Disability and Prosthesis Beyond Utility and Function

Presented at Nordic Network Gender Body Health conference ‘Disability, Arts and Health’, Bergen University, Bergen, 1-2 September 2016.

Not for citation.

Introduction #

Technologies are not mere external utilities, but are profoundly involved within human development. Explanation of such involvement takes various forms. Like natural and social artefacts, technologies have a historical development, and can acquire metaphysical baggage (Hui 2016). One way to conceptualise technology is in terms of prosthesis: a tool—from a flint or a hammer, to language—that extends or enables capacities. I’ll discuss prosthesis as a human-technology relation, and consider three such conceptualisations—instrumentalism, Bernard Stiegler’s originary technicity, and Gilbert Simondon’s concretisation—and discuss their relevance to and potential for thinking about disability.

Early Theories of Technology #

In Technology and the Character of Contemporary Life, Albert Borgmann suggests that early understandings of technology take one of two forms: instrumentalism and substantivism. In instrumentalism—which is ubiquitous—technologies are thought of simply as tools; mere means awaiting use towards autonomously-formulated human ends (Aristotle 2008). They are epistemically and ethically neutral, or “subservient to values established in other… spheres” (Feenberg 2002). Instrumentalism is broadly optimistic: technologies are means towards human freedom. Substantivism, by contrast, tends towards a pessimistic articulation of technology (Ellul 1964; Heidegger 2013; Horkheimer and Adorno 2007). Here, technology is no mere means, but an autonomous force that distorts or replaces other values, and comes to determine human behaviour. This follows from its underlying, instrumental logic, which engenders an objectivising disposition towards others and world—as mere manipulable resources—that alienates humans from their non-technological nature.

Differences notwithstanding, these share a cluster of related ontological presuppositions that flow from oppositions between natural and artificial, human and nonhuman (Latour 1993). I’ll concentrate on instrumentalism, and briefly mention three. The first is most fundamental: the principle of essentialism. This supposes that there exists some specification of what the human is, which properties it possesses. Second, the principle of autonomy. This posits an exclusively human property that is fundamental to definition of the human, that requires—in principle, if not always in fact—no additional material for its exercise. Humans are essentially autonomous subjects for whom technological objects are mere means: these extend a freedom that passes through them while leaving no trace. Finally, the principle of externality. This human is defined only by reference to itself, to its own capacities or properties. While technology can only be defined by reference to the human, it is entirely external to the essence of the human. Technology is just something—albeit something highly significant—that humans use to realise their ends. I’ll call this position—that betrays a clear humanist bent—‘weak prosthesis’; weak, because technology makes no profound contribution to, and has no enduring effect upon, the essence of the human. This position includes any technological intervention that purports to extend or restore human properties, where this is not understood as a concomitant modification of the human itself.

Instrumentalism and Disability #

I’ll turn now to disability, and how this separation between human essence and technology plays out in the concept of normal function. Medical accounts often consider disability an individual problem occasioned by a dysfunctional bodily property. In Christopher Boorse’s ’normal function’ concept, the “normal is the natural”, while diseases are “foreign to the nature of the species” (1977: 554). Humans who are unable to perform what he counts as normal activities—speaking, walking—are deemed dysfunctional. Impairment essentially and directly correlates with a reduction in health, and warrants correction or rehabilitation. Some medical ethicists adopt this as a regulatory standard (Buchanan et al. 2000). Here biological deviation from normal function—which is taken as an objective fact about humans—correlates with decreased social opportunity as a ’normal competitor’, or decreased quality of life. Only those who see, walk, talk, access “the ’normal opportunity range’” (Amundson 2000: 46). Accordingly, medicine and technology can help by restoring normal function.

I don’t mean to suggest that such interventions are always negative, or to discount positive reports by those using prosthetics or undergoing interventions that replicate functional and aesthetic norms. My concern is with technology and its role in the production of the human. I’m suggesting that weak prosthesis does more than it admits. The implied boundary between human and technology obscures their myriad interleavings. It stabilises across time the organising concept of a human essence whose autonomy correlates with morphological properties. Its purported neutrality obfuscates this productive role. This occurs in different technological registers: from the operative idea of ‘restoration’ for those with congenital impairments, to instruments that monitor for foetal ‘abnormalities’, resulting in selective termination. I’m not debating the ethics of these practices. I’m suggesting that technological intervention reproduces and renegotiates a boundary within the living between normalcy and deviation, and that this boundary is not read off nature, but introduced into it.

