Visceral Prostheses

Front matter

THEORY IN THE NEW HUMANITIES

Somatechnics and Posthuman Embodiment

Margrit Shildrick

SECTION ONE From mechanical to visceral prostheses 17

1 The disabled body and the prosthetic imaginary 23 Bodies in technology 24 Disability assemblages 31 Prosthetic creativity 37

2 The phenomenology of organ and tissue transplantation 45 The PITH project and Merleau-Ponty’s phenomenology 47 The gift of life and concorporeality 55 Deleuzian somatechnics 65

3 Micro-biologies 71 1 The microbiome 74 Immunity and the self 81 2 Microchimerism 84 Autoimmunity and the immunitary paradigm 94

SECTION TWO Ecosystems in action 103 4 Queer(y)ing dementia 107 Robotic technologies 110 vi CONTENTS

The impact of micro-biologies 121 Biophilosophy and dementia 125

5 Stem cell therapies and (bio)assemblages 129 Biocultural dimensions 132 The microchimeric and immunological context 138 Biophilosophy and SCT 143

6 Genetic origins and surrogacy 149 Microchimerism and the law 152 Entangled maternal/foetal cells and surrogacy 155 Post-individual corporeal philosophy 165

SECTION THREE Towards posthuman embodiment 169

7 Temporalities of life and death 173 Death and organ donation 176 Living on and hauntological relations 182 Temporality and sustainability 190

Notes 211 Bibliography 227 Index 249

LIST OF ILLUSTRATIONS

Phantom affect in an amputee man 30

Lisa Bufano performing 35

Diagram of a left ventricular assist device (LVAD) 61 Microbiota and the gut-brain axis 80

Classical chimera 86

PARO robot seal 113

PaPeRo robot 117

Potential uses of stem cells 130

ACKNOWLEDGEMENTS

Acknowledgements are often slippery things, necessarily as incomplete, indeterminate and open-ended as any postmodernist would wish. A passing remark from a random encounter may be as influential as the most intensive academic engagement. Every book is an assemblage of planned and irregular inputs, and I hope the emergence of the quasi-finished product will strongly resonate with at least some of the multiple contributors. Given the difficulty of assigning any weight to individual influence, and the exclusionary nature of lists, I am keeping names to a minimum and begin at the more formal end of the scale.

The research that underlies Visceral Prostheses has been several years in the making, but a personal grant from the Swedish Riksbankens Jubileumsfond enabled me to explore how I might put it all together in a coherent form. The success of that application owes much to Silje Lundgren at my original base of Linköping University. A later grant from the KONE Foundation competed the book project. I have also been very fortunate in having two recent fellowships — one at the Humanities Research Centre, Australian National University and the other at the Helsinki Collegium for Advanced Studies — both of which provided a forum for rigorous discussion and critique. My affiliation to Stockholm University as a Guest Professor was negotiated by Lisa Kall, who has become not only a good friend (and thank you too to Ossian Kall for his hospitality) but is also an inspiring scholar of phenomenology. Lisa and I are both committee members of the Nordic Network for Gender, Body, Health, another source of valuable explorations. My longest lasting research commitment has been with the brilliant collaborative Canadian/UK team that formed to research the manifold dimensions of heart transplantation. Everyone played a crucial part, but I’m especially grateful to Pat McKeever for her foresight in cementing an unlikely transdisciplinary alliance and to Heather Ross and Susan Abbey for taking the risk of stepping beyond their clinical reputations. Thanks are also due to all those people who invited me to speak at conferences and seminars worldwide, and to all the attendees who asked provocative questions or shared their own observations, as have the many students I have taught or supervised. I often feel like a magpie collecting shiny fragments (though the good scholar in me is compelled to acknowledge that the ornithological myth has been debunked). So many things trigger a new productive thought.

