The past and future of constructive technology assessment

Technology and the Situationist Challenge to Virtue Ethics

In this paper, I introduce a "promises and perils" framework for understanding the "soft" impacts of emerging technology, and argue for a eudaimonic conception of well-being. This eudaimonic conception of well-being, however, presupposes that we have something like stable character traits. I therefore defend this view from the "situationist challenge" and show that instead of viewing this challenge as a threat to well-being, we can incorporate it into how we think about living well with technology. Human beings are susceptible to situational influences and are often unaware of the ways that their social and technological environment influence not only their ability to do well, but even their ability to know whether they are doing well. Any theory that attempts to describe what it means for us to be doing well, then, needs to take these contextual features into account and bake them into a theory of human flourishing. By paying careful attention to these contextual factors, we can design systems that promote human flourishing.

Social science - STEM collaborations in agriculture, food and beyond: an STSFAN manifesto

Interdisciplinary research needs innovation. As an action-oriented intervention, this Manifesto begins from the authors' experiences as social scientists working within interdisciplinary science and technology collaborations in agriculture and food. We draw from these experiences to: 1) explain what social scientists contribute to interdisciplinary agri-food tech collaborations; (2) describe barriers to substantive and meaningful collaboration; and (3) propose ways to overcome these barriers. We encourage funding bodies to develop mechanisms that ensure funded projects respect the integrity of social science expertise and incorporate its insights. We also call for the integration of social scientific questions and methods in interdisciplinary projects from the outset, and for a genuine curiosity on the part of STEM and social science researchers alike about the knowledge and skills each of us has to offer. We contend that cultivating such integration and curiosity within interdisciplinary collaborations will make them more enriching for all researchers involved, and more likely to generate socially beneficial outcomes.

A quintuple helix model for foresight: Analyzing the developments of digital technologies in order to outline possible future scenarios

The challenge of contemporary society is that of planning possible paths for the future. In the current scenario of hyperconnection, men and technologies and human and artificial intelligence are intertwined in such complex ways as to generate multiple possible futures up to the limit of the capacity of imagination. In particular, it is precisely the frontier of digital and technological changes that obliges social actors and socio-economic institutions to know how to intercept the dynamism of the transformations taking place, supporting the ability to imagine a desirable future, which goes in the intelligent direction of sustainability, of wellbeing and the ethical responsibility of one's actions. In this perspective, the reflection on the so-called future studies is inserted, which becomes a necessity, especially in times of change: If the rhythm of change increases, we need to look further, but future studies are also a philosophy of thought because the future is already part of our present life in the form of anticipation of the future; and this is all the more true as social changes are improvised and systemic complexity increasingly turbulent. Based on these statements, this study aims to analyze how the triple helix model-or rather the quintuple helix model-can be a reference paradigm for social and technological forecasting in a systemic attempt to look at the future of science, digital technology, society, economy, and their interactions, in order to promote social, economic and environmental benefits. From the social perspective, the model could provide guidance to improve the anticipatory profile of organizations and communities, helping to understand-in a short time-what the present actions will be: Predict, discover, and anticipate united in active participation, communication, knowledge, and action become so essential in the processes of production, as in the past it was the accumulation of capital, and also the ethical sensitivity begins to play an increasingly critical role.

Electronic Tracking Devices for People With Dementia: Content Analysis of Company Websites

Background

Electronic tracking devices, also known as locators, monitors, or surveillance devices, are increasingly being used to manage dementia-related wandering and, subsequently, raising various ethical questions. Despite the known importance technology design has on the ethics of technologies, little research has focused on the companies responsible for the design and development of electronic tracking devices. This paper is the first to perform a qualitative analysis of the ethically related content of the websites of companies that design and develop electronic tracking devices.

Objective

The aim of this study was to understand how companies that design, develop, and market electronic tracking devices for dementia care frame, through textual marketing content, the vulnerabilities and needs of persons with dementia and caregivers, the way in which electronic tracking devices respond to these vulnerabilities and needs, and the ethical issues and values at stake.

Methods

Electronic tracking device company websites were identified via a Google search, 2 device recommendation lists (Alzheimer’s Los Angeles and the Canadian Agency for Drugs and Technologies in Health), and the 2 recent reviews of wander management technology by Neubauer et al and Ray et al. To be included, websites must be official representations of companies (not market or third-party websites) developing and selling electronic tracking devices for use in dementia care. The search was conducted on December 22, 2020, returning 199 websites excluding duplicates. Data synthesis and analysis were conducted on the textual content of the included websites using a modified form of the Qualitative Analysis Guide of Leuven.

Results

In total, 29 websites met the inclusion criteria. Most (15/29, 52%) companies were in the United States. The target audience of the websites was largely caregivers. A range of intertwined vulnerabilities facing persons with dementia and their caregivers were identified, and the companies addressed these via care tools that centered on certain values such as providing information while preserving privacy. Life after device implementation was characterized as a world aspired to that sees increased safety for persons with dementia and peace of mind for caregivers.

Conclusions

The way electronic tracking device content is currently conveyed excludes persons with dementia as a target audience. In presenting their products as a response to vulnerabilities, particular values are linked to design elements. A limitation of the results is the opaque nature of website content origins. How or when values arise in the process of design, development, and marketing is unknown. Therefore, further research should explore the process companies use to identify vulnerabilities, how values are decided upon and integrated into the design of products, and the perceptions of developers regarding the ethics of electronic tracking devices.

