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242 © Blackwell Publishing Ltd 2004 Nursing Philosophy, 5, pp. 242–250

O r i g

i n a l a r t i c l e

Blackwell Science, LtdOxford, UKNUPNursing Philosophy1466-7681Blackwell Publishing Ltd 200453242250Original articleConcerning TechnologyHilde M. Zitzelsberger

Correspondence: Hilde M. Zitzelsberger, 246 Stephenson

Point Road, Port Perry, Ontario, L9L 1B4, Canada, Tel./fax:

(

+

1) 905 982 1808; e-mail: [email protected]

Concerning technology: thinking with Heidegger

Hilde M. Zitzelsberger BSCN MSc PhD Candidate

Faculty of Nursing, University of Toronto, 50 St. George Street, Toronto, Ontario, M5S 3H4, Canada

Abstract In human lives, technology holds sway in mundane and extraordinary

ways, such as in the ways we work, entertain, transport, and feed our-

selves, and importantly in the ways we encounter and manage health,

disease, illness, and death. A significant area of Heidegger’s later work

is questioning technology. Unlike many current inquiries that centre on

contemporary technology’s function, utility, and positive transforma-

tions, Heidegger offers a radical way of thinking about technologythrough developing an inquiry that uncovers technology’s essence of

revealing. In this article, Heidegger’s thinking about technological

modes of revealing in regard to bodies, health, and illness is explored.

In Heidegger’s view, the ordered revealing of modern technology has

overshadowed other modes of revealing. This article highlights how

remembering concealment and unconcealment in its many modes can

be relevant to nurses and others involved in health care. Through tracing

Heidegger’s thinking about technology, a more critical approach to the

effects and outcomes of modern technologies within health care systems

can be generated.

Keywords:

Heidegger, philosophy, technology, health care, health,

bodies.

In human lives, technology holds sway in mundane

and extraordinary ways, such as in the ways we work,

entertain, transport, and feed ourselves, and impor-

tantly the ways we encounter and manage health,

disease, illness, and death. Health care technologies

that intervene, systemize, and alter courses of health

and illness have become a vital part of health care

provision in Western societies. As such, critical

inquiry into technology holds relevance for nurses

and others involved in health care. A significant area

of Heidegger’s later work is questioning technology.

Unlike many current inquiries that centre on technol-

ogy’s function, utility, or positive transformations,

Heidegger (1954/1993) in his essay ‘The Question

Concerning Technology’ offers a radical way of think-

ing about technology through developing an inquiry

that uncovers technology’s essence of revealing. In

Heidegger’s view, the ordered revealing of modern

technology has overshadowed other modes of reveal-

ing. My interest in thinking about technology with



Concerning Technology

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Heidegger stems from my involvement with people

living with disabilities and chronic illnesses in my aca-

demic work and professional practice in nursing. In

regard to health care of people with disabilities and

chronic illnesses, the use of multiple and variousforms of technological interventions, equipment, and

aids are commonplace, and often unquestioningly

viewed as solely beneficial for sustaining or enhanc-

ing life. Given this, I am moved to think about the

varied effects and outcomes of modern technologies

more deeply in regard to bodies, health, and illness.

In this article, Heidegger’s thinking about technology

is traced to generate a more critical approach to mod-

ern technologies in health care systems.

Questioning technology

Questioning builds a way. . . . The way is thinking.

