Three of the most striking features of technological change in the twenty-first century are its speed, variety, and scale: the means by which people communicate, shop, travel, work, read, play, associate, and learn have undergone continuous âdisruptiveâ changes over the past 50 years, and in this half century the rise of television, space exploration, and the airline industry have been succeeded by genetic engineering, computing, and the internet.
Two key intersections can help us explain the rapid pace of technological change affecting all aspects of contemporary societyâincluding health technologies and the process generally known as âtranslationâ whereby a technology becomes widely used, profitable, and normalised. The first key intersection is the increasing interconnectivity between technological domains that enables radical changes to traditional activities such as agricultureâin which today, routinely, robotics, computing, gene editing, and satellite technology are combined to enable more efficient planting, cultivation, and harvesting of new types of crops. These are the same recombinant intersections that enable unprecedented scales of capacity to be achieved, such as how many planes can be in the air at the same time and how many passengers can buy seats on them using electronic-ticketing apps on their mobile phones. The second key intersection is between technology and subjectivityâor consciousness. For we cannot explain technological change in terms of capacity alone: it must also be explained in terms of social identities, orientations, and associations. There must be a shared perception of a need and a whole worldview that supports this perception in order for machines to be invented that will use complex evolving algorithms to learn to hear your voice and speak back to you or even to drive your car.
One of Karl Marxâs most famous quotations can be summarised as the hand-mill gives you feudal society, the steam mill the industrial capitalist (1971, p. 9).1 What he meant, however, was not simply that a different technology produced a different kind of society. His interest lay in the specific nature of what he understood to be a complex evolutionary process, not unlike the changes to physiology affecting speciation that so interested his contemporary Charles Darwin. Why, Marx wanted to know, was a specific species of technologyâthe windmillâin operation for millennia before the sudden change to steam power? Why were careful technological adjustments made to windmills by hundreds of generations of mill-dependent societies for centuries prior to the frantic period of technological replacement that suddenly erupted in the late seventeenth century? Marx argues we cannot explain the revolutionary triumph of steam-driven mills over water- and wind-milling as a result of technological capacity, or power, alone because the orientation of innovation has changed so dramatically, which Marx argues must reflect a change in social structureâand above all a change in consciousness, or worldview.
The Bioindustrial Revolution
The question of rapid, or revolutionary, technological development has become one of the most pressing sociological questions before us not only because it is so difficult to explainâbut equally because it is so tempting not to explain technological change at all. This is because one of the signs a technology has become revolutionary is that it has become obvious, normal, and ordinary: the mobile phone seems to have become successful because so many people want to use it and because it delivers the step-changing functionality consumers are eager to buy. As with the mobile phone, so too with the internet, email, and computing: the utility of each seemingly explains its ubiquity and vice versa. Neither Marx nor many contemporary sociologists would deny the powerful role of basic scientific discovery in the process of technological change. However, there remains a compelling and even self-evident case that discovery alone is not a sufficient explanation for the dramatically increased speed and scale of technological change experienced since the end of the eighteenth century.
According to the classic Marxist argument that social relations determine technological change, and not the other way around, the most important relation is between the capitalist owner of the means of production and the wage labourers who have been disenfranchised not only of their individual labour power and skills, but also of their collective associations with the shared activities of production and their alienation from the means of production. Marx argues that much of the evolution of machinery during the industrial revolution was driven by the motivations of the capitalist-owner class to extract more value from the proletariatâa motivation that increasingly had become a norm and a requirement under the emergent social form of industrial capitalism. The crucial historical turning point of this process and its most revolutionary moment, he argues, is the point at which machines begin to make other machines, which will in turn replace workers with a more easily controllable, more efficient, tireless, and inanimate means of production.
From this point of view, technological change must be understood in terms not only of the production of desired goods, such as commodities, but also in terms of the broad social and historical forces that shape perceptions of value. The extraction of surplus value for profit achieved through increasing managerial control over the labour process is a recent idea: the value of work was not traditionally defined in such a manner. Mass production did not become socially valued because steam engines made large-scale industrial manufacturing possible. To the contrary, the highly specialised division of labour required by increasingly mechanised manufacture was consistently resisted by the urban proletariat, who saw few of its rewards. At the same time, the process of industrialisation has undoubtedly brought enormous benefits and marked the beginning of a new era of rapid worldwide economic growthâso rapid that in only two centuries the worldâs population has increased tenfold and a new geologic era has been proposed to mark the impact on the earth itself of industrial manufacturing.