Artificially Intelligent Super Computer Machines and Robotics: Apprehensions and Challenges – A Call for Responsible Innovation Framework

“Industrial revolution 4.0” is a term that is becoming increasingly popular among academics. A number of articles have been carved to emphasize the beneficial aspects of the stated issue under many titles such as cyber-physical systems, internet of things, artificial intelligence, smart manufacturing, digitalization of industrial production, and so on. However, few academics have delved into the negative or dark side of such a profound technological paradigm change, especially the artificially intelligent robotics, creating a large knowledge vacuum. Because of this, little is known about the negative repercussions of artificial intelligence (AI), a key component of the Fourth Industrial Revolution (or IR 4.0). It is an open secret now that AI machines may have serious impacts on human autonomy, fairness, justice, and agency. These unanticipated consequences have resulted in the development of an emerging concept, that is, responsible innovation. The responsible innovation framework binds the firm ethically, morally, and socially to be responsible, environmentally friendly, humanitarian, and business-oriented while developing innovative products. The current study proposes an integrated responsible innovation framework that acts as a science governance mechanism and considers organizations and stakeholders collectively responsible for upcoming technological innovations. This study has suggested several implications for policymakers.

GoTO: A Process-Navigation Tool for Telehealth and -Care Solutions, Designed to Ensure an Efficient Trajectory from Goal Setting to Outcome Evaluation

Objectives: The digital transformation of the healthcare sector involves the procurement and implementation of new health technologies, which will likely be a challenge to healthcare providers who are not part of large organizations. In response to the needs of small and middle-sized health and care organizations, we have developed a process navigator to guide providers of healthcare through the processes of innovation, the procurement of mature products, and their implementation in telehealth and telecare projects. Methods: A narrative overview identified health-technology-assessment-inspired models. Conversations with national and international colleagues identified project and implementation models. The origin of the included models was identified, and relevant articles were referred to to describe the essential principles, including the nature of stakeholder involvement and the evaluation processes when appropriate. Based on the inputs, we proposed the process navigator GoTO. Results: Six health-technology-assessment-inspired models, six project models, one implementation model, and one innovation model were identified and informed the creation of the GoTO process navigator. The navigator consists of four parts: inception (eight steps); materialization (three tracks, depending on the maturity of the planned solution); implementation (five steps); and the final assessment and evaluation. Conclusion: The GoTO process navigator is an intuitive guide for innovation, procurement, and implementation in telehealth and -care. The GoTo navigator can assist providers of digital health and care services throughout the process from the initial identification of goals to the final evaluation of outcomes.

Contestable AI by Design: Towards a Framework

As the use of AI systems continues to increase, so do concerns over their lack of fairness, legitimacy and accountability. Such harmful automated decision-making can be guarded against by ensuring AI systems are contestable by design: responsive to human intervention throughout the system lifecycle. Contestable AI by design is a small but growing field of research. However, most available knowledge requires a significant amount of translation to be applicable in practice. A proven way of conveying intermediate-level, generative design knowledge is in the form of frameworks. In this article we use qualitative-interpretative methods and visual mapping techniques to extract from the literature sociotechnical features and practices that contribute to contestable AI, and synthesize these into a design framework.

Anticipation and modal power: Opening up and closing down the momentum of sociotechnical systems

Within STS, there are three approaches to the creation and mobilization of futures: descriptive, normative, and interventive. Visions, expectations, and imaginaries are currently seen as anticipatory artifacts that close down the momentum of sociotechnical systems and, as such, are objects of critical scrutiny. At the same time, interventive techniques engaging with future representations are considered to be useful anticipatory instruments for opening up ranges of envisaged alternatives. This article reviews STS advances concerning the performativity of both de facto and interventive anticipatory practices in shaping the momentum of sociotechnical systems in light of the phenomenon of modal power: the modulation dynamics of what actors deem to be (im)plausible and/or (un)desirable. The diverse attempts of STS scholars and practitioners to understand, critique, and engage with the politics of opening up and closing down the momentum of sociotechnical systems require engaging with the creation, mobilization, and execution of modal power. The heuristics presented here are intended to be useful in framing and recognizing the political-epistemic radicality that the creation and mobilization of sociotechnical futures holds in the constitution of our sociotechnical orders as well as the role that the attribution of (im)plausibility or (un)desirability plays in such processes.

Discovering the Landscape and Evolution of Responsible Research and Innovation (RRI): Science Mapping Based on Bibliometric Analysis

The growing number of papers on Responsible Innovation (RI) and Responsible Research and Innovation (RRI) have shaped the popularity and usefulness of RI and RRI as a technology governance concept. This study reviews and assesses the development of RRI research through a bibliometric analysis of 702 RRI-focused papers and 26,471 secondary references published in the Web of Science Core Collection database between 2006 and 2020. Firstly, the paper provides a broad outline of the field based on annual growth trends, journal distribution, and disciplinary distribution for RRI publications. Secondly, this study reveals the current state of RRI research by identifying influential literature, journals, authors, countries, and institutions. Thirdly, a phased keyword analysis is conducted to determine the stage characteristics of the RRI field. Finally, based on the bibliometric analyses, this study summarises the evolutionary trajectory of RRI and makes recommendations for future research directions. As a complement to the previous qualitative literature review, the paper provides a systematic and dynamic understanding of RRI research.