Bernard Stiegler and Technicity #

Latterly, philosophers of technology have undertaken an ontological reorientation away from dualisms that place human subject over and against technological object, to instead understand humans as profoundly interrelated with technologies. I’ll talk now about Bernard Stiegler (1998), then discuss some implications of his position for disability and prosthesis. I’ll call his position strong or ‘constitutive’ prosthesis, because he understands technology as internal to the definition of humanitas. The human is constituted as such technological activity. His argument goes roughly as follows. The human is ‘born too early’: it has no inherent capacities, including memory. This susceptibility—this défaut or lack—is constitutive and originary: what the human has, essentially, is nothing: its essence is indetermination. It makes technology to mitigate this deficiency. Such supplements as language, sociality, and tools transform environs and ultimately defer death. The human exists as its concurrent externalisation in technical materials, and internalisation of this prosthetic ek-sistence. This is a co-constitution of ‘inside’ and ‘outside’, rather than an addition of external technology to the preexisting interior of a human essence: “[M]an invents himself in technics by inventing the tool—by ’externalising’ himself techno-logically […] the interior is invented through this movement: it cannot precede it” (Stiegler 1998: 141–42). Finally, this produces a rupture from ‘pure’ biological life. Technology comprises a new inorganic organisation of memory (Stiegler 1998): human culture made concrete in enduring technical artefacts. Humans, then, have definitively shifted from genetic to non-genetic memory: they are not determined to be what they are by their genetic endowments. They are liberated from genetics, and subject to new, non-biological exigencies, which only increases their indetermination.

Initially, this looks like a fruitful way to approach disability and prosthesis. If the ‘human condition’ involves a technological compensation for inherent vulnerability, everyone is lacking and none are complete. Moreover, technics is precisely liberation from biology. Consequently, disability need not identify a categorial division between completeness and insufficiency, between fully and partially human. Finally, technologies need not approximate normal function. However I don’t think that we should embrace Stiegler too hastily. This is because, first, he separates biology and technology too forcefully, and does not sufficiently acknowledge relations between bodies and technologies. For him, ‘Man’ still evolves biologically as an animal, but becomes human only through technical evolution: by using tools to anticipate possibilities other than those proscribed by genetics. Human invention principally concerns a vie d’esprit that is not biological, but technically-instantiated. Even though this vie d’esprit exists in material technologies, Stiegler skirts close to a technologised variation on mind-body dualism.¹ Externalisation in technics is simultaneously internalisation within the human, but only within technical subjectivity. This subjectivity is robustly divided from the biological body—equated by Stiegler with ‘stupidity’[bêtise]—which makes it difficult to grasp how technology interacts with and affects the body. This problem cannot be overstated, since Stiegler’s basic position is that humans exist precisely at their point of separation from biological features. This approaches a denial that biology is an aspect of humanity. It also entails a robust division between nature (locked into evolutionary adaptation and mechanistic repetition) and culture (liberated by technics to radically innovate). This is reminiscent of Sartre’s existentialism, that goes even further to effectively deny that the human has biological features (Esposito 2011).

This echoes debates in disability studies concerning whether impairment is a biological or social artefact. In Stiegler’s account, impairment would reside in the biological register, though it could be radically overcome by technics. This suggests an inability to adequately address a question motivating this paper: what role do technologies already play in disability? Surely biology and technology do not have separate causal histories?² I’ll suggest that the very emergence of disability is enacted in and through relations between bodies and technologies, broadly construed, that regularise valued and disvalued properties.

A second problem concerns lack: Stiegler rejects a fixed biological nature for an equally universal foundation. It is not insignificant that Stiegler begins from Lacanian premises, which lends his account a psychoanalytic tenor (LaMarre 2012). The human must recognise and reconcile itself to its essentially fragile nature. However, that humans are fragile as a matter of empirical fact doesn’t warrant the overdetermination of this characteristic into an ontological ground (Combes 2012). Crucially, taking humans as equally or universally vulnerable engenders a homogeneous conception that flattens out bodily diversity. Put differently, this claim can only find purchase by disregarding embodiment. Even assuming that we accept vulnerability as the human predicament, starting from concrete particular bodies (as does Simondon) would instead suggest heterogeneity, and vulnerability by degrees.

