Population ageing and increased digitalization each constitute an ongoing and profound transformation within contemporary modes of living, as growing advances in technological development mix and intermingle with the lived realities of older people as the final recipients. It is against the backdrop of this interplay that user involvement has enjoyed ever-rising advocacy to an almost normative degree. Beyond articulating methodological principles, however, the literature has remained surprisingly vague as to the practical implementation of the approach. Less appears to be known, (...) both empirically and conceptually, about how design and user involvement are done in practice and how they would matter to bring about intentional or unintentional effects. To engage with these developments, this thesis aims at taking the practices of user involvement and design to the centre of its inquiry by adopting a perspective from Science and Technology Studies. Specifically, the thesis seeks to both build on and contribute to the established body of STS on the connection between technology design and older users and ask: What is there to learn about user involvement as a method, if we focus on the practices of doing user involvement? To answer this question, the thesis studies four different aspects of the practices of user involvement and design. In particular, the thesis reviews the literature on how user involvement mattered in previous empirical projects that include older people, it examines how different configurations of participation matter in design workshops, it scrutinizes the achievement of user involvement in corporate practices and it traces the circumstantial performances of such practices. The largest empirical piece comes from a two-year ethnographic study of a small- to medium-sized enterprise, the material from which informed Paper III and Paper IV. The findings highlight how user involvement in practice is both contingent and transformative, as it selectively enrols different participants and performs multiple realities. In practice, user involvement appears to be dependent on a set of underlying premises and socio-material conditions and thus is always a dynamic and momentary achievement. Furthermore, the thesis shows how the practices of user involvement themselves may bring into existence different realities, articulating and materializing particular versions of objects and images of ageing. Accordingly, the thesis contributes theoretically by illuminating the underlying socio-material facets of user involvement, and by emphasizing ageing as a particular object/image of design. Specifically, the appended papers encompass a conceptual framework, as well as three new concepts: design multiple, shifting interstices and viscous image landscape, in order to theorize the underlying conditions for user involvement, its relationship with design and its entanglement with ageing. Practically, the thesis enunciates three main implications regarding questions of goodness, politics and ethics. (shrink)

Unlike sonographic examinations, sonic fetal heartbeat monitoring has received relatively little attention from scholars in the social sciences. Using the case of fetal heartbeat monitoring as part of midwifery prenatal care in Germany, this contribution introduces music as an analytical tool for exploring the aesthetic dimensions of obstetrical surveillance practices. Based on ethnographic stories, three orchestrations are compared in which three different instruments help audiences to listen to what becomes fetal heartbeat music and to qualify fetal and pregnant lives in (...) relation to each other. In the Doppler-based orchestration, audible heartbeat music is taken as a sign of a child in need of parental love and care cultivated to listen. The Pinard horn makes esoteric fetal music that can be appreciated by the midwife as a skilled instrumentalist alone and helps to enact a child hidden in the belly. The cardiotocograph brings about soothing music and a reassuring relationship with a child but also durable scripts of juridical beauty. This material-semiotic analysis amplifies how well-being is shaped in midwifery prenatal care practices. (shrink)

How do technologies such as webcams influence health care and what concepts may describe this? This article explores the literature and analyses what people looking through webcams do within a particular health care practice in the Netherlands, that is, within the rehabilitation of people suffering from severe chronic obstructive pulmonary disease or asthma. Several ways to describe the activities webcams support and perform are identified. The webcam is concentrating the activities of its users, by making them focus on the task (...) at hand and magnifies the characteristics of the already existing relationships between webcam users by imposing a relational distance that fits best with intimate contacts. Although webcams shift notions of space and distance, their working appears to be related, to a great extent, to their location. (shrink)

The changes that happen to healthcare services after the implementation of new assistive healthcare technologies (also called ‘welfare technology’ in the Nordic countries) concern more than increased efficiency and reducing healthcare expenditure. Of particular interest from an ethical point of view are the manners in which technologies shape the roles and identities of care receivers and healthcare personnel. The notion of ‘patienthood’ is explored in this paper as something that is both challenged by new technologies, and as something that is (...) opened up for active and potentially positive reshaping when care receivers support their illness or frailty with assistive healthcare technologies. This dual effect of technologies (as both challenge and opportunity) requires a rethinking of ethics of technologies, which for most part have been preoccupied with ethical issues prior to the implementation of a new technology into a healthcare service. Ethics of technology should also contribute to the concrete efforts of care receivers to establish something approximating a ‘good patienthood’ in relation to a new technology, making it opportune to dub it, instead, an ethics with technology. This paper explores how assistive healthcare technologies impact on care receivers and the care situation, and in relation to the notion of patienthood, before turning to what this implies for an ethics that has as its goal to support care receivers to reach a life with the technology that is in line with their own notions of well‐being and a good life. (shrink)

