Author(s):

  • Pols, Jeannette
  • Willems, Dick
  • Aanestad, Margunn

Abstract:

Prevention enthusiasts show great optimism about the potential of health apps to modify peoples’ lifestyles through the tracking and quantification of behaviours and bodily signs. Critical sociologists warn for the disciplining effects of self‐tracking. In this paper we use an empirical ethics approach to study the characteristics and strivings of the various types of ‘ethico‐psychological subjects’ that emerge in practices of self‐quantification by analysing how people and numbers relate in three cases of self‐quantification: in prevention discourse, in testimonies from the quantified self (QS) movement and in empirical work we did with people with Diabetes type I and with ‘every day self‐trackers’. We show that a free subject that needs support to enact its will is crucial to understand the optimism about prevention. In the QS‐movement the concern is with a lack of objective and personalised knowledge about imperceptible processes in the body. These subjects are decentered and multiplied when we trace how numbers in their turn act to make sense of people in our empirical study. We conclude that there are many different types of ethico‐psychological subjects in practices of self‐tracking that need to be explored in order to establish what good these practices of self‐quantification might do.

Document:

https://onlinelibrary.wiley.com/doi/full/10.1111/1467-9566.12894

References:
  • Aicardi, C., Del Salvio, L., Dove, D.S., Lucivero, F., et al . (2016) Emerging ethical issues regarding digital health data. On the World Medical Association Draft Declaration on Ethical Considerations regarding Health Data Bases and Biobanks, Croatian Medical Journal, 57, 207– 13. Crossref PubMed Web of Science®Google Scholar
  • Ajana, B. (2017) Self‐Tracking: Empirical and Philosophical Investigations. London: Palgrave MacMillan. Google Scholar
  • Beck, U., Giddens, A. and Lash, S. (1994) Reflexive Modernization. Cambridge: Polity Press. Google Scholar
  • Boltanski, L. and Thévenot, L. (2006) On Justification. Economies of Worth. Princeton: Princeton University Press. Web of Science®Google Scholar
  • Buyx, B. and Prainsack, B. (2012) Lifestyle related diseases and individual responsibility through the prism of solidarity, Clinical Ethics, 7, 2, 79– 85. Crossref Google Scholar
  • Cohn, S. (2014) From health behaviours to health practices: an introduction, Sociology of Health and Illness, 36, 157– 62. Wiley Online Library PubMed Web of Science®Google Scholar
  • Daston, L. and Galison, P. (2007) Objectivity. Brooklyn: Zone Books. Google Scholar
  • Davis, J. (2013) The qualified self. Available at: https://thesocietypages.org/cyborgology/2013/03/13/thequalified-self/ (Last accessed 31 March 2016). Google Scholar
  • Depper, A. and Howe, P.D. (2017) Are we fit yet? English adolescent girls’ experiences of health and fitness apps, Health Sociology Review, 26, 98– 112. Crossref Web of Science®Google Scholar
  • Dudhwala, F. (2018) Redrawing boundaries around the self: the case of self‐quantifying technologies. In R. Lynch and C. Farrington (eds) Quantified Lives and Vital Data, pp 97– 123. London: Palgrave Macmillan. Crossref Google Scholar
  • Dusenbury, L. and Falco, M. (1995) Eleven components of effective drug abuse prevention curricula, Journal of School Health, 65, 420– 5. Wiley Online Library CAS PubMed Web of Science®Google Scholar
  • Frankfurt, H.G. (1988) Freedom of the Will and the Concept of a Person. What Is a Person? New York: Springer. Google Scholar
  • Hortensius, J., Kars, M.C., Wierenga, W.S., Kleefstra, N., et al . (2012) Perspectives of patients with type 1 or insulin‐treated type 2 diabetes on self‐monitoring of blood glucose: a qualitative study, BMC Public Health, 12, 167. Crossref PubMed Web of Science®Google Scholar