Modes of thought that describe technology are

taken up by Heidegger as he develops thinking about

technology in order to open us to its essence so that

‘we shall be able to experience the technological

within its own bounds’ (p. 311). Instrumental and

anthropological characterizations of technology as ‘a

means to an end’ and ‘human activity’ (p. 312) com-

monly hold sway in contemporary times. While these

definitions correctly hold from more antiquated to

modern technologies, from the sawmill to the hydro-electric plant, inquiries about technology cannot be

consigned to discourses of instrumentality nor termi-

nate in the project of modern natural sciences, for

example physics or mathematics. In regard to modern

natural sciences, Heidegger explains that:

Through its so doing the deceptive appearance arises that

modern technology is applied science. This illusion can main-

tain itself precisely insofar as neither the essential province

of modern science nor indeed the essence of modern tech-

nology is adequately sought in our questioning. (p. 328)

Heidegger indicates that such critiques return to

their own representations, eluding questioning that

can probe technology’s essence, its possibilities and

dangers. Thus, solely scientific and instrumental con-

ceptions of technology block questioning of technol-

ogy’s essence and ‘conditions every attempt to bring

man into the right relation to technology’ (p. 313).

If we take this neutral stance, Heidegger remarks

that:

Everything depends on our manipulating technology in the

proper manner as a means. We will, as we say, ‘get’ technol-

ogy ‘intelligently in hand’. We will master it. The will to

mastery becomes all the more urgent the more technology

threatens to slip from human control. (p. 313)

Reliance on notions of human mastery of technology

when technology is viewed as an instrument extends

to and intensifies pursuit of mastery over that which

technology can invest and control, such as natural and

physical processes whether those of rivers, land, or

bodies, health, and illness.

Seeking the ‘true’ through the correct provides a

path into unveiling the essence of technology,

obscured by an instrumental definition of technology.

Heidegger questions: ‘What is the instrumental itself?

Within what do such things as means and ends

belong?’ (p. 313). He explains that ‘whenever ends

are pursued and means employed, whenever instru-

mentality reigns, there reigns causality’ (p. 313). For

Heidegger, unveiling causality along with corre-

sponding conceptions of technology is necessary to

move beyond the correct toward uncovering technol-

ogy’s essence. The primal meaning of causality, as

thought by the Greeks and to which means and ends

belong, was once known more completely. Thedeeper and broader significance of causality are dis-

closed by Heidegger through recovering the Aristo-

telian four causes: (1) causa materialis

(the matter of

which something is made); (2) causa formalis

(the

form into which matter is shaped); (3) causa finalis

(the telos which binds together the aspect (eidos or

idea) and matter that gives bounds to the form and

begins the purposeful life of the creation); and (4)

causa efficiens

(that which brings the finished effect).

Expanding the complex forces and elements by

which things come forth into appearance, Heidegger

includes notions of responsibility and indebtedness.

In Greek thought to which Heidegger returns us, the

four causes are aition

‘that to which something else is

indebted’ and ‘being responsible for something else’

(p. 314). The four causes together are coresponsible

and indebted to one another for the presencing of

what appears. Heidegger states:



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The principle characteristic of being responsible is this start-

ing something on its way into arrival. It is in the sense of

such a starting something on its way into arrival that being

responsible is an occasioning or an inducing to go forward.

(p. 316)

In the creation of something, the four undividable

causes that await ordering are gathered together con-

templatively to manifest something that can depart,

beginning its life and purpose. Heidegger finds that if

we understand the essence of causality as occasion-

ing, a bringing-forth into arrival by way of the four

causes, then we grasp causality as responsibility in the

sense that the Greeks thought it. The revealing move-

ments of the four causes are punctuated by Heidegger

through revisiting the verb cadere

, to fall, to which

the word causa

belongs. Considering causality as fall-

ing rather than producing an effect or outcome deter-

mined in advance suggests other ways of occasioning

than notions of a linear projection of means to end

brought about by the collected elements of the four

causes through human mastery.

