Revisiting the Wireless Body
A DISCUSSION OFThe Wireless Body
Though the notion of a “wireless body” is often presented as a recent concern in the age of electronic medical records, or pandemic-era telemedicine, Jeremy Greene shows us that this fantasy has been a structuring concern in medical care for the past 70 years or so. To many people, this alone might be a stunning finding—but it stuns only if we are without our history.
The notion that we might be able to quantify continuously the inner workings of the body (and then surveil and disseminate that data), and therefore prevent excess death, increase wellness, and render transparent the black box of the body may seem either still speculative or like a moral good or both. While the fantasy is simple and longstanding, its implications are less so.
The media of medicine have long promised not merely to reveal the body, but to democratize medical care in the United States. These media are often articulated as transcending barriers to care. That if we only connect the right devices to the right people in the right system, we might retrieve those who traditionally have been excluded from the scene of care. For, so the story goes, the scene of care would go to them.
In “The Wireless Body” (Issues, Fall 2022), Greene says, not so fast. In turning the patient’s inner workings into streams of data, we complicate the ethics of medicine by blending it with the ethics of data science. And we do so haphazardly. Even the question of what counts as medical data is a tricky and deeply concerning one. What might one system of patient protection, say the Health Insurance Privacy and Portability Act (HIPPA), protect, and what might be designed to fall outside its remit? Greene shows us that when patients become users, and we turn our companion technologies into medical devices, we might open up the black box of the body, but we also hand over our most sensitive medical data and, as the author points out briefly, the implications of that data can be volatile, as in the case of consumer apps that track menstruation and fertility in light of the US Supreme Court’s recent Dobbs decision on abortion. Markets shape the medium of care much more than practitioners and patients, and so do politics.
Greene shows us that always-on medical devices, from the wearable Holter monitor that records heartbeats to the tools that might be in your pocket right now, are not some neutral or obvious good. Instead, if we read them closely, we can use them to reveal the contradictions of American medicine and its competing impulses: to democratize and to scale it, to make it universal and to make it intimate with individuals, to provide patients freedom while indoctrinating them into bodily surveillance, to make them transparent objects of study while privatizing care and linking that care to proprietary devices and the biases and interests they carry.
Assistant Professor of Informatics