ABSTRACT
This chapter envisions technology for citizenship using medical devices as an example. Objectives include the following: (1) identify the who and how of the medical device resource and user systems in order to develop strategies for education, communication, and change, (2) stimulate sociotechnical studies that encompass factors internal to the technology development process such as design and external factors such as markets, and (3) generate examples of problem areas for future research. This chapter applies a model of technology development used by the U.S. Congress’ now-defunct Office of Technology Assessment (OTA) to identify, organize, and analyze the who and how of the medical device allocation and user systems. The medical device resource system is analyzed using critical theory, which focuses on psychosocial, economic, and political factors that crystallize into social organization. A legacy of discrimination in product development is explored in terms of barriers to mainstream markets, market incentives and disincentives, human factors in design, safety and efficacy regulatory criteria, inclusion and exclusion criteria in clinical trials. There is a dearth of disability-related sociotechnical studies of corporate and government decision making. These studies should be conducted and embedded in a broadly conceived engineering research agenda.