Significant to our contemporary situation, Heideg-

ger points out that the notion of cause as producing

predetermined effects or outcomes conceals all other

dimensions of causality. Heidegger draws attention to

our current state in which ‘the causa efficiens

, but one

of the four causes, sets the standard for all causality.’(p. 314). He states that ‘this goes so far that we no

longer count the causa finalis

, telic finality, as causal-

ity’ (p. 314), that which bound the creation to begin-

ning its purposeful life. When everything is viewed

within this schema of means–ends, Heidegger

remarks, even in theologies ‘God can sink to the level

of a cause, of causa efficiens

’ (p. 331). Moreover

though, in a time of modern technology, we view

ourselves as fundamental agents of production. Tech-

nology is held up as the instrumental means by which

we bring about ends which we have scientifically pro-

jected as possible. Taking ourselves to be the domi-

neering cause efficiens

, contained in our attempts to

master technology as an instrument is the intent to

order all which can be subject to technological cau-

sality. Highlighting the difference between causality

in a more complete sense as occasioning and the

limited modern sense of causality that is related to

technology, Heidegger questions the notion of tech-

nology, with us at the helm, as the sole means that

produces effects and attains outcomes.

If we recognize that technology is not merely an

instrumental means to an end for human enterprises,then we can question further the nature of technol-

ogy. To think about technology in its essence, Heideg-

ger states, we must ‘take seriously the simple question

of what the name “technology” means’ (p. 318). He

probes the deeper significance of technology, in con-

junction with the four modes of occasioning, through

an etymological understanding of the Greek word

techne,

from which technology derives. Heidegger

states that techne

once meant more than technology

as a ‘contrivance – in Latin, an instrumentum’ (p. 312)

as typically thought in contemporary times.

Techne

is a mode of aletheuein

. It reveals whatever does

not bring itself forth and does not yet lie here before us,

whatever can look and turn out now one way and now

another. . . . Thus what is decisive in techne

does not at all

lie in making and manipulating, nor in the using of means,

but rather in the revealing mentioned before. It is as reveal-

ing, and not as manufacturing, that techne

is a bringing-

forth. (p. 319)

Whether technologies of older times or modern

technologies, techne

is not merely crafting or manu-

facturing but more properly revealing through humanactivity. In that way techne

, as thought of by the

Greeks, refers to the contemplative and cultivating

skills of craftsmen and artists, ‘

techne

belongs to

bringing-forth, to poiesis

; it is something poetic’ (p.

318). Thinking about bringing-forth, as occasioning,

as poiesis,

assists in uncovering what is different in the

mode of revealing of modern technology. Still,

Heidegger remarks, all modes of revealing including

that which arises through modern technology ‘are

indeed fundamentally different, yet they remain

related in their essence’ (p. 326).

Techne

has an important connection with episteme

(knowledge). Heidegger notes that:

Both words are terms for knowing in the widest sense. They

mean to be entirely at home in something, to understand

and to be an expert in it. Such knowing provides an opening

up. As an opening up it is a revealing. (p. 319)




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As an example of the linkage between techne

and

episteme, I think of Heidegger’s words written in the

book that I read. This book does not exist without

prior knowledge of bookness in all that it encom-

passes (paper, ink, binding, reproduction, writtenlanguage, thought, etc.). Materials, form, aspect, and

telos are gathered together by human activity to

reveal a final product whose life begins, in part,

through its departure to a bookstore and then to

myself. The author’s prior knowledge includes that of

bookness as well as thoughtful reasoning opened up

through being written down to be read by others.

Many other people, such as people who cut the trees

for paper and publishers are involved in the finished

product I now read and which could not be brought

forth without multiple and differing knowledges and

activities.

That revealing is the essence of modern technol-

ogy, as described by Heidegger in his thinking

about techne

, is not a simple or straightforward

matter and thus requires further questioning.

Modern technology’s essence reveals, but is an

unconcealment that opens up in a specific way, a

challenging-forth rather than a bringing-forth in the

sense of poiesis

. Heidegger highlights the diver-

gence between techne

as poiesis

and techne

as mod-

ern technology.

