First and foremost, here are Janet and John, discussing this blog post for a short introduction:

Thorstein Veblen was a Norwegian-American economist and sociologist who developed groundbreaking theories on social and economic behavior during the late 19th and early 20th centuries. His most famous work, “The Theory of the Leisure Class,” published in 1899, provided a critique of the social values of upper-class society and their impact on social stratification. Although Veblen did not specifically address the situation of people with visible disabilities like amputees, his ideas can be extrapolated to provide insights into this area.

Also, I already posted about him in a previous blog post [here].

Applying his social analysis helps to provide a consistent and coherent understanding of what appears to be a baffling conundrum in prosthetic arm development.

Thorstein Veblen and demonstration or showcasing the “use” of a prosthetic arm by the user

According to Thorstein Veblen’s analysis of leisure class society, people such as craftsmen and workers, are generally considered to have a lowe social status. In his seminal work, “The Theory of the Leisure Class,” Veblen theorized that the status of these individuals is lower due to several factors:

1. Productive labor: Veblen argued that the leisure class, by definition, is characterized by a life of idleness and non-productive activities. In contrast, craftsmen and workers are engaged in productive labor, which is associated with lower social standing. In the context of Veblen’s theory, engaging in productive work is seen as an indication of the necessity to work for a living, and therefore as a sign of lower status.
2. No conspicuous consumption: Members of the leisure class engage in conspicuous consumption, displaying their wealth and social standing through the purchase and use of expensive goods and services. Craftsmen and workers, due to their lower incomes, are unable to participate in conspicuous consumption to the same degree, which further solidifies their lower social status.
3. No conspicuous leisure: Veblen posited that the leisure class engaged in activities that showcased their ability to afford a life of idleness. This included non-productive activities like attending social events, traveling, and pursuing hobbies. Craftsmen and workers, due to the demands of their productive labor, are unable to engage in conspicuous leisure, which contributes to their lower social standing.
4. Attempting pecuniary emulation: Veblen believed that lower-class individuals would try to emulate the consumption patterns and behaviors of the leisure class to elevate their own social status. This emulation, however, is often limited by the financial constraints of lower-class individuals, which results in a further reinforcement of their lower status. As craftsmen and workers cannot fully participate in the conspicuous consumption and leisure of the upper classes, their efforts to emulate the upper classes fall short.
5. Lack of invidious distinction: Members of the leisure class sought to maintain social distance from others by demonstrating their wealth and status through conspicuous consumption and leisure. This creates a clear distinction between the leisure class and those engaged in productive labor, reinforcing the lower status of craftsmen and workers.

In summary, according to Thorstein Veblen’s leisure class society theory, craftsmen and workers hold a lower status due to their engagement in productive labor, limited ability to participate in conspicuous consumption and leisure, and inability to fully emulate the consumption patterns and behaviors of the upper classes.

These factors allegedly contribute to a social hierarchy in which individuals engaged in productive labor are positioned below the leisure class.

In relation to prosthetic arm use and arm amputees’ behaviour with regard to their disability related perceived absent or low social status, the following can be presumed:

1. Conspicuous consumption: This refers to the practice of purchasing and displaying particularly expensive goods and services in an attempt to demonstrate one’s social status. The leisure class, in particular, engages in this behavior to assert their superiority over other social classes. This will potentially marginalize people with visible disabilities, as they may not have the resources to participate in conspicuous consumption, leading to their exclusion from these apparent “elite” circles. Conversely, these requirements for conspicuous consumption may also be exploited by amputees that either have their own financial resources or that manage to get insurance to pay for their conspicuous devices, in an attempt to elevate their own perceived low or absent social status as amputee, so we can from that alone expect to see these applications:
   1. Superbly expensive prostheses with prices that are extreme in absolute terms: Prosthetic devices, specifically myoelectric multiarticulated prosthetic arms or hands, by and large come at an exorbitant cost that is extreme in terms of financial cost, but that is also massive in terms of total cost of ownership as far as excessive training, excessive repairs, excessive user frustration, stump skin problems, and so on, are concerned. These devices are priced anywhere from around 25,000 USD to well over 120,000 USD for one prosthetic arm, making them generally unattainable for most individuals without insurance, and given their low ot absent reliability, they are also unattractive for any insurance that is interested in seeing the amputee equipped with a practically useful prosthetic arm in a work or use sense. While these high-tech prostheses are designed to appear and look advanced and sophisticated, they ironically are never practical for everyday use for real work, for several reasons. Firstly, the technical reliability of these devices is low. The intricate components and the complex control mechanisms required to operate the prosthetic arms or hands will not function consistently, posing irretrievable challenges and grievance, frustration and disappointment to users in their day-to-day activities. Secondly, the durability of these prosthetic devices is not ideal. Given their delicate nature, they are prone if not designed to suffer early damage or wear-and-tear. As a result, they are not suitable for individuals engaging in heavy or strenuous or even just moderate work or for those who require a more robust prosthetic solution. However, a main real reason to wear a prosthetic arm is to balance out overuse, and overuse usually comes from highly repetitive and strenuous work. Additionally, these prosthetic arms and hands are not suited for environments or situations involving heat, sweat, or moisture. They are not at all designed to handle these conditions, and their performance and reliability will be compromised if not absent in such circumstances. That puts the user at risk to overuse the other arm, if they are a unilateral amputee, and also, it puts devices, cameras, dishes, tools, equipment and maybe other people at risk, depending on use case specifics. Lastly, the grip geometries of these prosthetic devices usually do not align with the specific needs and constraints of arm amputees, so excessive trunk and arm motion may be required to achieve a particular grip. Typically, these expensive and “advanced” myoelectric prosthetic arms or hands lack the necessary strict orthopedic design focus to accommodate the unique requirements and specific limitations of the user. In summary, although myoelectric multiarticulated prosthetic arms and hands come with an insane price tag, their practicality in everyday life is at best limited but usually absent or very low. Issues with technical reliability, durability, environmental adaptability, and compatibility with amputee constraints render them far less useful and accessible than their more affordable body-powered counterparts. That is the description of a technology that, however, is defining of the aspiration of the user to elevate their social status and usually goes along with other attempts to elevate social status such as not regularly or routinely providing hard real work. Considering the notion of conspicuous consumption, which refers to the display of expensive goods and services as a means to assert one’s wealth and social status, it is therefore consistent with that value system that some arm amputees might prefer to secure and promote, showcase and present high-priced, visually impressive prosthetics, as a form of social signaling. These prosthetics may not be too functional or practical, but their luxurious appearance and the high price certainly constitutes a way for amputees to showcase their status and wealth, aligning with Veblen’s concept of pecuniary emulation. That would explain why it is entirely besides the point to build myoelectric junk and sell it for cheaper. If anything, the “appearance of ruggedness” (in absence of true ruggedness, in absence of any true control reliability or connector/wrist robustness, etc., as assumedly the case for Fillauer’s TASKA Hand) seems to be much favored by amputees that wish the expensive luxurious device with that outer appearance of “hardiness” while in fact, the device is not nearly as rugged as a well-built body powered arm with a sturdy gripper device such as e.g. the TRS Jaws or a Hosmer hook.
   2. Superbly expensive prostheses with prices that are extreme in relative terms, whereas the price itself my appear reasonable – such as somewhere between 700 and 8000 USD – but the build quality being that of very cheap if not just 3D printed plastics, usually constitute a distinct separate form of conspicuous consumption. There, the suggestion of wearing such a device is that the tech-flavor of “3d print” adds an extra layer of coolness, as it is used in an attempt to label the wearer as hip tech aficionado. Such a carefully crafted appearance can only be disturbed and tainted, fogged or soiled by implementing real hard work use optionalities.
2. Conspicuous leisure: Veblen argued that the leisure class often engaged in non-productive activities to showcase their ability to afford a life of idleness. This could include particular activities like attending social events, traveling, or pursuing non-productive hobbies. Now, this behavior could exclude people with visible disabilities who might face barriers to participating in such activities, further isolating them from the upper class, which makes it so useful for upper class members to employ this option as a mainstay of status confirmation. Conversely, Veblen’s idea of conspicuous leisure might be relevant in understanding the behaviours of some arm amputees who deliberately underperform manually, or ask for help when it is not at all necessary from a view of capability, or that exibit a clear preference for wearing a non-performing oder under-performing prosthetic arm, that looks like conspicuous leisure while at the same time making it absolutely impossible for them to offer a true helping (prosthetic?) hand for real work. By doing so, they could be engaging in a form of social signaling that communicates their ability to rely on others, effectively putting others in a functional servant position, or their own inability to help with any real work, thus indirectly demonstrating their wealth and social distance from craftsmen, workers or other peope that provide real work as a means for income. So this behavior might be an attempt to elevate their social standing and align themselves with the leisure class, even if it is not entirely genuine. Typical “jobs” then are “brand ambassador”, “actor”, “motivational speaker” or “influencer”, even “Cybathlon pilot” is a task that requires dedication to explicity non-productive work mostly (with only a few exceptions) using overengineered and vastly underperforming myoelectric prototypes of all sorts, whereas they usually never ever work in construction, or other real work.
3. Invidious distinction: As for the preference of some arm amputees for luxurious, non-functional prosthetics over more functional alternatives, this might be seen as a form of invidious distinction. By selecting prosthetics that showcase their wealth and status, they may be trying to set themselves apart from others, thereby also asserting their place within the upper classes. This choice might be influenced by the desire to emulate the consumption patterns of the leisure class: there, consuming at the expense of practicality and functionality is not a concession but the whole point.