Gilbert Simondon and Individuation #

So while Stiegler’s originary technicity looked promising, it doesn’t address the body’s own contingency, and its interrelation with, not transcendence by, technology. I’ll turn to Gilbert Simondon’s work to this end, before making some suggestions about technology’s role in the production of the human. Simondon’s organising concept—individuation—understands individuals in terms of process and relations. It can be very roughly characterised as follows. The individual can only be understood relative to the preindividual. These two concepts do not identify discrete substances, but two phases in an ongoing process that Simondon calls individuation. Individuals are the products of individuation (though in the case of living individuation, this process is never complete). The preindividual—perhaps Simondon’s signature concept—is the condition for individuation: a domain or reservoir of potential, ‘prior’ to structuration as an individual, and out of whose tensions individuals emerge. Individuals are resolutions of tensions with the preindividual field. The preindividual is continually replenished by the process of individuation, and remains primed to engender further transformations. Alongside the individual, individuation also produces a specific associated milieu, to which that individual relates. This relation between individual and milieu is the ’location’ of the preindividual. As Pascal Chabot writes, “[t]o exist is to be connected” (2013: 77). This means that relations are not accidents that affect a pre-given individual. Relations are part of what brings that individual into existence. The individual is not in relation; it is relation. An individual, then, exists as an unfolding trajectory. It is never self-identical or complete, but one phase of a becoming: the temporary crystallisation of a set of preindividual potentials. While there is structure or stability, it is an outcome of ‘underlying’ operation or process.

Simondon and Technology #

For Simondon, technology is a kind of individuation: a movement from abstract to concrete, called concretisation. The process of invention begins with an end or predictable outcome in mind. Understood thus, an object in its primitive form is abstract: a blueprint describing an assembly of elements, each of which is a “closed system” with its own discrete structure (Simondon 2012: 21). During their ‘perfection’, however, elements take on extra functions that were not anticipated in the original design. The technical object, then, acquires a range that exceeds original intention “due to the superabundant efficacy of the created object when it is a true invention” (Simondon 1966, 1197). And, it gradually realises relations to an associated milieu. So where the abstract object was entirely artificial—and identified closely with the inventor’s goals—a concrete object has a mode of existence irreducible to any human artifice or natural law, that “approximates the mode of existence of natural objects” (Simondon 2012: 46). Consider too how many things called natural are in fact artificial: a cultured flower is the product of human artifice (which would make it unnatural in classical terms), and cannot fruit by itself (Chabot 2013: 17). To simplify: the concrete object has essentially an openness that the abstract object lacked. It is loosened—albeit not completely—from human origin and ascribed purpose. Perfection does not instantiate Platonic form: a complete, abstract thing given in one blow. It inaugurates a pattern open to dynamic transformation, an object with a higher degree of openness, a greater “margin of indetermination” (Simondon 2012: 11). Indeed, it is precisely indeterminacy that becomes concrete: “concretisation lies in the solidity of openness” (LaMarre 2012: 92).

Relational Disability #

So, the basic insights of Simondon are: the preindividual—transformative potential—is primary; this gives both living and technical a fundamentally open, processual character. This is overlooked when attention is restricted to structure, taking this as exhaustive of the individual or object, and ignoring its genetic operations. Sure enough, the modern metaphysical chauvinism towards the self-identical submits such openness to a logic of closure, generating both an anthropocentric view of the human (as self-identical, self-contained and autonomous), and an instrumental view of technology (called the ’labour paradigm’). The latter doesn’t only address work, but rather describes a disposition towards technology—that affects life at all levels and scales—that ignores its genesis, its human relation, and above all its openness: “the inherence [in technicity] of values going beyond utility” (Simondon 2012: 222). I’ll dwell on this a little before turning to Simondon’s positive implications.

This closure—of human and technology within themselves, and from each other—is surely significant for disability, grounding as it does the abstract autonomy that underpins normal function (and that echoes instrumentalism). This allows humans to understand themselves as fully autonomous even as their actions are technologically-enabled (Latour 1993, 1999). Yet this implies ‘context-transcending abilities’, which would in turn suggest a self-sufficient, complete human. As Stiegler rightly suggests, this recalls the state of nature, which would represent “the absence of relation” (Stiegler 1998: 128).