The revealing that holds sway throughout modern technol-

ogy does not unfold into a bringing-forth in the sense of

poiesis

. The revealing that rules modern technology is a

challenging [Herausfordern], which puts to nature the

unreasonable demand that it supply energy which can be

exacted and stored as such. (p. 320)

Heidegger considers the crucial question of the

difference between modern technology developed

from industrial times onwards and older forms of

technology. The aggressiveness by which modern

technology is called upon to reveal through challeng-

ing-forth stems from ‘man’s ordering attitude and

behaviour’ which ‘display themselves first in the rise

of modern physics as an exact science’ (p. 326). The

assumptions and work of western natural sciences,

Heidegger tells us, ‘prepares the way not simply for

technology, but for the essence of modern technol-

ogy’ (p. 327).

It is said that modern technology is something incompara-

bly different from all earlier technology because it is based

on modern physics as an exact science. Meanwhile we

have come to understand more clearly that the reverse

holds true as well: modern physics, as experimental, isdependent upon technological apparatus and upon pro-

gress in building of apparatus. . . . Of what essence is mod-

ern technology that it thinks of putting exact science to

use? (p. 320)

Modern physics as a system of epistemic represen-

tation acts upon nature demanding it report itself in

some way or another through calculation and that it

remain orderable’ (p. 328). In this ordering, ‘causality

now displays neither the character of occasioning that

brings forth nor the nature of the causa efficiens

’ (p.

328), along with the loss of accompanying sense of

aition

or responsibility as the Greek thought of it. The

essential order of revealing of modern technology,

which puts exact physical sciences to use is termed

enframing (Gestell) by Heidegger.

Enframing means the gathering together of the setting upon

that sets upon man, i.e. challenges him forth, to reveal the

actual [everything], in the mode of ordering, as standing-

reserve. Enframing means the way of revealing that holds

sway in the essence of modern technology and that is itself

nothing technological. (p. 325)

While what is technological is the apparatus of

technology, for example, machine parts, the destining

of modern technology’s essence has a long history

that precedes the apparatus of modern technologies,

yet now orders available apparatus and ourselves for

use. What is significant then, from older technologies

to newer technologies, concerns domination of nature

through technological modes of challenging-forth

towards its own ordering. Thus, as Heidegger says,

‘this work is therefore neither only a human activity

nor a mere means within such activity. The merely

instrumental, merely anthropological definition of

technology is therefore in principle untenable’ (p.

326).

In the next sections, I explore modern technology’s

mode of revealing in more detail, and specifically in

regard to the body, health, and illness within health

care and nursing practice.



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Modern technology’s revealing

What has the essence of technology to do with reveal-

ing? The answer: everything

.

Modern technology’s way of revealing concernsnature as resource. Through enforced demanding of

natural processes, Heidegger describes the mode of

revealing that is imposed by modern technology.

The revealing that rules throughout modern technology has

the character of a setting upon (

das Stellen

), in the sense of

challenging-forth. Such challenging happens in that the

energy concealed in nature is unlocked, what is unlocked is

transformed, what is transformed is stored up, what is stored

up is distributed, what is distributed is switched about ever

anew. Unlocking, transforming, distributing, and switching

about are ways of revealing. (p. 322)

To illustrate, Heidegger outlines modern technol-

ogy’s grip on nature, in the sense of challenging-forth,

through his description of a hydroelectric plant set in

the flow of the Rhine River, which harnesses the

river’s energy commanding it for energy production

industries as well as the river’s natural beauty struc-

tured now for tourism. Heidegger asks: ‘What kind of

unconcealment is it, then, that is peculiar to that

which results from this setting-upon that challenges?’

(p. 322).

