The growth of self-tracking and personal surveillance has given rise to the Quantified Self movement. Members of this movement seek to enhance their personal well-being, productivity, and self-actualization through the tracking and gamification of personal data. The technologies that make this possible can also track and gamify aspects of our interpersonal, romantic relationships. Several authors have begun to challenge the ethical and normative implications of this development. In this article, we build upon this work to provide a detailed ethical analysis (...) of the Quantified Relationship. We identify eight core objections to the QR and subject them to critical scrutiny. We argue that although critics raise legitimate concerns, there are ways in which tracking technologies can be used to support and facilitate good relationships. We thus adopt a stance of cautious openness toward this technology and advocate the development of a research agenda for the positive use of QR technologies. (shrink)

Self-tracking devices point to a future in which individuals will be more involved in the management of their health and will generate data that will benefit clinical decision making and research. They have thus attracted enthusiasm from medical and public health professionals as key players in the move toward participatory and personalized healthcare. Critics, however, have begun to articulate a number of broader societal and ethical concerns regarding self-tracking, foregrounding their disciplining, and disempowering effects. This paper has two aims: first, (...) to analyze some of the key promises and concerns that inform this polarized debate. I argue that far from being solely about health outcomes, this debate is very much about fundamental values that are at stake in the move toward personalized healthcare, namely, the values of autonomy, solidarity, and authenticity. The second aim is to provide a framework within which an alternative approach to self-tracking for health can be developed. I suggest that a practice-based approach, which studies how values are enacted in specific practices, can open the way for a new set of theoretical questions. In the last part of the paper, I sketch out how this can work by describing various enactments of autonomy, solidarity, and authenticity among self-trackers in the Quantified Self community. These examples show that shifting attention to practices can render visible alternative and sometimes unexpected enactments of values. Insofar as these may challenge both the promises and concerns in the debate on self-tracking for health, they can lay the groundwork for new conceptual interventions in future research. (shrink)

This paper presents a literature review on the ethics of self-tracking technologies which are utilized by users to monitor parameters related to their activity and bodily parameters. By examining a total of 65 works extracted through a systematic database search and backwards snowballing, the authors of this review discuss three categories of opportunities and ten categories of concerns currently associated with self-tracking. The former include empowerment and well-being, contribution to health goals, and solidarity. The latter are social harms, privacy and (...) surveillance, ownership control and commodification of data, autonomy, data-facilitated harm, datafication and interpretability of data, negative impact on relation to self and others, shortcomings of design, negative impact on health perception, and regulation and enforcement of rules. The review concludes with a critical analysis of the existing literature and an overview of a future research agenda that could complement the current work on ethics of self-tracking. (shrink)

AI systems have often been found to contain gender biases. As a result of these gender biases, AI routinely fails to adequately recognize the needs, rights, and accomplishments of women. In this article, we use Axel Honneth’s theory of recognition to argue that AI’s gender biases are not only an ethical problem because they can lead to discrimination, but also because they resemble forms of misrecognition that can hurt women’s self-development and self-worth. Furthermore, we argue that Honneth’s theory of recognition (...) offers a fruitful framework for improving our understanding of the psychological and normative implications of gender bias in modern technologies. Moreover, our Honnethian analysis of gender bias in AI shows that the goal of responsible AI requires us to address these issues not only through technical interventions, but also through a change in how we grant and deny recognition to each other. (shrink)

We propose a pragmatist account of value change that helps to understand how and why values sometimes change due to technological developments. Inspired by John Dewey’s writings on value, we propose to understand values as evaluative devices that carry over from earlier experiences and that are to some extent shared in society. We discuss the various functions that values fulfil in moral inquiry and propose a conceptual framework that helps to understand value change as the interaction between three manifestations of (...) value distinguished by Dewey, i.e., “immediate value,” “values as the result of inquiry” and “generalized values.” We show how this framework helps to distinguish three types of value change: value dynamism, value adaptation, and value emergence, and we illustrate these with examples from the domain of technology. We argue that our account helps to better understand how technology may induce value change, namely through the creation of what Dewey calls indeterminate situations, and we show how our account can integrate several insights on moral change offered by other authors. (shrink)

This paper critically examines the extent to which health promoting wearable technologies can provide people with greater autonomy over their health. These devices are frequently presented as a means of expanding the possibilities people have for making healthier decisions and living healthier lives. We accept that by collecting, monitoring, analysing and displaying biomedical data, and by helping to underpin motivation, wearable technologies can support autonomy over health. However, we argue that their contribution in this regard is limited and that—even with (...) respect to their ‘autonomy enhancing’ potential—these devices may deliver costs as well as benefits. We proceed by rehearsing the distinction that can be drawn between procedural autonomy and substantive-relational autonomy. While the information provided by wearable technologies may support deliberation and decision-making, in isolation these technologies do little to provide substantive opportunities to act and achieve better health. As a consequence, wearable technologies risk generating burdens of anxiety and stigma for their users and reproducing existing health inequalities. We then reexamine the extent to which wearable technologies actually support autonomous deliberation. We argue that wearable technologies that subject their users to biomedical and consumerist epistemologies, norms and values also risk undermining processes of genuinely autonomous deliberation. (shrink)