ACKNOWLEDGEMENTS ix

The whole text was written — or in some chapters heavily reorganised and rethought from existing articles and presentations — during the period of corona virus lockdown in the UK, so face-to-face encounters were extremely limited. What took their place were endless email exchanges and Zoom meetings which proved surprisingly sustaining. Regular dates with the estimable team — and dear friends — of Nina Lykke, Marietta Radomska and Patricia MacCormack, who together offered forceful encouragement to start writing, have been a delight, and though intellectual discussion happened very much round the edges, each of them has been highly influential over many years of mutually impassioned critique in shaping this book. On a very direct level, several others whose views I respect have generously read discrete chapters and have offered invaluable feedback as I try out new ideas — Magda Górska, Liz MacGarvey, Janet Price and my partner Lis Davidson — while the enthusiasm of Christina Schiies and Sonja van Wichelen has been instrumental in honing the articles that underpin Chapters 5 and 6 respectively. These are ‘Stem Cell Transplantation, Microchimerism and Assemblages’ in Madeleine Herzog et al (eds) Stem Cell Transplantations between Siblings as Social Phenomena. Springer (forthcoming 2022) and ‘Maternal—Foetal Microchimerism and Genetic Origins: Some Socio-Legal Implications’, forthcoming in Science, Technology and Human Values.

Finally, special thanks to Margherita Pevere and Marco Donnarumma, both for the inspiring creativity of their own work and for their generosity in thinking through the cover image with me.

Introduction

The question of prostheses — as interventions into human embodiment — has occupied both philosophical and cultural enquiry throughout the last two centuries offering both the promise of improvement and the intimation that there is something strangely inhuman and negative about the use of such supplements. That fundamental ambivalence was powerfully captured in Sigmund Freud’s dictum that man has become a kind of prosthetic god (1961: 39), by which he meant that the technology contemporary to his own day had enabled the human race to acquire superhuman qualities that enhanced an already-exceptional status. The self-extensiveness of that godlike character did not, however, ensure happiness for human beings, according to Freud, but rather signalled something troubling. In the twenty-first century, we might no longer aspire to godlike status, but dreams of a transhuman futurity remain strong and still rely on the logic of prostheses, in which material supplements, advanced technologies and digital media (Foster 1997) allow us to imagine an enhanced, even perfected, state of human being. With fleshy limitations and vulnerabilities overcome and individual life extended, perhaps indefinitely, the promise outlined by the most optimistic proponents of transhumanism is at the same time unwelcome and unsettling to many, who wish to see a move away from the dimensions of human life as it is currently conceived. The alternative — and it is central to the explorations of this text — is an embrace of a posthuman future that instead of seeking to supplement and transcend the existing order prefers to uncover the multifarious ways in which embodiment already exceeds its established boundaries and meshes with non-human entities.

In the postmodern era, the interface of bodies, biologies and technologies increasingly challenges not only normative embodiment, but also the very understanding of what counts as human. And I emphasise ‘what’ here rather than ‘who’ to indicate that the posthuman no longer lines up human selfhood and human biology as the only facets that count. The deployment of prostheses, both inorganic and more significantly organic, is one major area which demonstrates how embodiment can be varied such that the usual markers of human being - bounded bodies, unique DNA, an enduring sense of self — can no longer be taken for granted. We are already familiar with the ways in which prosthetic technologies,! both external and internal to the body, have been utilised in relation to people with disabilities, and by those undergoing organ transplantation who may also experience mechanical aids prior to obtaining an organic prosthesis. What is less well-recognised is that research in the biological sciences indicates that each of us carries a variety of non-self, effectively prosthetic, cells and sub-cellular forms of life from multiple sources. Where prostheses once simply marked rehabilitation to normative practice or appearance, they now indicate transformative possibilities that both limit and extend the nature of the embodied self. Visceral Prostheses looks at the challenge to the Western understanding of the human that comes from those bodies that should be understood not as irregular forms of normative embodiment, but as the more visible cases of a common experience. The text engages with recent continental philosophy and feminist theory to open up the significance of prostheses in revaluing multiple variant forms and in thinking human and multispecies transcorporeality as the very condition of life.