Everywhere everything is ordered to stand by, to be imme-

diately on hand, indeed to stand there just so that it may be

called upon for a further ordering. Whatever is ordered

about in this way has its own standing. We call it standing

reserve [

Bestand

]. (p. 322)

Unlike revealing brought-forth by poiesis

, mod-

ern technology’s challenging-forth regulates the

structure and temporality of nature. Carol Bigwood

(1993) in her essay The Being of Water in the

Hydroelectric Plant

draws on Heidegger’s work to

illustrate technology’s approach to the fluidity of

water and movements of livestock whose energies

are unlocked, transformed, stored, and switched as

standing resources for manufacturing products for

human consumption. Her essay highlights that ‘the

movements of beings’ are underpinned by an Aris-

tolelean sense of movement. Under technology’s

sway, beings do not merely ‘pass from here to there

but in a broader sense as something changing from

this to that, and ultimately as the dynamism of

Be(com)ing, itself’ (p. 224). As such, natural courses

of entities are fundamentally challenged to move

differently than their originating order, in so far aspossible. Unconcealed as standing reserves through

technology, the ontological status of entities

becomes fundamentally concealed, redirected, or

eradicated.

Health care, nursing practice,and technology

I find Heidegger’s views of technology particularly

important to pursue in relation to health care and

nursing practice as they uncover ways to understand

technology’s nature and movements, our relationship

to technology, and all else appropriated by it. Heideg-

ger’s questioning of technology focuses on productive

manufacturing, the entrapment of natural elements of

the earth to produce available energy and materials

in terms of ‘maximum yield at the minimum expense’

(p. 321). The rise of modern technology in processes

of industrialization, underpinned by exacting physical

sciences, expands as well to the technologies of scien-

tific medicine and nursing. Here I extend Heidegger’s

work to my concerns in thinking of the body, health,

and illness. In that modern technology both uncon-ceals and conceals as it orders, how does the body

become present when claimed by this technological

viewpoint? I think here on scientific forms of knowl-

edge by which the body becomes revealed. Like any

natural resource, the body as an object of physical

sciences can by studied in the ways that it has pres-

ences, in terms of its matter, form, function, chemi-

cals, and physical movements. From this viewpoint,

the body can appear as little more than physicality

that is calculable, predictable, and thus, programma-

ble to some extent. In a way similar to Heidegger’s

description of the Rhine or Bigwood’s description of

water in a hydroelectric plant, the body in phases of

health and illness becomes known in a particular

manner. Applied through human activities, technol-

ogy as enframing separates itself from the body’s

originating processes enforcing an order of a different

kind. Heidegger remarks that ‘the essence of modern




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technology starts man on the way of that revealing,

through which the actual [everything] everywhere,

more or less, becomes standing reserve’ (p. 329). In

the sense that we can think of the body as standing-

reserve for these projects, the body then is destinedto be a resource whose naturalness can be

unconcealed and therefore, manipulated, exploited,

ordered, and reordered under the sway of technolog-

ical means. Yet, through revealing the body and its

processes in particular ways, other facets and pro-

cesses become concealed and unknown.

In that technology’s way of revealing has a long

history in physical sciences, modern of health care

technologies are enframed by it. The body revealed

as standing reserve is commonplace within health

care. Health care technologies are designed by

humans to intervene in the function of the body to

produce health or life in a form determined by human

intentions. By extension, mastering technology that

produces health or life leads to the mastery of disease,

illness, and death, rather than the cultivation of nat-

ural processes of healing, decline, or death. The body

now is called on to move to technological rhythms

rather than fundamental biological rhythms. Through

surgery or drugs, the body can be forced to follow a

course not of its original order by use of life-sustain-

ing technologies, such as dialysis or transplants. I

think of this in regard to chronic illness and disabili-ties in which life may be prolonged through challeng-

ing the body or parts of the body to continue in

artificial ways that do not reproduce the original

order of the body. The task of genetic intervention,

inside or outside the womb, is to uncover diseases,

such as mental and physical disabilities not yet man-

ifest, and to manipulate their order so that their orig-

inal experiential course is thwarted. While beneficial

and to be welcomed at times, notions of control of the

body’s processes perpetuate and promote further

precedents. Our successful manipulations of the

body’s function to date has moved debates on to the

subjects of harvesting fetal or organ tissues to alter

diseases, cloning, reproductive technologies, and

turning off the body’s energy through abortion,

assisted suicide, or other technological means.

