Hardware, Software, Peopleware, Subjectivity^[*]

Summary

Objective: This paper develops the closing address the author was asked to deliver at the MEDINFO 2004 Congress in San Francisco.

Method: Starting from three working conferences, dealing with evaluation of health information systems, where he was involved, the author describes the evolution of his personal ideas.

Results and Conclusions: First he proposes the main distinction between systems where the user(s) remain(s) external from the running program, from the ones where the user(s) interacting with the program become(s) the main component of the system.

In the first case, the methods of evaluation are the conventional methods used in Medical Technology Assessment. In the second case, the whole knowledge in anthropology (considered in its broadest meaning), may contribute strongly to evaluation.

It becomes clear that the subjectivity of the user(s), how he (or they) react(s) with the computing machinery, is a main key to the success or failure of the whole system.

As the eradication of subjectivity is often considered, since the beginning of “modern times”, as a condition for progress, the author claims that such a temptation is deleterious for our civilization threatened by a comeback of barbarity, and is scientifically wrong.

For that demonstration, he calls on both philosophical concepts (from Aristotle to E. Husserl, M. Henry and J. Searle), and the most recent advances of neurosciences.

Keywords

Medical information system - evaluation - subjectivity - modernity

^* 1st IMIA/UMIT Medical Informatics Award of Excellence Lecture, given on September 11, 2004 in San Francisco, USA, during MEDINFO 2004

• References

• 1 Degoulet P, Grémy F. Assessment of Health Information Technology. In. Flagle CD, Gremy F, Seymour P. (eds). Proceedings of the 1990 IMIAISTA HC joint working conference in Montpellier. Rennes: Editions de l’ENSP; 1991: 47-86.
• 2 Grémy F, Bonnin M. Evaluation of Automatic Health Information systems. What and How?. In: Assessment and Evaluation of Information Technologies. Van Gennip EMSJ, Talmon JL (eds). Amsterdam: IOS Press; 1995: 9-20.
• 3 Grémy F, Fessler JM, Bonnin M. Information systems evaluation and subjectivity. Int J of Med Informatics 1999; 56: 13-23.
• 4 Winograd T, Flores F. Understanding Computers and Cognition. Reading: Addison Wesley Publishing Co.; 1986
• 5 Henry M. La Barbarie. Paris: Grasset; 1987
• 6 Caritat A. Marquis de Condorcet. Esquisse d’un Tableau historique des progrès de l’esprit humain.
• 7 Husserl E. La crise des sciences europeennes et la phenomenologie transcendantale (1935-1936). French translation by Granel G. Paris: Gallimard; 1972
• 8 Henry M. opus quoted.
• 9 Lacan J. Les Ecrits. Seuil. Paris: 1966
• 10 Henry M. opus quoted.
• 11 Dilthey W. Einführung in die Geisteswissenschaften 1883. French translation: Introduction aux sciences de l’esprit. In Oeuvres; vol 1. Paris: Cerf; 1992
• 12 Heiddeger M. La question de la Technique. In Essais et Conférences. Paris: Gallimard; 1958
• 13 Huxley TH. quoted by James W in the Principles of Psychology. Cambridge: Harvard University Press; 1981
• 14 Kant I. Fondements de la Métaphysique des Moeurs. Paris: Librairie Philosophique Vrin; 1997
• 15 Pascal B. Pensées IV, 267 and 253. Dictionnaire de citations françaises. Paris: Edition Le Robert; 1978
• 16 Saint Augustin. Les Confessions. La Pléiade. Paris: NRF; 1998
• 17 Begout B. Edmond Husserl. In. Cabestan P. (ed). Introduction à la Phenomenologie. Paris: Ellipses; 2003
• 18 Searle JR. Du cerveau au Savoir. Paris: Hermann; 1985. La redécouverte de l’Esprit. Paris: Gallimard; 1992
• 19 Edelman GM. Plus vaste que le ciel: une nouvelle theorie generale du cerveau. Paris: Odile Jacob; 2004
• 20 Damasio A. Le sentiment meme de soi: corps, emotions, conscience. Paris: Odile Jacob; 1999
• 21 Vincent JD. Biologie des Passions Odile Jacob, Paris, 1986. Le coeur des autres, biologie de la compassion. Paris: Odile Jacob; 2003
• 22 Eliot TS. Choeurs extraits de The Rock, a pageant play.
• 23 Hippocrates La Loi. In: Hippocrate: De l’Art Médical. Paris: Le livre de poche. 1994