Meanwhile, yet another dimension of technological change is upon us, and in our own century, the rise of the biological sciences has raised a very different set of questions about the relationship of new technologies to social consensus and to industrial capitalism. No one has yet written the equivalent of Marxâs Capital (1867) for âthe age of biologyâ, although much ink has been spilt on the step-changing consequences for the human species of molecular genomics. In fact it may turn out that the new technologies derived from developmental and reproductive biology, rather than the human genome project, provided the equivalent of the historical turning point in the mid-nineteenth century, when machines began to make other machines, for this is when the potency of cells began to be harnessed to make other cells.
Fittingly, it was exactly a century after the posthumous publication of Marxâs magisterial three-volume Capital: A critique of political economy that Robert Edwards, the Cambridge biologist, phoned Patrick Steptoe, the consultant obstetrician based just outside Manchester, in Oldham, to discuss the possibility of collaborating on a new means of technologically assisted human reproduction, namely, in vitro fertilisation (IVF). Just over a decade later Louise Brown was born, and a second industrial revolution began to unfold in northwestern Englandâthis time based on a technological platform that enabled the reprogramming of reproductive biology. If IVF is the equivalent of the steam engine in what Ian Wilmut, Keith Campbell, and Colin Tudge (2001) have named âthe age of biological controlâ that is not only because it is so successful technologically (by which measure the steam engine is in a different league altogether) but because it is so popular. Crucially, IVF is successful and revolutionary, because it has been accompanied by a change in consciousness about not only human reproduction, but biology in general. In sum, biologyâincluding human reproductive biologyâhas come to be seen as a vast tool kit, a technological horizon, a new frontier of scientific and economic growth (Landecker 2007; Franklin 2013). The pursuit of new means to repair, reprogramme, and redesign biological entitiesâfrom genes and cells to bacteria and plants, as well as livestock and peopleâclosely resembles the process described by Marx a century and a half earlier of closely interlinked transformations in technology and consciousness affecting the means of production. Today it is the means of reproduction that are coming to be perceived as the promissory source of vast health and wealth benefits.
Today, as in the early nineteenth century, a great acceleration of technological change is occurring in the realm of what we might call biological equipmentâincluding our own as well as the myriad new species of apparatus and instruments manufactured for the biotechnology sector, such as gene sequencers, incubators, and time-lapse embryo monitors. Today, as in the past, the industrialisation of the bio tool follows a well-beaten path from the bespoke, site-specific crafting of basic scientific tools such handmade primers and pipettes to their industrial manufacture and marketing. We are witnessing the gradual expansion, standardisation, and mass production of whole new families of tools such as synthetic antibodies, receptors, blockers, and other cell- and molecular-signalling products in both the publicly funded and private commercial sectors of the biotech industry.
The rapid changes to the very idea of the bio tool that are revolutionising the health sector rely on precisely the two forms of technological intersection described previously: intersecting technological domainsâsuch as molecular marking and the internetâare what enable primer banks and depots to operate at a previously unimaginable scale and speed. But the intersection of technologies with consciousness and worldview matter too: as biotech becomes increasingly focussed on personalised medicine and precision interventions, both the professional scientific communities who develop new âtranslationalâ products and the various constituencies they serveâfrom patients and clinicians to investors and policymakersâare changing their ideas about what a bio tool can do.
This chapter, which is based on a lecture of the same name prepared for the Intersections conference in Geneva (2014), uses a personal and anecdotal set of examples to track some of the important changes at the intersection of biology, tools, and consciousness that I argue must be understood as fundamental to the rapid process of technological change currently transforming healthcare services in what has been dubbed âthe age of biological controlâ. Alongside the general questions I am asking here about technological change are some more specific questions about the models of knowledge and uncertainty we use to analyse the process of technological innovation. Personalised and precision medicine, two of the most important new paradigms for understanding a shift away from mass-produced drugs to new bespoke biological productsâsuch as those promised by both the regenerative medicine and the stem cell fieldsâare often also discussed in relation to preventative and participatory approaches to the management of d...