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Implications of past, present and future performance enhancing technologies
Performance Enhancement & Health 3 (2015) 59–60
Contents lists available at ScienceDirect
Performance Enhancement & Health journal homepage: www.elsevier.com/locate/peh
Editorial
Implications of past, present and future performance enhancing technologies
The underlying basis for Performance Enhancement and Health is both expanding and refining in response to the broadening scope of queries and submissions received by the journal. The broadening community of scholars taking an interest in the journal is finding creative ways of deconstructing and reconstructing the performance:health nexus (Mazanov & Quirk, 2012). From an Editorial point of view, this is both rewarding and challenging, as it keeps the team learning about and navigating entire fields of scholarship that have a bearing on questions relating to the nexus. With the broadening of scope comes the potential for analysis of the performance:health nexus using lessons from the past, examining contemporary issues, and working to anticipate the future.
1. Past – Mother’s Little Helper History has important stories to tell about the health implications of introducing new performance enhancing technologies. The years following World War 2 saw a massive increase in the amount of domestic labour saving technologies (e.g. washing machines) that had profound implications for the physical, psychological and social health of women (the biopsychosocial approach to health). In physical terms, the burden of intense physical activities (e.g. beating carpets or laundering clothes) was replaced by new burdens (e.g. increasing volume of laundry). In psychological terms, the introduction of domestic labour saving technology saw an increase in distress among women as they adapted to their new role. In social terms, the change in expectations of what women could achieve in the home (e.g. complex meal preparation) stymied anticipated increases in leisure time. In Australia, the revolution in domestic labour saving technologies saw widespread misuse and abuse of powders containing a potently addictive and sometimes deadly mix of aspirin, phenacetin and caffeine (Hennessey, 1993). The Rolling Stones captured the health implications of women self-medicating the introduction of performance enhancing technologies in the United Kingdom with the song “Mother’s Little Helper”. This historical example shows the importance of the lessons to be learned by reflecting on the health implications of performance enhancing technologies, and suggests a closer look at the use of prescription stimulants (e.g. methylphenidate or mixed salts amphetamines) in response to domestic labour demands (especially among parents) to see what the implications of those lessons might be. http://dx.doi.org/10.1016/j.peh.2015.07.002 2211-2669/© 2015 Published by Elsevier Ltd.
2. Present – wearables and work performance systems The growing appetite for smart technology leads to discoveries about what is possible with the new technology. There is no question that smart technology has the potential to dramatically improve performance across the human condition through the emergence of “mHealth”. For example, the introduction of continuous health monitoring through “wearables”, smart devices worn as accessories (e.g. watches or bracelets) or incorporated into clothes (e.g. socks), represents a tool that could potentially revolutionise the understanding of health. Wearables might also lead to unintended physical, psychological and social consequences, both good and bad. Physical health might improve through medical practitioners accessing objective data on what people did rather than rely on self-reports. Psychological health might be compromised in terms of developing dysfunctional health beliefs through a failure to understand what the wearable is doing (Patel, Asch, & Volpp, 2015). Social health might be improved through the establishment of massive data sets of real time behaviour (e.g. physical activity data) means epidemiologists and public health researchers could begin to understand health in fundamentally new ways (Kumar et al., 2013). Given the experiences with domestic technologies, the enthusiasm for the positive effects of new mass produced technologies designed to improve the human condition needs to be tempered with vigilance for the negative implications. Of course, this discussion could occur next to almost any aspect of the wave of smart technologies or their implications. For example, like wearables, attempts to enhance cybersecurity could lead to some unexpected implications for the health of individuals (e.g. security of information), organisations (e.g. insurance) and societies (e.g. access to information and democracy). While the question of health implications for enhancement technologies is obvious when it comes to new gadgets, the increasing sophistication of management systems has similar implications for health. What is less obvious is how performance and health considerations interact within those systems. For example, a new promotions system in a workplace may well lead to an increase in performance across a range of target indicators. The new promotions system could also have unexpected consequences for physical, psychological and social health. Physical health might be enhanced by the promotion system discouraging long working hours and encouraging employees to recover from sustained intense performance. Psychological health might be compromised
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Editorial / Performance Enhancement & Health 3 (2015) 59–60
through the application process becoming so onerous that it leads to depression among applicants irrespective of outcome. Social health could be compromised by systematically denying promotion to “working poor”. Where such questions have long been a part of occupational and organisational disciplines (e.g. occupational health psychology, industrial and organisational sociology and occupational medicine), the focus has tended to be on either performance or health rather than the dynamic reciprocal relationship between the two. Re-evaluating the discussion using the performance:health nexus may lead scholars to explicitly consider how health initiatives can enhance performance at work and performance initiatives are developed with explicit consideration for their health implications. For example, this might include the performance implications of different vacation policies or the health implications of different approaches to change management. 3. Future – “what if. . .” Beyond what has been and what is comes what might be. It is appropriate to consider the performance:health nexus for technologies just emerging onto the market, that exist as a realistic concept, or that exist only as a “what if” in the science fiction and fantasy genre. The emergence of debate in bioethics about the future of human enhancing technologies (e.g. Giubilini & Sanyal, 2015) demonstrates that no matter what the technology looks like, debating its implications can provide some guidance on what can happen when the technology emerges. For example, when the interactive performance enhancement and health implications for advanced nanotechnology, swarm technology or artificial intelligence are discussed relative to the lessons from other performance enhancing technologies (e.g. home appliances and wearables), perhaps some of the list of unanticipated consequences can grow that little bit shorter.