Mobile health (mHealth) technologies for self-monitoring health-relevant parameters such as heart frequency, sleeping patterns or exercise regimes aim at fostering healthy behavior change and increasing the individual users to promote and maintain their health. We argue that this aspect of mHealth supports healthism, the increasing shift from institutional responsibility for public health toward individual engagement in maintaining health as well as mitigating health risks. Moreover, this healthist paradigm leads to a shift from understanding health as the absence of illness to (...) regarding health as the performance of certain rituals in order to project healthiness. By drawing from the analogy between healthiness and traditional virtues, we evaluate the promises made by proponents of mHealth technologies for self-monitoring. We argue that the implementation and use of mHealth risk entrenching existing inequalities and, more particularly, tend to exclude populations situated at the losing end of those inequalities from participating in the quasi-virtue of healthiness. Consequently, the implementation and use of mHealth technologies not only present challenges for social justice but also undermine their primary societal goal—to promote public health. Finally, we offer several suggestions on how to realize the potential benefit of mHealth. (shrink)

In a lifelog, data from various sources are combined to form a record from which one can retrieve information about oneself and the environment in which one is situated. It could be considered similar to an automated biography. Lifelog technology is still at an early stage of development. However, the history of lifelogs so far shows a clear academic, corporate and governmental interest. Therefore, a thorough inquiry into the ethical aspects of lifelogs could prove beneficial to the responsible development of (...) this field. This article maps the main ethically relevant challenges and opportunities associated with the further development of lifelog technologies as discussed in the scholarly literature. By identifying challenges and opportunities in the current debate, we were able to identify other challenges and opportunities left unmentioned. Some of these challenges are partly explained by a blind spot in the current debate. Whilst the current debate focuses mainly on lifelogs held by individuals, lifelogs held by governmental institutions and corporations pose idiosyncratic ethical concerns as well. We have provided a brief taxonomy of lifelog technology to show the variety in uses for lifelogs. In addition, we provided a general approach to alleviate the ethical challenges identified in the critical analysis. (shrink)

In an increasingly technology-textured environment, smart, intelligent and responsive technology has moved onto the body of many individuals. Mobile phones, smart watches and wearable activity trackers are just some of the technologies that are guiding, nudging, monitoring and reminding individuals in their day-to-day lives. These devices are designed to enhance and support their human users, however, there is a lack of attention to the unintended consequences, the technology non-neutrality and the darker sides of becoming human-tech hybrids. Using the extended mind (...) theory and agential intra-action, we aim at exploring how human-technology hybrids gain collective skills and how these are put to use; how agency is expressed and how this affects the interactions; and what the darker sides are of being a human-technology hybrid. Using a qualitative method, we analyze the experiences of using a wearable activity tracker, with a specific focus on how the tracker and the individual solve tasks, share competences, develop new skills and negotiate for agency and autonomy. We contribute with new insight on human-tech hybridity and present a concept referred to as the agency pendulum, reflecting the dynamism of agency. Finally, we demonstrate how the extended mind theory and agential intra-action as a combined theoretical lens can be used to explore human-tech hybridity. (shrink)

Personal health technologies such as apps and wearables that generate health and behavior data close to the individual patient are envisioned to enable personalized healthcare - and self-care. And yet, they are consumer devices. Proponents of these devices presuppose that measuring will be helpful, and that data will be meaningful. However, a growing body of research suggests that self-tracking data does not necessarily make sense to users. Drawing together data studies and digital health research, we aim to further research on (...) data ambivalence, a term we use to refer to the ambiguities and uncertainties people experience when interpreting their own data, as well as the critical obligation towards cultivating ethically sound uses and responses to such data in context. We develop the relationship between data, interpretation, and context as a central theoretical and practical problem in the datafication of healthcare. We then show how interpretation and context matter for data ambivalence through an empirical study of heart patients with an implanted advanced pacemaker who were offered a Fitbit wristband for self-tracking as part of a research project. We argue that the hope, anxiety, and doubt connected to the promise and accuracy of data are tempered by the context and purpose of self-tracking, and by individual circumstances. Finally, we link the findings on context-sensitivity in data interpretation to questions about response-ability in cloud-based care infrastructures. We discuss the ethical dilemmas associated with the use of commercial wellness-technologies in healthcare, and with researching such emerging practices. (shrink)