This article is a written version of the lecture for the IPONS conference in Stockholm. The article starts from the claim that there is no such thing as technology, only different variations of technologies. These technologies, plural, all have their specific workings that we can only learn about by studying these empirically, by analysing the relations between people and their technologies. These relations are always unpredictable, as it is not given beforehand what values the participants pursue. Studying and understanding the (...) workings of healthcare technology is a crucial task for nursing studies, as nurses are often key actors in making these devices work. The article hands the reader some tools to engage in the study of technologies in practice, using an empirical ethics approach. (shrink)

Nurses and ethicists worry that the implementation of care at a distance or telecare will impoverish patient care by taking out ‘the heart’ of the clinical work. This means that telecare is feared to induce the neglect of patients, and to possibly hinder the development of a personal relation between nurse and patient. This study aims to analyse whether these worries are warranted by analysing Dutch care practices using telemonitoring in care for chronic patients in the Netherlands. How do clinical (...) practices of nursing change when telecare devices are introduced and what this means for notions and norms of good nursing? The paper concludes that at this point the practices studied do not warrant the fear of negligence and compromised relations. Quite the contrary; in the practices studied, telecare lead to more frequent and more specialised contacts between nurses and patients. The paper concludes by reflecting on the ethical implications of these changes. (shrink)

Discussing the workings of technology in care as aesthetic rather than as ethical or epistemological interventions focusses on how technologies engage in and change relations between those involved. Such an aesthetic study opens up a repertoire to address values that are abundant in care, but are as yet hardly theorized. Kamphof studies the problem that sensor technology reveals things about the elderly patients without the patients being aware of this. I suggest improvement of these relations may be considered in aesthetic (...) terms, for instance by developing the affective quality of people’s technological relationships. (shrink)

As part of current energy transitions in the Global North, households have begun adopting renewable energy technologies, such as heat pumps and solar power systems, in significant numbers. These changes give rise to the following question: how are technology and gender configured when new technologies enter everyday life? Based upon ethnographic fieldwork on interactions between households, technologies, and technicians and interviews with sales technicians, installers, and service mechanics, I demonstrate how both stable and fragile variants of renewable energy technologies are (...) enacted during prepurchase consultations and postpurchase installations, respectively. I employ science and technology studies scholarship, feminist ethics, and repair and maintenance studies—captured through the analytical lens of care—to analyze how technicians mobilize and tinker with gendered affection, knowledge, and action in households to effectuate adoption of renewable energy technologies. I clarify how, in this process, openings are created to configure both hegemonic and heterogeneous gender–technology relations. Finally, I advance discussion beyond gender issues by arguing that acknowledging the role of maintainability and the repair of user–technology relations in current energy transitions opens pathways not only for exploring gender in new and exciting ways in relation to technology but technician–user relationships as well. (shrink)

This article investigates the construction of laboratory animal science as a version of “good science.” In the 1950s, a transnational community of scientists initiated large-scale standardization of animals for biomedicine, which included the standardization of care of laboratory animals as well as the development of guidelines and regulations on laboratory animal use. The article traces these developments and investigates how the standardization work took part in enacting laboratory animals as compound objects of care—and laboratory animal science as being an intrinsically (...) ethical practice—as good science. Importantly, the analysis shows how technological development is inextricably accompanied by ethics, as it is the result of complex social organization involving multiple ethical commitments. By investigating the development of laboratory animal science historically, it is possible to tease out how values, norms, and standards have been made integral to specific practices in the first place and how they have developed and been sustained over time. The article contributes to current concerns in science and technology studies about how life is made, valued, and ordered at the intersection of science and society and in biomedicine, including how certain values and positions of valuation come to count as authoritative and others not. (shrink)

Digital technologies have become a crucial factor in nursing. Given the fact that many tasks could also be done by robots or AI systems, the place for the nurse in this scenario is unclear. In what way and to what extent will the implementation of ever more sophisticated technology affect nursing practice? It is the aim of this paper to analyse the potential challenges of nursing practice in the digital age. The analysis is conducted through the lens of new materialism, (...) a set of theoretical models that understand the relationship between humans and technology as dynamic and performative. According to this view, there is no prefixed essence of technology. Rather, the meaning of technology is enacted in concrete practice. The analysis shows that in past debates on technology use in nursing, the nurses’ role has been defined as guardians of humanity, defending the patient against the dehumanizing effects of technology. This role has been transferred to the digital age, where it is the duty of nurses to cushion the negative effects of digital technology. As an alternative to this outdated role, nurses should be included in processes of technology design and policymaking. Enabling nursing professionals to shape the circumstances of a digitally enhanced holistic practice may empower their status within the healthcare system and also benefit the patient by contributing to a more person‐centred care. (shrink)