Before outlining the way in which I shall problematise the conventional form, and then reimagine the technology and logic of prostheses, it is important to look at the recent history in which that technology has developed. Clearly the use of mechanical aids to human capabilities stretches much further back — one thinks of the many images of disabled people using wooden peg-legs, for example, or the discovery of prosthetic toes in ancient Egyptian tombs (Finch 2011) — but in the modern Western era public familiarity with many prosthetic apparatuses seems to have surged during and after the widespread bodily mutilations occasioned during the American Civil War. As enhanced anaesthetic techniques developed to preserve life, the need for reparative devices to rehabilitate wounded veterans — an estimated 60,000 men lost limbs alone in the war (Riordan 2004) — was met by a US government program named the ‘Great Civil War Benefaction’ which committed to provide all combatants disabled in battle with prosthetic aids (Hasewaga and Schmidt 2012). The financial incentive led to an acceleration in the design, production and use of artificial limbs, a development that was widely recognised and to an extent sentimentalised through the dissemination of the visual images fostered by glass-plate photography made available for public consumption. To the present day, armed conflict and war have remained among the primary drivers of prosthetic technologies,” with governmental-funded organisations like DARPA (Defense Research Projects Agency) and its Revolutionizing Prosthetics initiative for upper limb injuries, or the Neural Engineering System Design (NESD) program which is developing a machine-brain sensory interface for restorative and enhancement purposes, to the fore. DARPA is obligated to ensure that such advances percolate into the commercial market offering prosthetic relief, not so much to average people with disabilities, but to those able to afford cutting-edge technologies, until less sophisticated spin-offs are mass produced to offer improvements in everyday use. The coming together of militarism, capitalism and consumerism in the history of prostheses is a recurring thread.

The term ‘prosthesis’ itself (derived from the homologous Greek word meaning ‘addition’) first appeared in English in early-eighteenth-century medical texts, where it was used to denote the ‘replacement of a missing part of the body with an artificial one’ (Wills 1995: 215). In that sense it signalled a therapeutic use in which a specific loss or lack in the natural attributes and functions of the human body could be compensated to some degree by a mechanical and wholly external device. A prosthetic leg or even a simple crutch might aid mobility, while a glass eye, although non-functional, might give an approximation of facial normality. The split between appearance and functionality has been a long-standing issue in the pragmatics of prostheses with disabled users often having to choose between aesthetics — understood as the best resemblance to normative body image — and practicality. In the convention with its stress on simple substitution and rehabilitation to normality, prostheses are understood to operate primarily within the field of disability and its associated states of ageing and ill-health. That is not however where it can remain, and once the commonplace meaning of the term prosthesis is abandoned, we can engage instead with an expanded understanding of the ‘prosthetic impulse’ (Smith and Morra 2006) that marks out the energies and flows of usually — but not always — technological devices that are inseparable from human being. In short, our embodiment exemplifies a mode of somatechnics. As such, the operative arena opens on to a nexus of unexpected but constitutive assemblages that disorder the very idea of normative corporeality. Disability, as Chapter 1 will demonstrate, is far from being an unfortunate condition that can be ameliorated by mechanical aids, but rather the jump-off point for an adventure in applied posthumanism. This is not to belittle the discriminatory experiences of disabled people in mainstream society, but - as my adaptation of Eve Kosofsky Sedgwick’s radical rethinking in Tendencies of the experience of her cancer as ‘an adventure in applied deconstruction’ (1994: 12) signals — to make a break with normative thinking.