Instead I’m suggesting that there is a banal, low level prostheticity to the average and everyday. Much apparent complementarity between ’normal’ humans and environments is not spontaneous, but the outcome of activities, both historical and contemporary, that render the world thus through harmonisation with a valued functional ideal. Rather than a universally valid—that is, ’normal’—mode, there are normalised relations that prioritise certain modes. Importantly, the underlying logic understands these relations as between determinate entities—the normal individual, the neutral tool—and remains at the level of structure, without attending to their engendering processes. Rather than ability or disability antecedent of situation, there are enabling and disabling relations. ‘Ability’ correlates less with innate features, and more with temporally-normalised relations between bodies and a world of technologies (broadly construed) that en-able them. Conversely, disability reduces neither to physical properties nor inherent lack. It is a spatiotemporal event, that occurs where a merely atypical body encounters others with incongruent orientations, where affordances are absent or inapt. Disability and ability are relations between real bodies and technologies, where the contribution of the latter is effaced.

Transductive Prosthesis and Technical Ethics #

Now I’ll turn to the affirmative register of Simondon’s thought, to make some suggestions for alternative ways to think the human-technology relation, which I’ll call transductive prosthesis: transductive because neither participant is entirely the agent, and every individuation is conditioned upon earlier individuations, that conserve their own potential for transformation. While Stiegler is right that technical evolution transforms the human, this is not based in a compensation for vulnerability. There is nothing essentially lacking in humans (or any individual). Muriel Combes (2012: 49) suggests that Simondon proffers a humanism “constructed on the ruins of anthropology and on the renunciation of the idea of a nature or human essence”. Saying that the essence of the human is that it has no essence, while aporetic, is still a universalising claim. Simondon instead asserts that they are instead characterised by potential to differentiate that is characteristic of the living in general. Humans are but one vector within a continuity of living individuation. Humans and technological objects each contain this potential, essentially but differently.³ There is something human in technology, not because they are makers and users, but because the technical individual is an elaboration of potentialities within humans. Nevertheless, technology is not constitutive in Stiegler’s sense: it is merely one—albeit highly significant—trajectory of individuation. Technology doesn’t stand opposed to the living or compensate for its weaknesses: it ramifies the living. Even though they emerge from human activities, their openness means that technologies retain a kind of quasi-agency that is not parasitic upon humans. The human-technology relation is co-individuation: a “dialogue between humans and machines” that engages preindividual forces in human and technology that individuate together (LaMarre 2012: 98). Humans are “conductors in the world orchestra of technology around them”, of which they too are part (Simondon 2012: 11). Simondon will explicitly suggest that the human is not a pre-given set of somatic or cognitive capacities, but a living being that enters into relations with technical objects in an associated milieu. The relation of humans to machines is piecemeal, a pragmatic “perpetual invention” (Simondon 2012: 12). And technology retroacts upon or loops back into nature. Their inventions transform milieus, which provokes in turn new invention.

I’ll finally make three brief recommendations about disability-technology relations in a Simondonian key. First, taking individuation seriously means resisting closure and teleology in biology and technology alike. Remaining with structure only discloses regularity, and (somewhat) warrants the understanding of humans as (however imperfect) instantiations of ideal form. Instrumental understandings of health and technology leave their categories untouched, and reproduce metaphysical commitments to closure within individuality that occludes the reality and primacy of relation. A related point concerns technical objects. If these have a genesis and lineage that is concurrently implicated in human becoming, we should attend to the anthropocentric—not merely human—in prosthesis. I’ve already mentioned the reduction of technology to productivity—due to the longstanding tendency to think the human-technology relation analogically with mastery and bondage—that short-circuits technology’s potential. Perhaps technological solutions for disability implicitly tend towards normalisation not simply because of present economic imperatives, but also because productivity is sedimented within technology’s purported role or purpose (Barthélémy 2015).

The obverse practice attends to processes of taking-form. Such in-forming is not construction by humans out of passive nonhumanity. Simondon reontologises bodies: not as substances but as real trajectories of becoming. There is an ontology of disability. It is neither biological nor social, but individuated within many, real but contingent, relations that, through repeated practices, acquire an apparent fixity. This fixity might be contested: by recognising “technical concretization and the transductive relation between humans and technology” (Landes 2014: 169). And by following material processes that affect which bodies inhabit the world: how and why such productions happen, and that it could have been otherwise.

A final point concerns taking-up of potential towards a more open future. Liberating technology from productivity releases its inventive power. My former references to ’the human’ were (hopefully) only pragmatic. I instead advocate a non-anthropocentric theory of technical relations that relinquishes emphasis upon merely abstract autonomy and function—with their implicit purity and closure—for plurality and connection. Invention can take many forms. There is moderate: pragmatic living-with-machines that substitutes relational agency for individual autonomy (Latour 1999). Technology still facilitates action. However, if technicity assists almost all action, invention is freed from approximation of normal modalities. Consider Papadimitrou’s becoming en-wheeled: “a way of being in the world that is not merely mechanical or practical” (2008: 695). It may even create entirely new ways of acting (Bach-y-Rita et al. 1969). Or, rather than complementary or supplementary addition to bodies, an aesthetic andexperimental elaboration. Importantly, as we’ve seen, individuation also brings with it an associated milieu. So a new technical relation is simultaneously the creation of a new milieu. Of course, this is already happening everywhere. We only need to look for it, and keep bringing it to light.

