Empowerment is a prominent ideal in health promotion. However, the exact meaning of this ideal is often not made explicit. In this paper, we outline an account of empowerment grounded in the human capacity to adapt and adjust to environmental and societal norms without being completely determined by those norms. Our account reveals a tension at the heart of empowerment between (a) the ability of self-governance and (b) the need to adapt and adjust to environmental and societal norms. We address (...) this tension by drawing from the work of Freud, Canguilhem, and Lacan. First, we clarify through a discussion of Freud’s notion of sublimation that it is difficult to assess empowerment independent of any social valuations, but also that it is no less problematic to make it dependent on social valuations alone. Second, we draw from the work of Canguilhem to show how empowerment can be understood in terms of the individual’s capacity to tolerate the aggressions of a multiplicity of environments. Third, using Lacan, we show how empowerment requires incorporation of social and symbolic norms, without necessarily rendering ourselves a mere product of these norms. Finally, we demonstrate how the views of these authors can complement one another, resulting in a more sophisticated understanding of empowerment. (shrink)

Fitness apps on mobile devices are gaining popularity, as more people are engaging in self-tracking activities to record their status of fitness and exercise routines. These technologies also evolved from simply recording steps and offering exercise suggestions to an integrated lifestyle guide for physical wellbeing, thus exemplify a new era of "quantified self" in the context of health as individual responsibility. There is a considerable amount of literature in science, technology and society (STS) studies looking at this phenomenon from different (...) perspectives, linking it with the sociology of self-surveillance and neoliberal regimes of health. However, the human-technology interface, through which the micro- (behavioral) and macro- (social) aspects converge, still calls for extensive examination. This paper approaches this topic from the postphenomenological perspective, in combination with empirical studies of design analysis and interviews of fitness apps, to reveal the human-technology link between the design elements and people's perception through the direct experiences and interpretations of technology. It argues that the intentionality of self-tracking fitness app designs mediates the human-technology relations by "guiding" people into a quantified knowledge regime. It shapes the perceptions of fitness and health with representations of meanings about a "good life" of individual success and management. This paper also gives a critique of current individual, performance-oriented fitness app designs and offers the possibility of seeking alternatives through the multistable nature of human-technology relations—how altering interpretation and meaning of the design with a cultural or social context could change the form of technological embodiment. (shrink)

In his contribution, ‘Represent me: please! Towards an ethics of digital twins in medicine’1, Braun shows that there is a fundamental ambivalence inherent in (the interaction with) digital twins: they can either open up new freedoms for the simulated persons, or, conversely, endanger and restrict their freedom. To prevent digital twins from restricting people’s freedom, Braun suggests a strong focus on control. Braun’s focus on control is insufficient, I will argue, because his idea of control works only retroactively: it can (...) only react to restrictions of freedom that have already occurred, but it cannot prevent them, nor can it restore any lost freedom. Control is therefore insufficient to defend people’s freedom. To prove my claim, I will first use an everyday example to illustrate the fundamental ambivalence inherent in digital twins. Second, I will show that digital twins endanger people’s freedom in a hermeneutic way. Finally, I will demonstrate why controllability cannot prevent this hermeneutic endangerment. I understand digital twins, like Braun, as simulation of a person, as their dynamic and precise effigy. Simulated twins use machine-learning and artificial intelligence capabilities to make predictive analyses about the simulated person and the future development of her health. Imagine: You are eating dinner. Meanwhile, your partner lectures you about the calorie density and nutrient composition of your food, warns you that your portion size exceeds your daily calorie requirement by x calories. It calculates how your dinner will negatively impact your body mass index (BMI) and physical fitness, and predicts what the consequences will be for your overall health. Based on these data and predictions, it creates an individualised diet plan for you—and at the same time shows you by how much you could improve your vital values by sticking to that plan. This example helps to illustrate the fundamental …. (shrink)