Nursing work has become increasingly reliant on

health-care technologies to provide knowledge of and

care to patients. From this vantage point, those who

work in health-care institutions are not mere techni-

cians in these technological enterprises. In effect,

patient and practitioner alike become claimed by

technology as standing reserve. Heidegger remarksthat:

Only to the extent that man for his part is already challenged

to exploit the energies of nature can this revealing that

orders happen. If man is challenged, ordered to do this, then

does not man himself belong even more originally than

nature within the standing reserve? (p. 323)

In the politics and economy of health care, that

which is technological is granted the priority form

of care. In health-care systems, people who work

closest to the body in nontechnological or lower-

technological ways, such as personal care attendants

and nurses, for the most part, are socially positioned

as lower status within technological hierarchies,

whereas those who work at a greater distance from

the body through technologies are granted more

social privilege and status. I think here also of medical

research about the body in which studies of the

body’s originating processes and the ways that these

processes can be technologically tampered with drive

our research agendas and funding. Heidegger tells us

that in technological systems, we are both resource

and gathered as the orderer of standing reserve.

Precisely because man is challenged more originally than

are the energies of nature, i.e. into the process of ordering,

he is never transformed into mere standing reserve. Since

man drives technology forward, he takes part in the ordering

as a way of revealing. (pp. 323–324)

Thus, the system of health care drives nurses and

other practitioners to be increasingly available to

technology’s demands to provide service in health-

care institutions. In this way and many others, we are

claimed to be on call for technology so that as

Heidegger remarks, ‘everything disappears into the

objectlessness of standing reserve’ (p. 324). Nursing

is embedded and the culprit is this technologically

driven system. So enframed, ourselves, patients, and

all else are revealed as resource. Following this,

Heidegger’s statement that ‘the illusion comes to

prevail that everything man encounters exists only



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insofar as it is his construct’ (p. 322) can be debated

with regard to medical and health care systems.

Overall and in general, the engagement of nurses

with health-care technologies has been accepted and

incorporated into practice, rather than being the subject of a more critical inquiry into both the benefits

and problems. Heidegger’s inquiry into technology as

a destining of revealing that challenges-forth every-

thing into standing reserve points to many dangers.

Crucial to Heidegger’s questioning of the essence of

technology is the question of our essence, of our own

being and becoming. Heidegger tells us that:

The threat to man does not come in the first instance from

the potentially lethal machines and apparatus of technology.

The actual threat has already afflicted man in his essence.

The rule of enframing threatens man with the possibilitythat it could ever be denied to him to enter a more original

revealing and hence experience the call of a more primal

truth. (p. 333)

It is not the technological apparatus or techniques

that are the danger, but technology’s essence as a

destining of revealing of Gestell, that diminishes or

hides other modes of revealing. The ordering of

revealing that holds sway in Western technological

cultures threatens our own becoming as well as pos-

sibilities for revealing in the sense of bringing-forth.

In effect, as the essence of technology as a destiningof revealing remains concealed to us, so too does the

fullness of our nursing work with sick and well people

remain concealed.

As nursing work becomes ever more bound to

technology, the question of whether we stand at a

threshold in which our technological capacities give

rise to a different kind of order is important. Has

modern technology’s way of revealing obstructed all

ways of revealing in health care? Seemingly rampant,

enframing’s ruling does not fully obliterate all modes

of revealing. In light of the danger and saving inher-

ent in all revealing, Heidegger suggests that, ‘the rule

of enframing cannot exhaust itself solely in blocking

all lighting-up of every revealing, all appearance of

truth’ (p. 334). To elucidate the saving possibilities in

technology’s essence, the meaning of essence is revis-

ited by Heidegger. Interestingly, he notes that ‘it is

technology itself that makes the demand on us to

think in another way about what is usually under-

stood by essence’ (p. 335). Why is this so? If essence

is thought of as ‘what a thing is’ (p. 311) then instru-

mental and anthropological characterizations of tech-

nology as a means and human activity may hold sway.Yet, considering causality and technology’s essence,

revealing in the form of enframement lies within the

realm of human activity, yet ‘neither does it happen

exclusively in man, or definitely through man’ (p.