The politics of scaling

A fixation on 'scaling up' has captured current innovation discourses and, with it, political and economic life at large. Perhaps most visible in the rise of platform technologies, big data and concerns about a new era of monopolies, scalability thinking has also permeated public policy in the search for solutions to 'grand societal challenges', 'mission-oriented innovation' or transformations through experimental 'living labs'. In this paper, we explore this scalability zeitgeist as a key ordering logic of current initiatives in innovation and public policy. We are interested in how the explicit preoccupation with scalability reconfigures political and economic power by invading problem diagnoses and normative understandings of how society and social change function. The paper explores three empirical sites - platform technologies, living labs and experimental development economics - to analyze how scalability thinking is rationalized and operationalized. We suggest that social analysis of science and technology needs to come to terms with the 'politics of scaling' as a powerful corollary of the 'politics of technology', lest we accept the permanent absence from key sites where decisions about the future are made. We focus in on three constitutive elements of the politics of scaling: solutionism, experimentalism and future-oriented valuation. Our analysis seeks to expand our vocabulary for understanding and questioning current modes of innovation that increasingly value scaling as an end in itself, and to open up new spaces for alternative trajectories of social transformation.

Integrated Policy Package Assessment (IPPA): A Problem-Oriented Research Approach for Sustainability Transformations

In this paper, we present the Integrated Policy Package Assessment (IPPA) approach and relate IPPA to three substantial concepts of problem-oriented research concerned with societal transformations: technology assessment (TA), sustainability research (SR), and responsible research and innovation (RRI). The IPPA approach provides (political) decision-makers with transformation and orientation knowledge via a four-step process of (1) design, (2) analysis, (3) evaluation, and (4) discourse of a policy package assessment. It is illustrated with a case study of urban passenger transport. As an integrated approach, IPPA has substantial ties to TA, SR, and RRI. It connects with TA in fundamental ways, since it combines the field of TA with the field of regulatory assessment based on consequence analysis. Connectable to the field of SR, IPPA addresses deliberation processes and sustainable pathway identification based on multi-criteria assessment. In addition, akin to the area of RRI, IPPA shows cross-cutting axes with regards to social resonance assessment and stakeholder evaluation with a focus on multi-actor responsibilities. In this contribution, we link evidence-based impact assessment with transformation pathway mechanisms and corresponding policy packages, backed by stakeholder-based responsible innovation feedback loops. This enhances the ex-ante analysis of policy packages regarding their intended as well as unintended consequences.

It's a circular argument: Examining how a novel configuration impacts information flow in submarine control rooms

The continuing advancement of technology means that sociotechnical systems are primed for revolutionary changes to ways of working that can increase capability. It is critical to consider the unintended impact technology can have on human operators particularly regarding information flow and interactions within teams. Previous research revealed that the co-location of operator's dependent on each other for task relevant information can optimise information flow previously constrained by engineering considerations. The current work compared a novel circular configuration to that of a contemporary submarine control room. In the circular configuration, consoles faced inwards, permitting eye contact between operators, and three large screen displays were introduced to provide all operators with the same information. Ten teams participated in low and high demand dived tracking scenarios in a simulated submarine control room. All communications between operators were recorded in order to generate social, information, and task networks. These were statistically compared to networks generated from a baseline study of contemporary operation. Overall, the volume of verbal communications significantly reduced, information exchange was more structured, and the volume of tasks completed by operators significantly increased when operating in an inward facing circle configuration. The current work provides support for a data driven evidence-based approach to design that is information centric but endorsed by the end user to optimise performance and increase productivity. Implications of the work and future research ideas are discussed.

The Value of Citizen Participation in Technology Assessment, Responsible Research and Innovation, and Sustainable Development

The participation of citizens in scientific research has a long tradition, and in some disciplines, especially medical research, it is even common practice. In Technology Assessment (TA), Responsible Research and Innovation (RRI), and Sustainable Development (SD), the participation of citizens can be of considerable value. In this paper, we explore this value for three concepts, based on the researcher’s insights from three participatory research projects. The first project is the citizen science project TeQfor1, which was conducted with, for, and on the type 1 diabetes community, who do not feel adequately supported by the conventional health care system. In the second project, citizens with vision impairments participated in the technological development of an audio-tactile navigation tool in the TERRAIN project. The third project (Nachtlichter) dealt with light pollution. Based on the three projects presented, we show that citizen participation makes specific contributions to TA, RRI, and SD. We also investigate the specificity of citizen engagement and motivation by differentiating between existing and emerging involvement. In conclusion, we discuss the benefits that may be added by participatory approaches for the three concepts of TA, RRI, and SD.

Valuing patient engagement: Reflexive learning in evidence generation practices for health technology assessment

Much attention in health technology assessment (HTA), a health system governance mechanism used for determining the value of health technologies, is being paid to improving the quality and patient-relevance of the evidence used in assessment pratices. Whilst the direct involvement of patient actors throughout HTA processes has become a more routine element of institutional practice, the 'impacts' of patient engagement (PE) initiatives have proven difficult to determine and enhance. In reflexive governance theories, reflexive learning is a critical mechanism of multi-stakeholder arrangements that better handles the complexities of technologies and how they are understood through governance practices. This paper explores how reflexive learning can be used to build a richer conceptualisation of PE in HTA, in order to generate suggestions for enhancing PE practices and their impact. We critically apply reflexive learning insights on qualitative data derived from the co-creation process of a PE evaluation framework, organised through an EU project focused on strengthening PE practices across medicines development (2018-2020), including 24 interactive case studies, 3 multi-stakeholder workshops, and our observations throughout the project. The findings characterise two dimensions of reflexive learning in PE: First, reflexive learning refers to the adaptive reorganisation of evidence generating practices, including the revision of medicines' evaluation criteria and the conditions under which evidence 'relevant' to HTA is constructed. Second, reflexive learning spotlights the sociopolitics which shape technology evaluation. Four themes affecting meaningful and sustained PE in medicines development were analysed: institutional boundaries due to established evaluation criteria; timing of engagements; network relations between institutional actors; and the politics of patient representation. Extending beyond discrete PE activities and their reported impacts, reflexive forms of learning are crucial to yielding more 'meaningful' PE for HTA and medicines development, facilitating a HTA practice that more meaningfully deals with the complexities of medicines evidence generation.