Works Cited #

Amundson, R. (2000), ‘Against Normal Function’, Studies in History and Philosophy of Biological and Biomedical Sciences, 31 (1): 33–53.

Aristotle (2008), Physics, Oxford World’s Classics, tran. R. Waterfield, Oxford: Oxford University Press.

Bach-y-Rita, P., C. C. Collins, F. A. Saunders, B. White and L. Scadden (1969), ‘Vision Substitution by Tactile Image Projection’, Nature, 221 (5184): 963–64.

Barthélémy, J.-H. (2015), Life and Technology: An Inquiry Into and Beyond Simondon, tran. B. Norman, Lüneberg: Meson Press.

Boorse, C. (1977), ‘Health as a Theoretical Concept’, Philosophy of Science, 44 (4): 542–73.

Borgmann, A. (1984), Technology and the Character of Contemporary Life. Chicago: University of Chicago Press.

Buchanan, A. E., D. W. Brock, N. Daniels and D. Wikler (2000), From Chance to Choice: Genetics and Justice, Cambridge: Cambridge University Press.

Chabot, P. (2013), The Philosophy of Simondon: Between Technology and Individuation, trans. A. Krefetz and G. Kirkpatrick, London: Bloomsbury.

Combes, M. (2012), Gilbert Simondon and the Philosophy of the Transindividual, Technologies of Lived Abstraction, tran. T. LaMarre, London: MIT Press.

Ellul, J. (1964), The Technological Society, tran. J. Wilkinson, New York: Vintage Books.

Esposito, R. (2011), ‘Politics and Human Nature’, Angelaki: Journal of the Theoretical Humanities, 16 (3): 77–84.

Feenberg, A. (2002), Transforming Technology: A Critical Theory Revisited, Oxford: Oxford University Press.

Heidegger, M. (2013), ‘The Question Concerning Technology’, The Question Concerning Technology and Other Essays, 3–35, New York: Harper Perennial.

Horkheimer, M. and T. W. Adorno (2007), Dialectic of Enlightenment, Stanford: Stanford University Press.

LaMarre, T. (2012), ‘Afterword: Humans and Machines’, Gilbert Simondon and the Philosophy of the Transindividual, Technologies of Lived Abstraction, 90–107, London: MIT Press.

Landes, D. A. (2014), ‘Individuals and Technology: Gilbert Simondon, from Ontology to Ethics to Feminist Bioethics’, Continental Philosophy Review, 47 (2): 153–76.

Latour, B. (1993), We Have Never Been Modern, tran. C. Porter, Cambridge, MA: Harvard University Press.

Latour, B. (1999), Pandora’s Hope: Essays on the Reality of Science Studies, Cambridge, MA: Harvard University Press.

Moore, G. (2013), ‘Adapt and Smile or Die!: Stiegler Among the Darwinists’, in C. Howells and G. Moore (eds), Stiegler and Technics, 17–33, Edinburgh: Edinburgh University Press.

Oyama, S. (2000), The Ontogeny of Information: Developmental Systems and Evolution, Second, Science and Cultural Theory, London: Duke University Press.

Papadimitriou, C. (2008), ‘Becoming En-Wheeled: The Situated Accomplishment of Re-Embodiment as a Wheelchair User After Spinal Cord Injury’, Disability & Society, 23 (7): 691–704.

Sharon, T. (2013), ‘The Missing Link: How Biology Can Help Philosophy of Technology Complete Its Ontological Shift’, Tijdschrift voor Filosofie, 75: 121–45.

Simondon, G. (2012), Du Mode d’existence Des Objets Techniques, Paris: Éditions Aubier.

Simondon, G. (1965/1966), ‘Imagination et invention, course material (hand-out)’, Bulletin de Psychologie, December 1965: 395–414; February 1966: 916–29; March 1966: 1074–95.

Stiegler, B. (1998), Technics and Time: The Fault of Epimetheus, tran. G. Beardsworth, Stanford: Stanford University Press.