IEEE Technology and Society Magazine - June 2015 - 74

has significantly reduced the weight of prostheses compared with old-fashioned ones made of steel, PVC, and
until recently, wood and leather. Silicon suction sockets
simplify donning of the prosthesis (in some cases, avoiding
the use of harnesses and straps), providing a better fit and
limiting problems relating to irritation around the stump.
The use of silicon as an alternative to PVC, which is usually
used to line prostheses, has the advantage of being able to
create ultra-realistic and customizable prostheses, reducing the visibility of the disability.

Contrasts Between Technological
Advances and Real Use of Prostheses

This observation is, actually, not very surprising. The
anthropology of technology, among other fields, has
shown for a long time that many phenomena other than
technical performance condition the appropriation and
use of a technical device, particularly when the device is
designed to interact with the body.
During the previous century, a large number of thinkers pondered the relationship between the body and technology. The aim of this article is not to present a history
of the very rich field of the anthropology of technology.
That would be pretentious given the complexity and the
range of the work that exists in this field. All the same, it
is impossible to take an active interest in the prosthesis
as a technical object, without considering the work of M.
Mauss, A. Leroy-Gourhan, G. Canguilhem and G. Simondon in order to conceive of better technical objects.
More than a pure technical object, a prosthesis is
both "body," and a "body-technique." It is body in the
sense that it physically replaces part of the body, and a
"body-technique" [22] since it requires learning and the
use of new body techniques. Moreover, it is intimate and
permanent, at least in the sense of its vocation. It is used
intensively in the home (which is rare for a robotic device
since the only robots that have entered peoples' homes
are service robots, which do not need to have such a
high level of functioning and reliability), and by users who

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(a)

The Prosthesis: An Ultimate Technical Object

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Despite these numerous technical advances, several
facts can be noted, particularly when comparing current
devices with older ones. First, there is a large discrepancy between the number of research teams working
on the development of robotic limbs in laboratories and
industry, and the number of limbs that are currently commercially available. This demonstrates the complexity of
the technological transfer of products destined for a very
small market, with little economical attraction. Second,
it is surprising to see that there has been very little conceptual change in prostheses since the beginning of the
previous century (particularly those developed following
the First World War during which atrocious injuries led to
remarkable progress in medicine, surgery, and prosthetics), or even since the Renaissance period (see Figure 3).
This technical stagnation is corroborated by clinical
observations. According to clinicians, there has been
no, or little, positive change with regard to the appropriation of prostheses by patients. This contrasts with
a report on external upper limb prostheses carried out
by the French Health Authority in 2010 which underlines
that, despite technical difficulties, use of a prosthesis
improves functional independence and quality of life

in upper limb amputees, however, almost a quarter of
upper limb amputees do not use a prosthesis [15].
Moreover, there is a lack of interest in technology
by users, and sometimes even total rejection. Clinicians are regularly confronted with users who, after
having tried a recent myoelectric prosthesis, prefer to
go back to a mechanical cable-based device or even a
purely aesthetic limb.

(b)

(c)

FiguRe 3. (a) Artificial hand, from Ambroise Paré's Instrumenta chyrurgiae et icones anathomicae (Surgical Instruments and
Anatomical Illustrations), Paris, 1564. (b) Artificial iron arm from the 16th century. (c) First World War artificial left arm with shoulder
straps. Made with leather and aluminium by W. R. Grossmith.

IEEE Technology and Society Magazine

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june 2015

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