Contextualizing Security Innovation: Responsible Research and Innovation at the Smart Border?

Current European innovation and security policies are increasingly channeled into efforts to address the assumed challenges that threaten European societies. A field in which this has become particularly salient is digitized EU border management. Here, the framework of responsible research and innovation (RRI) has recently been used to point to the alleged sensitivity of political actors towards the contingent dimensions of emerging security technologies. RRI, in general, is concerned with societal needs and the engagement and inclusion of various stakeholder groups in the research and innovation processes, aiming to anticipate undesired consequences of and identifying socially acceptable alternatives for emerging technologies. However, RRI has also been criticized as an industry-driven attempt to gain societal legitimacy for new technologies. In this article, we argue that while RRI evokes a space where different actors enter co-creative dialogues, it lays bare the specific challenges of governing security innovation in socially responsible ways. Empirically, we draw on the case study of BODEGA, the first EU funded research project to apply the RRI framework to the field of border security. We show how stakeholders involved in the project represent their work in relation to RRI and the resulting benefits and challenges they face. The paper argues that applying the framework to the field of (border) security lays bare its limitations, namely that RRI itself embodies a political agenda, conceals alternative experiences by those on whom security is enacted upon and that its key propositions of openness and transparency are hardly met in practice due to confidentiality agreements. Our hope is to contribute to work on RRI and emerging debates about how the concept can (or cannot) be contextualized for the field of security-a field that might be more in need than any other to consider the ethical dimension of its activities.

Responsible Innovation and Climate Engineering. A Step Back to Technology Assessment

Much in Responsible Research and Innovation (RRI) is part of a participatory turn within the Technology Assessment (TA) and Science and Technology Studies (STS) community. This has an influence also on the evaluation of Climate Engineering (CE) options, as it will be shown by reference to the SPICE project. The SPICE example and the call for democratisation of science and innovation raise some interesting concerns for the normative evaluation of CE options that will be addressed in the paper. It is by far not clear, or so it will be argued, how much of the innovation process of CE technologies should be put in the hands of social actors and the wider public. This is due not only to special features about CE technologies but also to some more principle concerns against some features of participatory RRI approaches. Still, this does by no way mean that ethical and societal issues in the context of CE technologies should be ignored. Rather, the paper will argue that one can take a step back to expert TA linked to the evolution of approaches of ethical impact analysis in this area. This does not only lead to reconsider the emphasis on participation and democratisation of research and innovation, but also opens up for an alternative evaluative framework for CE technologies developed in the last part of the paper.

Innovation Dynamics of Socio-Technical Alignment in Community Energy Storage: The Cases of DrTen and Ecovat

With energy transition gaining momentum, energy storage technologies are increasingly spotlighted as they can effectively handle mismatches in supply and demand. The decreasing cost of distributed energy generation technologies and energy storage technologies as well as increasing demand for local flexibility is opening up new possibilities for the deployment of energy storage technologies in local energy communities. In this context, community energy storage has potential to better integrate energy supply and demand at the local level and can contribute towards accommodating the needs and expectations of citizens and local communities as well as future ecological needs. However, there are techno-economical and socio-institutional challenges of integrating energy storage technologies in the largely centralized present energy system, which demand socio-technical innovation. To gain insight into these challenges, this article studies the technical, demand and political articulations of new innovative local energy storage technologies based on an embedded case study approach. The innovation dynamics of two local energy storage innovations, the seasalt battery of DrTen® and the seasonal thermal storage Ecovat®, are analysed. We adopt a co-shaping perspective for understanding innovation dynamics as a result of the socio-institutional dynamics of alignment of various actors, their articulations and the evolving network interactions. Community energy storage necessitates thus not only technical innovation but, simultaneously, social innovation for its successful adoption. We will assess these dynamics also from the responsible innovation framework that articulates various forms of social, environmental and public values. The socio-technical alignment of various actors, human as well as material, is central in building new socio-technical configurations in which the new storage technology, the community and embedded values are being developed.

Art-Science Collaboration in an EPSRC/BBSRC-Funded Synthetic Biology UK Research Centre

Here I examine the potential for art-science collaborations to be the basis for deliberative discussions on research agendas and direction. Responsible Research and Innovation (RRI) has become a science policy goal in synthetic biology and several other high-profile areas of scientific research. While art-science collaborations offer the potential to engage both publics and scientists and thus possess the potential to facilitate the desired "mutual responsiveness" (René von Schomberg) between researchers, institutional actors, publics and various stakeholders, there are potential challenges in effectively implementing collaborations as well as dangers in potentially instrumentalizing artistic work for science policy or innovation agendas when power differentials in collaborations remain unacknowledged. Art-science collaborations can be thought of as processes of exchange which require acknowledgement of and attention to artistic agendas (how can science be a conceptual and material resource for new aesthetics work) as well as identification of and attention to aesthetic dimensions of scientific research (how are aesthetics and affective framings a part of a specific epistemological resource for scientific research). I suggest the advantage of specifically identifying public engagement/science communication as a distinct aspect of such projects so that aesthetic, scientific or social science/philosophical research agendas are not subsumed to the assumption that the primary or only value of art-science collaborations is as a form of public engagement or science communication to mediate biological research community public relations. Likewise, there may be potential benefits of acknowledging an art-science-RRI triangle as stepping stone to a more reflexive research agenda within the STS/science communication/science policy community. Using BrisSynBio, an EPSRC/BBSRC-funded research centre in synthetic biology, I will discuss the framing for art-science collaborations and practical implementation and make remarks on what happened there. The empirical evidence reviewed here supports the model I propose but additionally, points to the need to broaden the conception of and possible purposes, or motivations for art, for example, in the case of cross-sectoral collaboration with community engaged art.

