Indeed, my view is heavily American-centric. And the trends of the past-- which you're right about-- may not apply to the future given increasing wealth inequality, the cost-of-living crisis, and the climate crisis (for which undoubtedly the poorest of us will be forced to shoulder most of the burden).

I'm explicitly not saying this work shouldn't be done, it should! But it does not exist in a vacuum, and it would be silly to pretend that it is not colored by vastly unequal access to modern healthcare. The reason I get excited about technology is because of the potential it holds for making us all happier and freer to do the things we like for longer. We are lost if we do not at least speak about the thunderclouds on the horizon for this philosophy of technology.