While Veblen’s ideas focus on the behavior of the leisure class and the impact on social stratification, they can be applied to understand the challenges faced by people with visible disabilities like amputees in a society that values wealth, status, and the pursuit of leisure.

The exclusionary nature of conspicuous consumption, leisure and individuous distinction, as well as the emulation of these behaviors by lower classes, can contribute to the marginalization and stigmatization of people with visible disabilities. On the other hand (!), Thorstein Veblen’s ideas on leisure class society and social values of upper classes can help us better understand the behaviors and preferences of some other arm amputees in terms of social status: their preference for luxurious, non-functional prosthetics, their tendency to underperform or ask for help when not necessary, and their focus on appearance over practicality could all be seen as attempts to align with the values of the leisure class and signal their elevated status in society.

For the construction and sales of myoelectric multiarticuled prosthetic hands, this means that:

1. Absence or low level of actual function is a positive selling point. This includes clumsy grip geometry, crappy myoelectric signal quality and fragile builds. Incidentally, all current myoelectric multiarticulated prosthetic hand share these qualities.
2. Trying to build a myoelectric arm that does provide superb support for real work (i.e., for hazardous levels of repetitive or heavy work) would be to defy its use case, to defy its social role as luxus item signaling social superiority conformant to above-mentioned value systems. It thus is entirely in line with these social aspects that the last decades of failed myoelectric control reliability fully serves this particular value system. Trying to build and test myoelectric arms for mundane or profane or menial work therefore is to actually misunderstand what this is all about. The user that wants a myoelectric contraption does not want to clean toilets, carry boxes, perform hours of garden work outside in summer, or install wooden boards. They want the perfect excuse to not having to do any of that while looking reasonably well equipped.

The real craftsman and manual worker will know that a reliable and well angulated grip geometry (e.g., Hosmer hook Nr. 5, TRS Jaws, etc.), a comfortable socket (without electrodes, or ridges), a reliable control system (a well-built cable control, not the commercial parts as sold by Fillauer or Otto Bock) and a comfortable shoulder brace, are the way to go. Those that do not know will find out by themselves, sooner or later – as the failure of the myoelectric junk is usually pretty self explanatory.