Socio-Problematization of Green Chemistry: Enriching Systems Thinking and Social Sustainability by Education

The current research on systems thinking criticizes the additive nature of green chemistry (GC) not being supportive of systems thinking to achieve holism in its practices. This paper argues that systems thinking should comprise of the social issues, and, therefore, it studies renowned papers by GC pioneers and reviews on the field regarding how they address the social dimension of sustainability. It points out how GC has ignored social sustainability in its discourses, practices, and evaluations, leading to a reductionist interpretation of sustainability. Then, this paper presents some challenges to be overcome in order to achieve balanced sustainability. A systemic chemical thinking is advocated, considering chemistry in culture and chemistry as culture, expanding the chemistry rationality from ontological and technological dimensions into the epistemological and ethical ones. It is then discussed how chemistry education can help to promote sustainability in a broad and systemic way.

Aligning sustainability assessment with responsible research and innovation: Towards a framework for Constructive Sustainability Assessment

Emerging technologies are increasingly promoted on the promise of tackling the grand challenge of sustainability. A range of assessment and governance approaches seek to evaluate these claims, but these tend to be applied disparately and lack widespread operationalisation. They also face specific challenges, such as high levels of uncertainty, when it comes to emerging technologies. Building and reflecting on both theory and practice, this article develops a framework for Constructive Sustainability Assessment (CSA) that enables the application of sustainability assessments to emerging technologies as part of a broader deliberative approach. In order to achieve this, we discuss and critique current approaches to analytical sustainability assessment and review deliberative social science governance frameworks. We then develop the conceptual basis of CSA - blending life-cycle thinking with principles of responsible research and innovation. This results in four design principles - transdisciplinarity, opening-up, exploring uncertainty and anticipation - that can be followed when applying sustainability assessments to emerging technologies. Finally, we discuss the practical implementation of the framework through a three-step process to (a) formulate the sustainability assessment in collaboration with stakeholders, (b) evaluate potential sustainability implications using methods such as anticipatory life-cycle assessment and (c) interpret and explore the results as part of a deliberative process. Through this, CSA facilitates a much-needed transdisciplinary response to enable the governance of emerging technologies towards sustainability. The framework will be of interest to scientists, engineers, and policy-makers working with emerging technologies that have sustainability as an explicit or implicit motivator.

Treatment With Tumor-infiltrating Lymphocytes in Advanced Melanoma: Evaluation of Early Clinical Implementation of an Advanced Therapy Medicinal Product

Tumor-infiltrating lymphocytes (TIL)-therapy in advanced melanoma is an advanced therapy medicinal product (ATMP) which, despite promising results, has not been implemented widely. In a European setting, TIL-therapy has been in use since 2011 and is currently being evaluated in a randomized controlled trial. As clinical implementation of ATMPs is challenging, this study aims to evaluate early application of TIL-therapy, through the application of a constructive technology assessment (CTA). First the literature on ATMP barriers and facilitators in clinical translation was summarized. Subsequently, application of TIL-therapy was evaluated through semistructured interviews with 26 stakeholders according to 6 CTA domains: clinical, economic, patient-related, organizational, technical, and future. In addition, treatment costs were estimated. A number of barriers to clinical translation were identified in the literature, including: inadequate financial support, lack of regulatory knowledge, risks in using live tissues, and the complex path to market approval. Innovative reimbursement procedures could particularly facilitate translation. The CTA survey of TIL-therapy acknowledged these barriers, and revealed the following facilitators: the expected effectiveness resulting in institutional support for an internal pilot, the results of which led to the inclusion of TIL-therapy in a national coverage with evidence development program, the availability of an in-house pharmacist, quality assurance expertise and a TIL-skilled technician. Institutional and national implementation of TIL-therapy remains complex. The promising clinical effectiveness is expected to facilitate the adoption of TIL-therapy, especially when validated through a randomized controlled trial. Innovative and conditional reimbursement procedures, together with the organization of knowledge transfer, could support and improve clinical translation of TIL and ATMPs.

Hitting a moving target: digital transformation and welfare technology in Swedish municipal eldercare

INTRODUCTION

This article contributes to the discussion on digital transformation and welfare technology in municipal eldercare. The aim of welfare technology solutions is to exceed the current welfare system and to meet the challenges of an ageing population through technological innovations and applications that help people to better cope with health issues and strengthen their participation, activity and independence regarding their own healthcare.

METHODS

First, this article outlines a number of different perspectives on technological and social change. Against this backdrop, this article portrays the challenges faced by Swedish municipal eldercare organizations due to the moving targets of digital transformation and the development of welfare technologies.

CONCLUSION

In this context, eldercare organizations are at risk of becoming victims of the fast pace at which technology develops and the rhetoric of technological determinism; they may try to pursue the latest technological innovation at the expense of their stakeholders' needs. The implementation and deployment of welfare technology become a real-world social experiment. Without proper tools for evaluation, welfare technology might be implemented and deployed as an end in itself, instead of as means for better ageing or improved eldercare. This article concludes by framing a set of questions to help increase the understanding of welfare technology implementation and deployment in order to mitigate risks and improve outcomes. IMPLICATIONS FOR REHABILITATION Analysis of different perspectives regarding technological and social change. Identification of the challenges faced by municipal eldercare organizations due to digital transformation. Presentation of evaluation questions to increase the understanding of welfare technology implementation and deployment in order to mitigate risks and improve outcomes.