My own exploration of the meaning and significance of prostheses is increasingly read through the diverse phenomena of disability, organ transplantation and the micro-biology of the immune system in the context of the microbiome and of microchimerism.* In biomedicine the latter refers to a small but significant presence of non-self-cells coexisting within a dominant population of self-cells in the same body but carrying different DNA. The phenomenon, which I elaborate in Chapter 3, is highly challenging in its disruption of biomedical, philosophical and socio-cultural expectations alike. Each of the three areas — disability, transplantation and micro-biology — has been explored in isolation, but I will examine their complex interfaces around the question of how our understanding of normative embodiment is being transformed in the age of advanced biotechnologies. Where conventional conceptions of prostheses refer to devices that replace or augment impaired parts of the body for rehabilitation purposes, I broaden the scope to encompass both mechanical and organic prostheses, which, going further, will include any material incorporated into the structure and performativity of the body — familiar examples are the microbes that inhabit the gut — that cannot be identified with what is understood as the substance of the biological self. I use the term visceral prostheses to indicate both the embodied physicality and, more metaphorically, the ‘stickiness’ of prosthetic assemblies. Whatever the context, such prostheses do not remain separate from the forms of embodiment under consideration, but signal a state of entanglement or hybridity that gives a depth of ontological meaning that cannot be reduced to its constituent parts. That perception is very clearly at work in the case of transplantation and in internal biology, as I shall go on to explore, but how does it enhance our understanding of the interface between putative disability and prostheses?* Although there is plentiful evidence of the desire to separate the embodied self from any technological aid — the mainstream disability community is careful to refer to a wheelchair user, for example —I would argue that that reflects a modernist mindset that pays scant attention to the phenomenology of embodied experience in which a prosthesis, whether high or low-tech, becomes integrated into selfhood. In that phenomenological mode, which draws on the work of Merleau-Ponty (1962), the common understanding of the self is problematised. As with the other registers explored in this book, the resultant prostheticised entity is best described as an assemblage in which the very concept of what is meant by human being is at stake.

Visceral Prostheses, then, proposes new understandings of the limits and possible enmeshments of human embodiment that alongside a philosophical theorisation encompass cutting-edge interdisciplinary research in critical disability studies, transplantation studies and in biomedicine. Although some initial work is underway that makes links between these fields, this is a largely unexplored area even in the medical humanities. At the same time, it is important to remember that the sphere of biomedicine itself cannot be thought of as a unified domain but more often one in which rigid disciplinary silos impede the cross-fertilisation of disparate insights. The mainly immunological research that has established the prevalence of microchimerism, for example, has been slow to gain recognition within the wider field (Martin 2010), though there are finally signs of growing credibility. My own position as a postmodernist and feminist philosopher and body theorist, with an extensive interest in the problematics of critical disability and heart transplantation, has long enabled me to engage with and draw out the significance of how those areas exemplify a rejection of the modernist notion of the singular embodied self. It is, however, with the further move into the highly complex and technical research of the biological sciences that new and often startling insights have begun to emerge that embed abstract speculations in the most material setting of flesh and blood bodies. It is not that science offers verification as such — for the biomedical imaginary is as entrenched as any other — but more that the different perspectives enrich understanding.

Even within contemporary scholarship, both feminist and postmodernist, and long after the materialist turn,’ there remains nonetheless a surprising reluctance to think through a scientific lens lest it should diminish or essentialise the concerns of the humanities. And from the opposite direction, clinical researchers and practitioners are often deeply wary of the ambiguities and ambivalences associated with the humanities. The suspicion of science — and, for feminists, of bioscience in particular — as an authoritative and reductive discourse has been hard to shift, and it may feel that the traffic in ideas is not reciprocal. Bioscientists themselves, often for reasons of professional reputation, are usually highly reluctant to commit to extraevidential thinking or to consider the non-medical implications of their research, although that cannot universally be the case. As Samantha Frost (2016) makes clear the concept of human life as intrinsically biocultural is well-established in many research labs, and in my own work, I have been fortunate to confer with several bioscientists working on the microbiome and microchimerism who are eager to share not just the empirical data but their more speculative reflections. What I hope to do in Visceral Prostheses — from an admittedly extra-scientific perspective — is to open up some of those tantalising pathways where bioscience and the humanities speak to each other. Perhaps the most innovative thrust of the enterprise concerns the least-known aspect of the problematic, specifically my development of the notion of microchimerism as a prosthetic process with implications for us all. The synergy of diverse research, both theoretical and empirical, can not only deliver new modalities of thought about the most pressing questions of human life and death, but also at the limit destabilise those very categories and point towards posthuman embodiment.