The theory of technological mediation aims to take technological artifacts seriously, recognizing the constitutive role they play in how we experience the world, act in it, and how we are constituted as (moral) subjects. Its quest for a compatible ethics has led it to Foucault’s “care of the self,” i.e., a transformation of the self by oneself through self-discipline. In this regard, technologies have been interpreted as power structures to which one can relate through Foucaultian “technologies of the self” or (...) ascetic practices. However, this leaves unexplored how concrete technologies can actuallysupportthe process of self-care. This paper explores this possibility by examining one such technology: a gamified To-Do list app. Doing so, it first shows that despite the apparent straightforwardness of gamification, confrontation and shame play an important role in how the app motivates me to do better. Second, inspired by Ihde’s schema of human-technology relations, it presents different ways in which the app may confront me with myself. Subsequently, it accounts for the motivation and shame that this technologically mediated confrontation with myself invokes through a Levinasian account of ethical subjectivity. In so doing, it also shows how Levinas’ phenomenology implies a responsibility for self-care and how nonhuman, technological others may still call me to responsibility. It concludes with a reflection on the role of gamification in technologically mediated subjectivation and some implications for design. (shrink)

This paper explores and rehabilitates the value of decisional privacy as a conceptual tool, complementary to informational privacy, for critiquing personalized choice architectures employed by self-tracking technologies. Self-tracking technologies are promoted and used as a means to self-improvement. Based on large aggregates of personal data and the data of other users, self-tracking technologies offer personalized feedback that nudges the user into behavioral change. The real-time personalization of choice architectures requires continuous surveillance and is a very powerful technology, recently coined as (...) “hypernudging.” While users celebrate the increased personalization of their coaching devices, “hypernudging” technologies raise concerns about manipulation. This paper addresses that intuition by claiming that decisional privacy is at stake. It thus counters the trend to solely focus on informational privacy when evaluating information and communication technologies. It proposes that decisional privacy and informational privacy are often part of a mutually reinforcing dynamic. Hypernudging is used as a key example to illustrate that the two dimensions should not be treated separately. Hypernudging self-tracking technologies compromise autonomy because they violate informational and decisional privacy. In order to effectively judge whether technologies that use hypernudges empower users, we need both privacy dimensions as conceptual tools. (shrink)

Neuroadaptive technology (NAT) is a closed-loop neurotechnology designed to enhance human–computer interaction. NAT works by collecting neurophysiological data, which are analysed via autonomous algorithms to create actions and adaptations at the user interface. This paper concerns how interaction with NAT can mediate self-related processing (SRP), such as self-awareness, self-knowledge, and agency. We begin with a postphenomenological analysis of the NAT closed loop to highlight the built-in selectivities of machine hermeneutics, i.e., autonomous chains of algorithms that convert data into an assessment (...) of psychological states/intentions. We argue that these algorithms produce an assessment of lived experience that is quantitative, reductive, and highly simplistic. This reductive assessment of lived experience is presented to the user via feedback at the NAT interface and subsequently mediates SRP. It is argued that congruence between system feedback and SRP determines the precise character of the alterity relation between human user and system. If feedback confirms SRP, the technology is regarded as a quasi-self. If there is a disagreement between SRP and feedback from the system, NAT is perceived to be a quasi-other. We argue that the design of the user interface shapes the precise ways in which NAT can mediate SRP. (shrink)

In this article, we address the case of self-tracking as a practice in which two meaningful backgrounds play an important role as the spatial dimension of human practices. Using a phenomenological approach, we show how quantification multiplies backgrounds, while at the same time generating data about the user. As a result, we can no longer speak of a unified background of human activity, but of multiple dimensions of this background, which, additionally, is perceived as having no pivotal role in the (...) process, often being hidden, situated beyond human consciousness, or taken for granted. Consequently, the phenomenological experience of the background turns into a hermeneutic practice focused on the interpretation of representations and descriptions. By adopting a phenomenological approach, we show the problems and limitations of quantification of human activities occurring in self-tracking and the theoretical problems associated with the scheme of human-technology relations. (shrink)

Purpose This paper aims to fill this gap by providing a conceptual framework for discussing “technologies of the self and other,” by showing that, in most cases, self-tracking also involves other-tracking. Design/methodology/approach In so doing, we draw upon Foucault’s “technologies of the self” and present-day literature on self-tracking technologies. We elaborate on two cases and practical domains to illustrate and discuss this mutual process: first, the quantified workplace; and second, quantification by wearables in a non-clinical and self-initiated context. Findings The (...) main conclusion is that these shapings are never neutral and have ethical implications, such as regarding “quantified otherness,” a notion we propose to point at the risk that the other could become an object of examination and competition. Originality/value Although there is ample literature on the quantified self, considerably less attention is given to how the relation with the other is being shaped by self-tracking technologies that allow data sharing. (shrink)