A Systems Approach to Project Stakeholder Management: Fuzzy Cognitive Map Modeling

Projects that make effective use of project stakeholder management (PSM) tend to run smoothly and be successful because stakeholders understand and agree with the project approaches and outcomes. Projects with ineffective stakeholder management, on the other hand, frequently experience delays and cost overruns or may even be terminated. To date, project teams have limited methodological support for PSM: Existing methods are dominantly static and internally focused, making it difficult to manage so-called external stakeholders, who are not under the authority of the project manager. This work aims to improve PSM practice by closing the methodological gap. We developed a novel decision-support methodology, based on Fuzzy Cognitive Map (FCM) modeling that leverages stakeholders’ public comments to anticipate the project’s impacts on them and to make conflicts between stakeholder interests and project objectives transparent. A demonstration of the method is provided using a single case—namely, a longitudinal case study at Bonneville Power Administration (BPA), a federal agency that provides power to the Pacific Northwest.

Situating anticipation in everyday life: Using sensory methods to explore public expectations of synthetic biology

Public involvement in technological anticipation is a common feature of contemporary sociotechnical innovation. However, most engagements abstract sociotechnical futures, rather than situating them in the everyday practices in which people are routinely engaged. Recent developments in synthetic biology have established the potential for 'drop in' replacements for ingredients in consumer products, particularly in flavour and fragrance markets. This article explains how a sensory methodology can be used to explore citizens' everyday experiences and how these can be used to ground anticipation of possible sociotechnical futures. The article uses a socio-historical approach to analyse and compare two practice domains - caring for families and hygiene and personal care - to show how biosynthetic futures can disrupt existing relations between people, objects and ideas. The implications for conceptualising publics in synthetic biology and for approaches to public engagement and participation are discussed more broadly.

Precaution, Responsible Innovation and Beyond - In Search of a Sustainable Agricultural Biotechnology Policy

The recent ruling by the European Court of Justice on gene edited plants highlighted regulatory inadequacy as well as a decades-old political problem, namely how to reconcile diverging expectations regarding agricultural biotechnology in Europe. Over time, regulators had tried out various tools to address concerns and overcome implementation obstacles. While initially focussing on risk (with the Precautionary Principle), they later tried to better embed technology in society (e.g., through Responsible Research and Innovation). The PP got criticized early-on; meanwhile, it seems to have lost much of its salience. Responsible Research and Innovation (RRI) is associated with problems of participation and political impact, often rendering it a public awareness tool only. We discuss problems with both approaches and conclude that also RRI falls short of facilitating technology implementation in the way regulators might have had in mind. Rather than leaving political decisions to technical risk assessment or ethics and public awareness, we argue for re-establishing a broad yet sober process of opinion formation and informed decision-making in agricultural policy.

Constructing future scenarios as a tool to foster responsible research and innovation among future synthetic biologists

The emerging field of synthetic biology, the (re-)designing and construction of biological parts, devices and systems for useful purposes, may simultaneously resolve some issues and raise others. In order to develop applications robustly and in the public interest, it is important to organize reflexive strategies of assessment and engagement in early stages of development. Against this backdrop, initiatives related to the concept of Responsible Research and Innovation (RRI) have also appeared. This paper describes such an initiative: the construction of future scenarios to explore the plausibility and desirability of potential synthetic biology innovations. We guided teams of synthetic biology students who participated in the large international Genetically Engineered Machines (iGEM) competition, in constructing scenarios aimed at exploring the plausibility and desirability of potential synthetic biology innovations. In this paper we aim to examine to what extent, and how, constructing such future scenarios contributes to RRI. In order to do so, we conducted observations and interviews to understand what kind of learning and reflection was promoted by constructing the scenarios in terms of four dimensions, which are discussed prominently in the literature on RRI: anticipation, inclusion, reflexivity and responsiveness. While we focus on how constructing future scenarios can contribute to strengthening RRI at a project (and individual) level, we also consider how far our experiment may foster RRI in the iGEM competition in general, and perhaps even inspire constructive collaboration between 'social scientists' and 'natural scientists' in the context of larger scientific research programmes.

Rawls's Wide Reflective Equilibrium as a Method for Engaged Interdisciplinary Collaboration: Potentials and Limitations for the Context of Technological Risks

The introduction of new technologies in society is sometimes met with public resistance. Supported by public policy calls for "upstream engagement" and "responsible innovation," recent years have seen a notable rise in attempts to attune research and innovation processes to societal needs, so that stakeholders' concerns are taken into account in the design phase of technology. Both within the social sciences and in the ethics of technology, we see many interdisciplinary collaborations being initiated that aim to address tensions between various normative expectations about science and engineering and the actual outcomes. However, despite pleas to integrate social science research into the ethics of technology, effective normative models for assessing technologies are still scarce. Rawls's wide reflective equilibrium (WRE) is often mentioned as a promising approach to integrate insights from the social sciences in the normative analysis of concrete cases, but an in-depth discussion of how this would work in practice is still lacking. In this article, we explore to what extent the WRE method can be used in the context of technology development. Using cases in engineering and technology development, we discuss three issues that are currently neglected in the applied ethics literature on WRE. The first issue concerns the operationalization of abstract background theories to moral principles. The second issue concerns the inclusiveness of the method and the demand for openness. The third issue is how to establish whether or not an equilibrium has been reached. These issues should be taken into account when applying the methods to real-world cases involving technological risks. Applying the WRE method in the context of engaged interdisciplinary collaboration requires sensitivity for issues of power and representativeness to properly deal with the dynamics between the technical and normative researchers involved as well as society at large.