  • de Laet, M. (2017) Personal Metrics: Methodological Considerations of a Praxiographical Approach. Methodological Reflections on Practice Oriented Theories. Cham: Springer. Google Scholar
  • Law, J., Ruppert, E. and Savage, M. (2011) The double social life of methods. Google Scholar
  • Levy‐Philipp, L. (2017) The practices of every‐day trackers. What does it mean to put your health in your hands, or pockets? Master’s thesis, Vrije Universiteit Amsterdam. Google Scholar
  • Lupton, D. (2012) M‐health and health promotion: the digital cyborg and surveillance society, Social Theory & Health, 10, 229– 44. Crossref Web of Science®Google Scholar
  • Lupton, D. (2013) The digitally engaged patient: self‐monitoring and self‐care in the digital health era, Social Theory & Health, 11, 256– 70. Crossref Web of Science®Google Scholar
  • Lupton, D. and Maslen, S. (2018) ‘The more‐than‐human sensorium’: sensory engagements with digital self‐tracking technologies, The Senses and Society, 13, 2, 190– 202. Crossref Web of Science®Google Scholar
  • Mittelstadt, B.D. and Floridi, L. (2016) The ethics of big data: current and foreseeable issues in biomedical contexts, Science and Engineering Ethics, 22, 303– 41. Crossref PubMed Web of Science®Google Scholar
  • Mol, A. (2010) Care and its values. Good food in the nursing home. In A. Mol, I. Moser and J. Pols (eds) Care in Practice. On Tinkering in Clinics, Homes and Farms, pp 215– 34. Bielefeld: Transcript Verlag. Crossref Web of Science®Google Scholar
  • Moser, I. (2005) On becoming disabled and articulating alternatives. The multiple modes of ordering disability and their interferences, Cultural Studies, 19, 6, 667– 700. Crossref Web of Science®Google Scholar
  • Nikolas, R. (1999) Governing the soul: The shaping of the private self. London: Free association books. Google Scholar
  • Nissenbaum, H.F. (2010) Privacy in Context: Technology, Policy, and the Integrity of Social Life. Stanford: Stanford University Press. Google Scholar
  • Owens, J. and Cribb, A. (2017) ‘My fitbit thinks I can do better!’ Do health promoting wearable technologies support personal autonomy?, Philosophy and Technology. https://doi.org/10.1007/s13347-017-0266-2. Google Scholar
  • Piras, E.M. and Francesco, M. (2017) Clinical self‐tracking and monitoring technologies: negotiations in the ICT‐mediated patient–provider relationship, Health Sociology Review, 26, 1, 38– 53. Crossref Web of Science®Google Scholar
  • Pols, J. (2015) Towards an empirical ethics in care: relations with technologies in health care, Medicine, Health Care, and Philosophy, 18, 81– 90. Crossref PubMed Web of Science®Google Scholar
  • Pols, J. (2017) Good relations with technology: empirical ethics and aesthetics in care, Nursing Philosophy, 18, e1254. Wiley Online Library Web of Science®Google Scholar
  • Raczynski, K., Waldo, M., Horne, A.M. and Schwartz, J.P. (2012) Evidence‐Based Prevention. Melbourne: Sage. Google Scholar
  • Ruckenstein, M. (2014) Visualized and interacted life: Personal analytics and engagements with data doubles, Societies, 4, 68– 84. Crossref Google Scholar
  • Ruppert, E., Law, J. and Savage, M. (2013) Reassembling social science methods: the challenge of digital devices, Theory, Culture & Society, 30, 22– 46. Crossref Web of Science®Google Scholar
  • Schüll, N.D. (2016) Data for life: wearable technology and the design of self‐care, BioSocieties, 11, 317– 33. Crossref Web of Science®Google Scholar
  • Schwennesen, N. (2017) When self‐tracking enters physical rehabilitation: from ‘pushed’ self‐tracking to ongoing affective encounters in arrangements of care, Digital Health, 3, 1– 8. Crossref Web of Science®Google Scholar
