation between successful aging and human enhancement, and then my attempt to narrow the project to cognitive aspects of ageing and cognitive enhancement. Comments to one or all three parts are much appreciated.

The genealogy of the notion of ’successful aging’
At present there is much focus on the notion of successful aging (healthy aging, optimal aging) in Denmark and other developed countries. The increasing life expectancy of the population in combination with low birth rate and low rate of immigration gives rise to both political and economic concerns about the future maintenance of the living standards for an aging workforce. The increasing number of elderly people gives rise to new demands for developing new knowledge about how individuals can live a healthy life and remain healthy, even in old age.

The notion of ‘successful aging’ is not new. It can in fact be traced back to at least the 1960’s and became ubiquitous in the field of aging research in the 1980′ and 1990’s [1][2][3][4][5]. The dissemination of the notion is connected to a development trend in aging research, whereby scientists gradually changed their understanding of aging as a research object for gerontological/geriatric research. From primarily being concerned with the treatment of diseases in later part of a life course to an increased focus on disease prevention and to a broader public health oriented approach to aging involving several different scientific fields, also beyond the biomedical sciences [4][6], cf. [7].

The aim of this project is to undertake a genealogical study[8][9] of the development of the notion of successful aging from the increased focus on prevention in the middle of the 1980’s until today. The literature on the subject is sparse, consisting of a few short chapters with an overview of the historical development of age research, cf. [6][10]. A more detailed historical study of this development based on the primary literature (scientific articles, textbooks, policy documents, etc.), is supposedly going to produce a deeper and better understanding of the notion of successful aging, which in turn will help qualify the current scientific and public discussions about the prevention and treatment of age-related diseases. The study will thus hopefully also help identify some of the conditions that may influence future understandings of what ‘successful aging’ is and the ways in which the future research in the field might develop.

References:
1. Williams, Richard H., and Wirth, Claudine, G. (1965). Lives through the years: styles of life and successful aging. New York: Prentice-Hall.
2. Rowe, J. W. and Kahn, R. L. (1987). Human Aging: Usual and Successful. Science, 237: 143-149.
3. Rowe, J. W. and Kahn, R. L. (1998). Successful aging. USA: Pantheon Books.
4. Baltes, P. B. and Baltes, M. M. (1990) (eds.). Successful aging: Perspectives from the behavioral sciences. Cambridge, UK: Cambridge University Press.
5. Bond, L. A., S. J. Cutler, and A. Grams (1995). Promoting Successful and Productive Aging. Thousand Oaks, CA: Sage Publications, Inc.
6. Amstrup, K og Poulsen, I. (2007). Geriatri – en tværfaglig udfordring. København: Munksgaard Danmark.
7. Kirk, H. (2008). Med hjernen i behold – Kognition, træning og seniorkompetencer. København: Akademisk Forlag.
8. Villadsen, K. (2006). Genealogi som metode: fornuftens tilblivelseshistorier. Kaspar Villadsen & Ole Bjerg (2005) (eds.). Sociologiske metoder: Fra teori til empiri i kvalitative og kvantitative studier. Frederiksberg: Samfundslitteratur.
9. Foucault, Michel (1992). The archaeology of knowledge. London: Routledge.
10. Bengtson, V.L. and Schaie, K.W (1999) (eds.). Handbook of Theories of Aging. New York: Springer Publishing Company, inc.