The expanded notion of prostheses, as both external and internal to corporeality, that the project explores is right at the cutting edge in understanding transformations of the body and in recognising the alreadyexistent ubiquity of transcorporeality. Scholars as diverse as the feminist Katherine Hayles (1999), critical disability theorists David Mitchell and Sharon Snyder (2000) and philosopher Bernard Stiegler (1998) all play critically with the idea that we are all always already prosthetic. That notion underpins a challenge to the concrete, specific and material means and processes through which bodies appear as essentialised, and therefore as fundamentally unchangeable forms. What this means for either embodied individuals or for the socio-cultural imaginary is the focus of sustained debate, not least because while we cannot ignore the insight that the human body can be manipulated, extended or substituted seemingly without limits, there is, as Don Ihde (2008) insists, no certain outcome to such processes. At the present time, the expansive development of innumerable biotechnologies that intervene in the body is a matter of both optimism and caution, and deserve deep consideration, though many aspects fall beyond the scope of this book. The parameters I have set depend on tapping into and then pushing to new plateaus existing pockets of alternative and disparate thinking in a number of crucial arenas: transplantation studies, with its concern for ontological issues as well as cultural differences (Sharp 2006; Shildrick 2014); prosthetic theory (Smith and Morra 2006; Shildrick 2013a), which always contests the boundaries of the given body; critical disability studies, especially in its recent turn to a body-based phenomenological and/ or Deleuzian approach (Goodley 2007; Shildrick 2009; Gibson et al 2012); and immunology, which has recently emerged as a powerful site of challenge to the singular embodied self in both political (Esposito 2008, 2013; Staikou 2014) and biomedical thinking (Bianchi 2007; Cohen 2009; Pradeu 2012).

Donna Haraway’s question ‘Why should our bodies end at the skin?’ (1991: 178) has become ever more relevant and has particular significance in the extended context of prostheses, which I understand as both exceeding the putatively ‘natural’ body and being located deep inside its very biology. As such transformatory processes accelerate in their soma-technological capacities, or simply come to light as existing facets of the body, we urgently need to address the issue of posthuman embodiment. What makes the approach of Visceral Prostheses truly innovative is that under the umbrella concept of the prosthesis, I will tease out the interconnections between the areas of the lived experience of disability, and of organ and tissue transplantation — both of which I extend into other conditions of embodiment — with the emergent field of microchimerism. The point is to show how thinking them together can mobilise more adequate theoretical perspectives on the issue of transcorporeal embodiment — and indeed transspecies embodiment — and more importantly how those postconventional scenarios underpin a reconfigured bioethics. The potential shift in our understanding of the highly heterogeneous material conditions of embodiment, which nevertheless yield some striking commonalities in relation to transcorporeality, constitutes a major opportunity to move scholarship forward. By most accounts, the horizon of the posthuman is not far distant and I would urge that academia has an ethical responsibility to respond to it, not least by exploring the extended parameters offered by posthumanist discourse.