4. Exploring the nexus As the journal advances exploration of the performance:health nexus the scope for consideration expands. It can be easy to assume that performance enhancement impugns health or that concern for health limits the possibilities of performance enhancement. Challenging this assumption leads to two conclusions. The first is that the relationship between the two concepts is dynamic and reciprocal. The second is that the relationship can be complementary, such that improving performance can improve health, and that addressing health concerns can improve performance. The expanding scope for consideration also suggests that exploration of contemporary interactions between performance and health needs to be informed by past experiences and extrapolation to possible futures. We look forward to the ongoing contribution to debate on the interaction between efforts to enhance the human condition through robust evidence and critical discussion. References Giubilini, A., & Sanyal, S. (2015). The ethics of human enhancement. Philosophy Compass, 10(4), 233–243. Hennessey, E. M. (1993). ‘Her stand-by for keeping going’: APC use during the boom decades. Journal of the Royal Historical Society of Queensland, 15(5), 248–264. Kumar, S., Nilsen, W. J., Abernethy, A., Atienza, A., Patrick, K., Pavel, M., et al. (2013). Mobile health technology evaluation: the mHealth evidence workshop. American Journal of Preventive Medicine, 45(2), 228–236. Mazanov, J., & Quirk, F. (2012). The performance enhancement-health nexus. Performance Enhancement & Health, 1(1), 1–2. Patel, M. S., Asch, D. A., & Volpp, K. G. (2015). Wearable devices as facilitators, not drivers, of health behavior change. Journal of the American Medical Association, 313(5), 459–460.
Available online 29 July 2015
Contents lists available at ScienceDirect
Performance Enhancement & Health journal homepage: www.elsevier.com/locate/peh
Editorial
Implications of past, present and future performance enhancing technologies
The underlying basis for Performance Enhancement and Health is both expanding and refining in response to the broadening scope of queries and submissions received by the journal. The broadening community of scholars taking an interest in the journal is finding creative ways of deconstructing and reconstructing the performance:health nexus (Mazanov & Quirk, 2012). From an Editorial point of view, this is both rewarding and challenging, as it keeps the team learning about and navigating entire fields of scholarship that have a bearing on questions relating to the nexus. With the broadening of scope comes the potential for analysis of the performance:health nexus using lessons from the past, examining contemporary issues, and working to anticipate the future.
1. Past – Mother’s Little Helper History has important stories to tell about the health implications of introducing new performance enhancing technologies. The years following World War 2 saw a massive increase in the amount of domestic labour saving technologies (e.g. washing machines) that had profound implications for the physical, psychological and social health of women (the biopsychosocial approach to health). In physical terms, the burden of intense physical activities (e.g. beating carpets or laundering clothes) was replaced by new burdens (e.g. increasing volume of laundry). In psychological terms, the introduction of domestic labour saving technology saw an increase in distress among women as they adapted to their new role. In social terms, the change in expectations of what women could achieve in the home (e.g. complex meal preparation) stymied anticipated increases in leisure time. In Australia, the revolution in domestic labour saving technologies saw widespread misuse and abuse of powders containing a potently addictive and sometimes deadly mix of aspirin, phenacetin and caffeine (Hennessey, 1993). The Rolling Stones captured the health implications of women self-medicating the introduction of performance enhancing technologies in the United Kingdom with the song “Mother’s Little Helper”. This historical example shows the importance of the lessons to be learned by reflecting on the health implications of performance enhancing technologies, and suggests a closer look at the use of prescription stimulants (e.g. methylphenidate or mixed salts amphetamines) in response to domestic labour demands (especially among parents) to see what the implications of those lessons might be. http://dx.doi.org/10.1016/j.peh.2015.07.002 2211-2669/© 2015 Published by Elsevier Ltd.