Medical Technology Assessment: The use of the Analytic Hierarchy process as a Tool for Multidisciplinary Evaluation of Medical Devices

Most types of medical technology assessment are performed only after the technology has been developed. Consequently, they have only minor effects on changes in clinical practice. Our study introduces a new method of constructive medical technology assessment that can change the development and diffusion of a medical device to improve its later clinical effectiveness. The method, based on Saaty's Analytic Hierarchy Process, quantitatively supports discussions between various parties involved in technological development and diffusion. We applied this method in comparing a new blood pump with two competitors based on technical, medical and social requirements. These discussions changed the evaluators’ perspectives, reduced diasagreements, and ended in a reliable evaluation of the pump's performance. On the basis of these results, adaptations were derived which improved the design and diffusion of the blood pump. This application shows the adequate potential of our method to steer technological development and diffusion of artificial organs.

Organizing a Collaborative Development of Technological Design Requirements Using a Constructive Dialogue on Value Profiles: A Case in Automated Vehicle Development

Following societal and policy pressures for responsible innovation, innovators are more and more expected to consider the broader socio-ethical context of their work, and more importantly, to integrate such considerations into their daily practices. This may require the involvement of 'outsiders' in innovation trajectories, including e.g. societal and governmental actors. However, methods on how to functionally organize such integration in light of responsible innovation have only recently started to emerge. We present an approach to do just that, in which we first develop value profiles of the involved actors, and second, design a workshop setting that allows innovators to develop design requirements in collaboration with representatives of parties that are not usually involved in such innovation design practices. Using a case study in automated vehicle development, we positively demonstrate the possibility and utility of our approach. We stress that in this study we wish to demonstrate the functionality of our developed method, and did not search for scientifically valid outcomes regarding this technical field.

The Strength of Ethical Matrixes as a Tool for Normative Analysis Related to Technological Choices: The Case of Geological Disposal for Radioactive Waste

The ethical matrix is a participatory tool designed to structure ethical reflection about the design, the introduction, the development or the use of technologies. Its collective implementation, in the context of participatory decision-making, has shown its potential usefulness. On the contrary, its implementation by a single researcher has not been thoroughly analyzed. The aim of this paper is precisely to assess the strength of ethical matrixes implemented by a single researcher as a tool for conceptual normative analysis related to technological choices. Therefore, the ethical matrix framework is applied to the management of high-level radioactive waste, more specifically to retrievable and non-retrievable geological disposal. The results of this analysis show that the usefulness of ethical matrixes is twofold and that they provide a valuable input for further decision-making. Indeed, by using ethical matrixes, implicit ethically relevant issues were revealed-namely issues of equity associated with health impacts and differences between close and remote future generations regarding ethical impacts. Moreover, the ethical matrix framework was helpful in synthesizing and comparing systematically the ethical impacts of the technologies under scrutiny, and hence in highlighting the potential ethical conflicts.

Holding the Project Accountable: Research Governance, Ethics, and Democracy

This paper seeks to address research governance by highlighting the notion of public accountability as a complementary tool for the establishment of an ethical resonance space for emerging technologies. Public accountability can render development and design process of emerging technologies transparent through practices of holding those in charge of research accountable for their actions, thereby fostering ethical engagement with their potential negative consequences or side-effects. Through practices such as parliamentary questions, audits, and open letters emerging technologies could be effectively rendered transparent and opened up to broader levels of scrutiny and debate, thereby contributing to a greater adherence of emerging technologies to ethics and moral consensus. Fundamental democratic practices could thus not only lead to better informed choices in design and development processes, but also contribute to more morally substantive outcomes.

Societal impact of synthetic biology: responsible research and innovation (RRI)

Synthetic biology is an emerging field at the interface between biology and engineering, which has generated many expectations for beneficial biomedical and biotechnological applications. At the same time, however, it has also raised concerns about risks or the aim of producing new forms of living organisms. Researchers from different disciplines as well as policymakers and the general public have expressed the need for a form of technology assessment that not only deals with technical aspects, but also includes societal and ethical issues. A recent and very influential model of technology assessment that tries to implement these aims is known as RRI (Responsible Research and Innovation). In this paper, we introduce this model and its historical precursor strategies. Based on the societal and ethical issues which are presented in the current literature, we discuss challenges and opportunities of applying the RRI model for the assessment of synthetic biology.

Science Outside the Lab: Helping Graduate Students in Science and Engineering Understand the Complexities of Science Policy

Helping scientists and engineers challenge received assumptions about how science, engineering, and society relate is a critical cornerstone for macroethics education. Scientific and engineering research are frequently framed as first steps of a value-free linear model that inexorably leads to societal benefit. Social studies of science and assessments of scientific and engineering research speak to the need for a more critical approach to the noble intentions underlying these assumptions. "Science Outside the Lab" is a program designed to help early-career scientists and engineers understand the complexities of science and engineering policy. Assessment of the program entailed a pre-, post-, and 1 year follow up survey to gauge student perspectives on relationships between science and society, as well as a pre-post concept map exercise to elicit student conceptualizations of science policy. Students leave Science Outside the Lab with greater humility about the role of scientific expertise in science and engineering policy; greater skepticism toward linear notions of scientific advances benefiting society; a deeper, more nuanced understanding of the actors involved in shaping science policy; and a continued appreciation of the contributions of science and engineering to society. The study presents an efficacious program that helps scientists and engineers make inroads into macroethical debates, reframe the ways in which they think about values of science and engineering in society, and more thoughtfully engage with critical mediators of science and society relationships: policy makers and policy processes.