However prostheses are conceived; they have the potential to shake our faith in corporeal integrity even when they are enlisted with the aim of simply restoring the clean and proper body. My claim is that prostheses can always effect powerful transformations of the embodied subject that move beyond mere modification towards the far more radical step of rethinking the limits of the human. In invoking at very least an inevitable — yet troubling and productive — hybridity, such supplements to the human embodiment raise the question of identity to another register. Leaving aside for a moment the micro-biological aspects referred to above which greatly extend our understanding of prostheses, the descriptive history of the use of mechanical, and latterly organic, aids, to replace missing or faulty parts, and more recently of enhancement technologies to ‘improve’ bodily appearance or functionality, focuses on the matter of instrumental expediency. Such histories offer deceptively simple classifications that fail to engage with contemporary body theory, and even as a prosthesis evokes a sense of the human/technological interface, the concomitant notion of hybridity is itself already limited in its allusion to two or more separate entities that come together to form a new whole. As will become clear in the text, what concerns me instead is the generation of a deep ambiguity and final undecidability that mark an ontological as well as epistemological shift. In either sense, however, the notion of the prosthesis tellingly plays out an infinite confusion of identities and boundaries between the human, animal and machine, where each category itself is already highly complex and indeterminate. The once-astonishing notion of the cyborg as a form of technologised human being is now greatly complicated by the realisation that biotechnologies, nanotechnologies, information technologies and cognitive science are potentially mutually implicated in a model that raises the fundamental philosophical question of what constitutes the human as such. As Smith and Morra put it:

Prostheses ... have the potential to form an integral part of certain speculations on the corporeal surface, the psyche, and the interior and exterior limits of the body and to the ways that these efforts to renegotiate discourses on ‘the human’ might attend to the edges between these material and immaterial surfaces and limits. (2006: 6-7)

My purpose in bringing together disability, micro-biology, transplantation and their subsets is to suggest ways in which insights from each area can combine to shed light on the philosophical and cultural meanings and significances of prosthetic embodiment. In many senses the centuries-old project of the European Enlightenment has reached the point of inadequacy — not necessarily redundancy, as there are still many facets to carry forward — and what is now urgently needed is a thorough reconfiguration of the bioethics, epistemology and ontology of what has hitherto been understood as ‘proper’ human embodiment. In the postmodern era, the purity of strictly ‘human’ embodiment is highly contested and it is necessary to think a different future that does not take for granted the wholeness, separation and independence of the body. By gaining a deeper understanding of the conceptual underpinnings of the prosthetic experience, which are fundamentally about the relation between self and otherness, and less obviously about the nature of life and death, and indeed our deference to linear temporality — at least within the confines of Westernised thought —I want to suggest ways forward in the task of welcoming prostheticised embodiment, whether in the context of disability, donated body parts or internal biology. That final domain is of particular significance for although the troublesome aspects of the human/ machine interface have already generated much critical commentary, my further complication of the term prosthesis takes up the implicit challenge set out by many of the contributors to the edited collection, The Prosthetic Impulse (Smith and Morra 2006). While reasserting the ‘phenomenological, material and embodied nature of the “prosthetic impulse”’ (2006: 3), the editors explicitly caution against dismissing the speculative potential of the term. In my own use, I give particular weight to the philosophical significance of wholly organic prostheses as in transplanted material and more specifically to the largely unexplored arena of cellular translocation. As my attention turns inwards, the viscerality of prostheses becomes increasingly evident.

In each modality I want to focus not just on how the incorporation of non-self elements that cause disruption must be negotiated, but more challengingly on whether incorporation - which implies a primary agent — remains the appropriate term. On a pragmatic level, disabled people who deploy prostheses, and especially those with non-congenital disabilities, must always strive to accommodate something alien to their own prior lived experience (Sobchack 2010). Yet rather than simply achieving a re-integration of the embodied self and a rehabilitation of their practices, such people often feel marked by the unfamiliar experiential input and capabilities that construct the prosthetically embodied self (Serlin 2006). The patterns of inclusion and exclusion, and categories of normal and abnormal, and natural and artificial, that generally circulate in societies of the global North contribute further to such inherent ambiguities and contradictions.° The turn to transplantation, where the prosthesis is most usually organic, reveals a similar disturbance to the conventional binary pattern in that when the donor organ crosses the threshold of the recipient body, ontological questions of self and other frequently arise. This is not simply an abstract subjective concern insofar as the transplant organ brings to its new site an alien DNA that will persist for life (Shildrick et al 2009). Full integration is never possible, for as the donor DNA circulates in the peripheral blood supply, enduring microchimerism — the major concern of my third modality — is likely to occur. The event of microchimerism, which causes both philosophical and biomedical trouble, inevitably invokes and radically challenges the fundamental tenet of immunology that self and non-self are fully distinguished at the cellular level. Although in each area the ideal is integration — effectively a reconstruction of any existing personal or socio-cultural identity - what constitutes the embodied self is no longer clear.