329). Heidegger moves from common philosophical

thought of essence as ‘what something is’ (p. 334) to

an earlier Greek thought ‘the essence of something

as what it is that unfolds essentially, in the sense of

what endures’ (p. 335), not in permanence as a thing

but in continuous becoming. In claiming that, ‘only

what is granted endures. What endures primally out

of the earliest beginning is what grants’ (p. 336),

Heidegger wants us to grasp that the essence of tech-

nology is revealing that challenges-forth; however,

the original unfolding that is granted, technological

or otherwise, is that of bringing-forth. Thus, technol-

ogy’s essence as a mode of revealing holds within

itself saving possibilities. Heidegger asks ‘might there

not perhaps be a more primally granted revealing that

could bring the saving power into its first shining forth

in the midst of the danger that in the technological

age rather conceals than shows itself’ (p. 339). Con-

cealed within the realm of technology’s destining, hesuggests that poiesis

may lay hidden, and safe-kept

poiesis

may encourage modes of bringing-forth in the

sense of the arts. The dilemma lies in that, as Heideg-

ger says, ‘the revealing that challenges has its origin

as a destining in bring-forth. But at the same time

enframing, in a way characteristic of a destining,

blocks poiesis

’ (p. 335).

Heidegger’s (1954/1993) thinking in his essay ‘The

Question Concerning Technology’ exposes a deeper

understanding of technology and our relationship to

technology, and thus holds significance to those who

work in health care. His intent is to have us think

about technology whose essence ‘is by no means tech-

nological’ (p. 311). Heidegger tells us that unconceal-

ment through the science of technology may permit

correct determinations of natural orders, yet, ‘pre-

cisely through those successes the danger may remain

that in the midst of all that is correct, the true will




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withdraw’ (p. 331). This caution concerns, among

other things, the concealment of technology’s

essence, such as when technology is thought of as

merely instrumental, rather than as a destining of

revealing and particularly a revealing that is not inharmony with occasioning of the four causes but

rather as a veiled challenging of them. Furthermore,

this concerns our relationship to technology’s

essence, in which ‘only the true brings us into a free

(or open) relationship with that which concerns us

from its essence’ (p. 313). In that this ordered unfold-

ing has held sway in modern technology and has over-

shadowed other modes of revealing, bringing a

Heideggerian perspective to nursing practice allows

thinking on technology’s mode of revealing rather

than ‘merely gaping at the technological’ or ‘repre-

senting it as an instrument’ (p. 337) and thus, it opens

our relationship to technology.

In what ways could remembering concealment

and unconcealment in its many modes be relevant

to nurses? The ways may not be widespread or final,

but momentary and on-going. Heidegger posits the

ways are ‘here and now and in little things’ (p. 338).

In regard to our own situations, Heidegger claims it

is never too late to ask questions of how our activi-

ties are challenged forth by our own enframing as

standing reserves and how we ‘admit ourselves into

that wherein enframing itself essentially unfolds’(p. 329). Given this, we may identify and reflect on

how we are or enlist ourselves and others, our col-

leagues, patients, and others, as standing reserves in

health-care practices and systems. A question that

could be asked of any technology encountered may

be: what kind of order of revealing is imposed. Fur-

ther, in that ‘all revealing belongs within a harbour-

ing and concealing’ (p. 330), we may think on that

which remains hidden, when everything is com-

manded as standing reserve or resource. In accor-

dance with Heidegger, I would suggest that the

unconcealment and concealment of the nature’s

originating order cannot be completely blighted by

technology’s mode of revealing. In practice, nurses

often witness revelations of sickness or death or

instances of healing not predicted despite extensive

technological efforts to challenge-forth bodily pro-

cesses otherwise.

