Technology and the management of trust in insurance medicine.
This article deals with the question how technology contributed to the performing of objective assessments of health risks and to the public trust in the insurance institution. Many authors have pointed to the relevance of medical or statistical technology with regard to the constitution of objectivity, because these technologies should be capable of diminishing the influence of social interactions--the "human element"--on the process of producing knowledge about health risks. However, in this article it is shown that the constitution of objective risk assessments and public trust cannot be seen as the product of one particular type of technology, but that it is the product of a socio-technical network, in which several heterogeneous elements become interrelated and interdependant. The historical reconstruction of this network also sheds a new light on the role of 'the human element' in the constitution of objectivity and trust. It shows that elements in the network which regulate the social interaction between the subjects involved are of no less importance to generate trust than technologies which tend to abstract from this interaction. In other words, objective and subjective elements are intertwined much more than is often recognized, and public trust is to a fairly large degree depends on conventions in social interaction.
Department of Health Ethics and Philosophy, University of Maastricht, The Netherlands. Klasien.Horstman@ZW.unimaas.nl
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D020811:Biomedical Technology; D004608:Eligibility Determination; D006801:Humans; D007343:Insurance Carriers; D007348:Insurance, Health; D010808:Physical Examination; D018570:Risk Assessment; D013223:Statistics as Topic; D035502:Trust