The use and/or incorporation of prostheses cannot be read, then, as simply utilitarian and in both disability and organ transplantation they are often associated with a dysphoria that indicates the difficulties of identity reformation (Sharp 2006; Ross et al 2010; Sobchack 2010). Despite a biomedical reading of prostheses as always therapeutic and often literally life-saving, recipients may tell a different story not just of enduring physical discomfort but of mental/psychic distress that far exceeds the positivist claims made for biotechnological interventions. The phenomenon of microchimerism, in contrast, is so little known or acknowledged that its immediate physical or psychic effects cause no psycho-social difficulty; yet, biomedically it is believed to be concomitant — both positively and negatively — with a range of autoimmune diseases, Alzheimer’s disease and much unexplained morbidity. In biomedical literature, microchimerism is variously associated with transplantation (Starzl et al 1992), pregnancy (Maloney 1999; Bianchi 2007), non-irradiated blood transfusions (Nelson 2002), bone marrow transplants (Nikolic and Sykes 1997) or the fusion of two zygotes that develop into a single body with two distinct sets of DNA (Norton and Zehner 2008), with further suggestions that lactation and fluid sexual exchanges can also generate the phenomenon (Yan et al 2005). More to the point of this study, it relocates the self-other problematic of prostheses away from the ‘whole’ body to the viscerality of the cellular level (Nelson 2012). In short, as the prevalence of microchimerism is slowly being recognised as ubiquitous, it raises challenges to our belief in genetic singularity and inviolability, just as the microbiome is doing on another sub-cellular level.

The overriding question is to ask what kinds of re-embodiment are being enacted. Can chimeric embodiment, for example, break free of origin narratives (place/nation, gender, race, culture, genetics) and overcome their persistence in the imaginaries (socio-cultural, psycho-social and bioscientific) that underlie the prevalent modes of thought in the global North? The realisation that the parameters of the modernist forms of knowledge that are habitually deployed in the context of prostheses are in any case highly limited is something that Western-based or educated scholars, such as myself, must always keep in mind. A fully decolonial critique and an expert appreciation of non-Western practices would, I believe, open up exciting new possibilities of how we understand the fragility, indeed the impossibility, of the singular self, which other cultures have long accepted.’ My ambitions outrun my expertise and what I offer here is a steppingstone to a differently realised project that would not be primarily reliant on contesting some forms of colonial thought from an ostensibly more sensitive position within the same colonising system. With that in mind, the aim of demonstrating how all the key areas of my investigation both contest and sustain Western imaginaries — in which only those who are normatively embodied as whole, independent, separate and distinct are afforded the privileged status of human - remains both necessary and urgent. Based on the differential material practices, the problematic demands a detailed critique of the socio-cultural processes at work in each field as a tension is generated between disruption and successful transposition in relation to prosthetic phenomena. The aim is to shake up the familiar certainties of modernist thought by exposing all the gaps, fissures and aporia between the ideal and the actual that render some lives unsustainable. In attending to the actual uncertainty of the human body, the objective is to instantiate a new understanding of transcorporeal embodiment that challenges the assumed purity — or at least the clarity — of the human as such and moves towards what is loosely called the posthuman. In short, by rethinking the transformatory potential of prosthetic embodiment in its various guises, it becomes possible to go beyond the dominant conventions of modernism and enable an entanglement with otherness and difference that is the mark of posthuman assemblage. And once the ontological and epistemological bases are reconfigured, it becomes apparent that what is required is a differently composed and intrinsically flexible bioethics.