  • Schwennesen, N. and Koch, L. (2009) Visualising and calculating life: matters of fact in the context of prenatal risk assessment. In A. Wahlberg (ed) Contested Categories: Life Sciences in Society, pp 69– 87. Aldershot: Ashgate. Google Scholar
  • Sharon, T. (2015) Healthy citizenship beyond autonomy and discipline: tactical engagements with genetic testing, BioSocieties, 10, 295– 316. Crossref Web of Science®Google Scholar
  • Sharon, T. and Zandbergen, D. (2016) From data fetishism to quantifying selves: self‐tracking practices and the other values of data, New Media & Society, 19, 11, 1695– 709. Crossref Web of Science®Google Scholar
  • Smith, G.J.D. and Vonhethoff, J.D. (2016) Health by numbers? Exploring the practice and experience of datafied health, Health Sociology Review, 26, 1, 6– 21. Crossref Web of Science®Google Scholar
  • Swan, M. (2013) The quantified self: fundamental disruption in big data science and biological discovery, Big Data, 1, 85– 99. Crossref PubMed Web of Science®Google Scholar
  • Swierstra, T. (2013) Nanotechnology and techno‐moral change, Ethics & Politics, 15, 1, 200– 19. Google Scholar
  • Tempini, N. (2015) Governing PatientsLikeMe: information production and research through an open, distributed, and data‐based social media network, The Information Society, 31, 193– 211. Crossref Web of Science®Google Scholar
  • Thévenot, L. (2001) Pragmatic regimes governing the engagement with the world. In T.R. Schatzki, K. Knorr‐Cetina and E. Savigny (eds) The Practice Turn in Contemporary Theory, pp 56– 73. London: Routledge. Google Scholar
  • Tobler, N.S. (1992) Drug prevention programs can work: research findings, Journal of Addictive Diseases, 11, 1– 28. Crossref CAS PubMed Google Scholar
  • Visser, F. (2017) Self‐monitoring in insulin‐dependent diabetes via health‐apps; a bad influence on the perception of the self? Master’s thesis, University of Amsterdam. Google Scholar
  • Vogel, E. (2018) Metabolism and movement: Calculating food and exercise or activating bodies in Dutch weight management, BioSocieties, 13, 2, 389– 407. Crossref Web of Science®Google Scholar
  • Vogel, E. and Mol, A. (2014) Enjoy your food: on losing weight and taking pleasure, Sociology of Health and Illness, 36, 305– 17. Wiley Online Library PubMed Web of Science®Google Scholar
  • VWS (2015) Voortgangsrapportage ehealth en zorgverbetering. Kamerbrief. Rijksoverheid Nieuws. Available at https://www.rijksoverheid.nl/onderwerpen/e-health/documenten/kamerstukken/2015/10/08/kamerbrief-voortgangsrapportage-ehealth-en-zorgverbetering (Last accessed 5 March 2019). Google Scholar
  • Willems, D. (2000) Managing one’s body using self‐management techniques: practicing autonomy, Theoretical Medicine and Bioethics, 21, 23– 38. Crossref CAS PubMed Web of Science®Google Scholar
  • Willems, D. (2010) Varieties of goodness in high‐tech home care. In A. Mol, I. Moser and J. Pols (eds) Care in Practice. On Tinkering in Clinics, Homes and Farms. Bielefeld: Transcript verlag, pp 257– 76. Crossref Google Scholar
  • Willems, D. and Pols, J. (2010) Goodness! The empirical turn in health care ethics, Medische Antropologie, 23, 1, 161– 70. Google Scholar
  • World Health Organisation (WHO) (2016) Global Report on Diabetes. Geneva: WHO Library Cataloguing‐in‐Publication. Google Scholar
  • World Health Organisation (WHO) (2008) World Health Report 2008. Primary Health Care (Now More Than Ever). Geneva: WHO. Google Scholar
  • World Health Organisation (WHO) (2011) mHealth: New Horizons for Health through Mobile Technologies: Second Global Survey on eHealth. Global Observatory for eHealth Series, Vol. 3. Geneva: WHO. Google Scholar
  • Yates‐Doerr, E. (2015) The Weight of Obesity: Hunger and Global Health in Postwar Guatemala. Oakland: University of California Press. Crossref Google Scholar