2. Present – wearables and work performance systems The growing appetite for smart technology leads to discoveries about what is possible with the new technology. There is no question that smart technology has the potential to dramatically improve performance across the human condition through the emergence of “mHealth”. For example, the introduction of continuous health monitoring through “wearables”, smart devices worn as accessories (e.g. watches or bracelets) or incorporated into clothes (e.g. socks), represents a tool that could potentially revolutionise the understanding of health. Wearables might also lead to unintended physical, psychological and social consequences, both good and bad. Physical health might improve through medical practitioners accessing objective data on what people did rather than rely on self-reports. Psychological health might be compromised in terms of developing dysfunctional health beliefs through a failure to understand what the wearable is doing (Patel, Asch, & Volpp, 2015). Social health might be improved through the establishment of massive data sets of real time behaviour (e.g. physical activity data) means epidemiologists and public health researchers could begin to understand health in fundamentally new ways (Kumar et al., 2013). Given the experiences with domestic technologies, the enthusiasm for the positive effects of new mass produced technologies designed to improve the human condition needs to be tempered with vigilance for the negative implications. Of course, this discussion could occur next to almost any aspect of the wave of smart technologies or their implications. For example, like wearables, attempts to enhance cybersecurity could lead to some unexpected implications for the health of individuals (e.g. security of information), organisations (e.g. insurance) and societies (e.g. access to information and democracy). While the question of health implications for enhancement technologies is obvious when it comes to new gadgets, the increasing sophistication of management systems has similar implications for health. What is less obvious is how performance and health considerations interact within those systems. For example, a new promotions system in a workplace may well lead to an increase in performance across a range of target indicators. The new promotions system could also have unexpected consequences for physical, psychological and social health. Physical health might be enhanced by the promotion system discouraging long working hours and encouraging employees to recover from sustained intense performance. Psychological health might be compromised
60
Editorial / Performance Enhancement & Health 3 (2015) 59–60
through the application process becoming so onerous that it leads to depression among applicants irrespective of outcome. Social health could be compromised by systematically denying promotion to “working poor”. Where such questions have long been a part of occupational and organisational disciplines (e.g. occupational health psychology, industrial and organisational sociology and occupational medicine), the focus has tended to be on either performance or health rather than the dynamic reciprocal relationship between the two. Re-evaluating the discussion using the performance:health nexus may lead scholars to explicitly consider how health initiatives can enhance performance at work and performance initiatives are developed with explicit consideration for their health implications. For example, this might include the performance implications of different vacation policies or the health implications of different approaches to change management. 3. Future – “what if. . .” Beyond what has been and what is comes what might be. It is appropriate to consider the performance:health nexus for technologies just emerging onto the market, that exist as a realistic concept, or that exist only as a “what if” in the science fiction and fantasy genre. The emergence of debate in bioethics about the future of human enhancing technologies (e.g. Giubilini & Sanyal, 2015) demonstrates that no matter what the technology looks like, debating its implications can provide some guidance on what can happen when the technology emerges. For example, when the interactive performance enhancement and health implications for advanced nanotechnology, swarm technology or artificial intelligence are discussed relative to the lessons from other performance enhancing technologies (e.g. home appliances and wearables), perhaps some of the list of unanticipated consequences can grow that little bit shorter.
4. Exploring the nexus As the journal advances exploration of the performance:health nexus the scope for consideration expands. It can be easy to assume that performance enhancement impugns health or that concern for health limits the possibilities of performance enhancement. Challenging this assumption leads to two conclusions. The first is that the relationship between the two concepts is dynamic and reciprocal. The second is that the relationship can be complementary, such that improving performance can improve health, and that addressing health concerns can improve performance. The expanding scope for consideration also suggests that exploration of contemporary interactions between performance and health needs to be informed by past experiences and extrapolation to possible futures. We look forward to the ongoing contribution to debate on the interaction between efforts to enhance the human condition through robust evidence and critical discussion. References Giubilini, A., & Sanyal, S. (2015). The ethics of human enhancement. Philosophy Compass, 10(4), 233–243. Hennessey, E. M. (1993). ‘Her stand-by for keeping going’: APC use during the boom decades. Journal of the Royal Historical Society of Queensland, 15(5), 248–264. Kumar, S., Nilsen, W. J., Abernethy, A., Atienza, A., Patrick, K., Pavel, M., et al. (2013). Mobile health technology evaluation: the mHealth evidence workshop. American Journal of Preventive Medicine, 45(2), 228–236. Mazanov, J., & Quirk, F. (2012). The performance enhancement-health nexus. Performance Enhancement & Health, 1(1), 1–2. Patel, M. S., Asch, D. A., & Volpp, K. G. (2015). Wearable devices as facilitators, not drivers, of health behavior change. Journal of the American Medical Association, 313(5), 459–460.
Available online 29 July 2015