In regard to the dangers and saving inherent in the

modern technology put to use, might we think more

deeply about modes of revealing through which

things come into presence and are induced to go for-

ward? Although the challenging-forth of moderntechnology holds sway, Heidegger advocates remem-

brance of ways of revealing through poiesis

of techne

that lead to a more fundamental order. Techne

, as

modern technology, is recognized by Heidegger as

having a long history in coming forth, in which ‘that

which is earlier with regard to its rise into dominance

becomes manifest to us men only later’ (p. 327). The

that which is earlier’ referred to by Heidegger is

epistemologies of the sciences that preceded current

uses of technology. He tells us that ‘there was a time

when it was not technology alone that bore the name

techne

. Once the revealing that brings forth truth

into the splendor of radiant appearance was also

called techne

’ (p. 339). Although nursing work

heavily relies on modern sciences and technologies,

tracing Heidegger’s thinking about technology opens

us to manifold forms of techne

currently employed

and stimulates continued engagement in techne

as

poiesis

that support modes of revealing in the sense

of bringing-forth rather than challenging-forth. In

that techne

and episteme are conjoined, we may rec-

ognize and uphold the many ways of knowing and

acting involved in processes of the work of health,healing, and illness. If in our nursing work, we revive

a sense of causality to which Heidegger has alerted

us, we may be mindful of the interplay of the undi-

vidable four causes in occasioning or inducing some-

thing to go forward. Thus, medicine and health care

might not be taken as the producer of healing or

health, with ourselves the masters of its technology.

Furthermore, the work of nursing does not result in

a tangible and finished ergon or product, as would

art, for example the silver chalice whose creation is

discussed in relation to causality in Heidegger’s

essay. As such, we might remember that the bring-

ing-forth of techne

as poiesis

may be more akin to

the poiesis

of physis

(nature), ‘the arising of some-

thing from out of itself’ (p. 317) which moves more

freely in action and rest, life and death. Heidegger’s

inquiry into technology stimulates thinking on the

rhythms of unconcealment and concealment of



250



, 5

, pp. 242–250

physis

(nature) to remember and support different

modes of perceiving the body, health, and illness

than are possible through the episteme of modern

natural science and the enframing of modern tech-

nology. The proximity of nurses to the life and situa-tions of others place us in an opportune position to

witness and engage coresponsibly in the varied

modes by which health and healing, as well as illness

and death, unfold in our daily practice.

Conclusion

Heidegger remarks that ‘we shall never experience

our relationship to the essence of technology so long

as we merely represent and pursue the technological,

put up with it, or evade it’ (p. 311). Yet, as we cope

with technology by affirmation, denial, or lethargy,

the essence of technology and our relationship to it

remains concealed. In this article, I have traced

Heidegger’s questioning of modern technology in

contemporary Western thought and practices to move

my thinking about technology in health care work in

new directions. In particular, I have been interested

in exploring what Heidegger’s work illuminates about

technology’s ordered revealing in regard to bodies,

health, and illness within health-care systems. His

work fosters an approach that extends thinking about

technology in professional and academic work, as

well in daily life.

Acknowledgements

I would like to extend sincere appreciation to Dr

Francine Wynn for her mentorship in the develop-

ment of this article. I also would like to acknowledge

Dr Patricia McKeever and Laurie Clune for their

support and guidance. This article has been supported

by the CIHR Strategic Research and Training Pro-

gram in Health Care, Technology, and Place and the

Hospital for Sick Children Foundation.

References

Bigwood

C. (1993) The being of water in the hydroelectric

plant. In: Earth Muse: Feminism, Art, and Nature

, pp. 224–

335. Temple University Press, Philadelphia.

Heidegger

M. (1954/1993) The question concerning technol-

ogy. In: Martin Heidegger, Basic Writings

(ed. & tr. D.F.

Krell) Rev edn, pp. 311–341. HarperCollins, New York.

zitzelsberger 2004 - concerning technology- thinking with heidegger

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