May Stakeholders be Involved in Design Without Informed Consent? The Case of Hidden Design

Stakeholder involvement in design is desirable from both a practical and an ethical point of view. It is difficult to do well, however, and some problems recur again and again, both of a practical nature, e.g. stakeholders acting strategically rather than openly, and of an ethical nature, e.g. power imbalances unduly affecting the outcome of the process. Hidden Design has been proposed as a method to deal with the practical problems of stakeholder involvement. It aims to do so by taking the observation of stakeholder actions, rather than the outcomes of a deliberative process, as its input. Furthermore, it hides from stakeholders the fact that a design process is taking place so that they will not behave differently than they otherwise would. Both aspects of Hidden Design have raised ethical worries. In this paper I make an ethical analysis of what it means for a design process to leave participants uninformed or deceived rather than acquiring their informed consent beforehand, and to use observation of actions rather than deliberation as input for design, using Hidden Design as a case study. This analysis is based on two sets of normative guidelines: the ethical guidelines for psychological research involving deception or uninformed participants from two professional psychological organisations, and Habermasian norms for a fair and just (deliberative) process. It supports the conclusion that stakeholder involvement in design organised in this way can be ethically acceptable, though under a number of conditions and constraints.

Constructive eHealth evaluation: lessons from evaluation of EHR development in 4 Danish hospitals

BACKGROUND

Information and communication sources in the healthcare sector are replaced with new eHealth technologies. This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using traditional summative evaluation methods. The Constructive eHealth evaluation method (CeHEM) provides a solution to these problems by offering an evaluation framework for supporting and facilitating end-user involvement during all phases of eHealth development. The aim of this paper is to support this process by sharing experiences of the eHealth evaluation method used in the introduction of electronic health records (EHR) in the North Denmark Region of Denmark. It is the first time the fully developed method and the experiences on using the CeHEM in all five phases of a full lifecycle framework is presented.

METHODS

A case study evaluation of the EHR development process in the North Denmark Region was conducted from 2004 to 2010. The population consisted of clinicians, IT professionals, administrators, and vendors. The study involved 4 hospitals in the region. Data were collected using questionnaires, observations, interviews, and insight gathered from relevant documents.

RESULTS

The evaluation showed a need for a) Early involvement of clinicians, b) The best possible representation of clinicians, and c) Workload reduction for those involved. The consequences of not providing this were a lack of ownership of decisions and negative attitudes towards the clinical benefits related to these decisions. Further, the result disclosed that by following the above recommendations, and by providing feedback to the 4 actor groups, the physicians' involvement was improved. As a result they took ownership of decisions and gained a positive attitude to the clinical benefits.

CONCLUSIONS

The CeHEM has proven successful in formative evaluation of EHR development and can point at important issues that need to be taken care of by management. The method provides a framework that takes care of feedback and learning during eHealth development. It can thus support successful eHealth development in a broader context while building on a well-known success factor: end-user involvement in eHealth development.

What can science and technology studies learn from art and design? Reflections on 'Synthetic Aesthetics'

In this paper we reflect on a project called 'Synthetic Aesthetics', which brought together synthetic biologists with artists and designers in paired exchanges. We - the STS researchers on the project - were quickly struck by the similarities between our objectives and those of the artists and designers. We shared interests in forging new collaborations with synthetic biologists, 'opening up' the science by exploring implicit assumptions, and interrogating dominant research agendas. But there were also differences between us, the most important being that the artists and designers made tangible artefacts, which had an immediacy and an ability to travel, and which seemed to allow different types of discussions from those initiated by our academic texts. The artists and designers also appeared to have the freedom to be more playful, challenging and perhaps subversive in their interactions with synthetic biology. In this paper we reflect on what we learned from working with the artists and designers on the project, and we argue that engaging more closely with art and design can enrich STS work by enabling an emergent form of critique.

Definitions and Conceptual Dimensions of Responsible Research and Innovation: A Literature Review

The aim of this study is to provide a discussion on the definitions and conceptual dimensions of Responsible Research and Innovation based on findings from the literature. In the study, the outcomes of a literature review of 235 RRI-related articles were presented. The articles were selected from the EBSCO and Google Scholar databases regarding the definitions and dimensions of RRI. The results of the study indicated that while administrative definitions were widely quoted in the reviewed literature, they were not substantially further elaborated. Academic definitions were mostly derived from the institutional definitions; however, more empirical studies should be conducted in order to give a broader empirical basis to the development of the concept. In the current study, four distinct conceptual dimensions of RRI that appeared in the reviewed literature were brought out: inclusion, anticipation, responsiveness and reflexivity. Two emerging conceptual dimensions were also added: sustainability and care.

A Mobilising Concept? Unpacking Academic Representations of Responsible Research and Innovation

This paper makes a plea for more reflexive attempts to develop and anchor the emerging concept of responsible research and innovation (RRI). RRI has recently emerged as a buzzword in science policy, becoming a focus of concerted experimentation in many academic circles. Its performative capacity means that it is able to mobilise resources and spaces despite no common understanding of what it is or should be 'made of'. In order to support reflection and practice amongst those who are interested in and using the concept, this paper unpacks understandings of RRI across a multi-disciplinary body of peer-reviewed literature. Our analysis focuses on three key dimensions of RRI (motivations, theoretical conceptualisations and translations into practice) that remain particularly opaque. A total of 48 publications were selected through a systematic literature search and their content was qualitatively analysed. Across the literature, RRI is portrayed as a concept that embeds numerous features of existing approaches to govern and assess emerging technologies. Our analysis suggests that its greatest potential may be in its ability to unify and provide political momentum to a wide range of long-articulated ethical and policy issues. At the same time, RRI's dynamism and resulting complexity may represent its greatest challenge. Further clarification on what RRI has to offer in practice-beyond what has been offered to date-is still needed, as well as more explicit engagement with research and institutional cultures of responsibility. Such work may help to realise the high political expectations that are attached to nascent RRI.