Between Care and Control

• In Event: Quantified Patients and Physicians

Abstract

This paper deals with the consequences of bringing technologies that promote control into healthcare by questioning the characteristics of these technologies in relation to person-centered care models. Digital health today includes a large variety of technologies, many with the potential to change the very foundations of healthcare. Devices and systems for self-monitoring, data collection and analysis through AI and big data are examples these technologies. Besides the trend of more digital technology there is also a growing interest for more person- and patient-centered care models. These models often draw on holistic approaches that reaches beyond the biomedical understanding of the body. This movement can be seen as going beyond the biomedical paradigm where subjective matters often are neglected in favor of objective measurements (Ashcroft and Van Katwyk, 2016). However, what the emerging technology in the context offers is often more associated to measuring and monitoring the body, less on the person (Rapp and Tirassa, 2017). We argue that this reflects a transition and change of focus towards control rather than care, and thereby challenge person- and patient centered care models. Vicky Singleton (2010) gives an thoughtful parallel to this transition where the new technology of control comes in conflict with the traditional care for animals when implementing digital tracking systems for cattle. Could be moving in a similar direction? That is, transitioning care into a matter of monitoring and controlling bodies (obscuring the self). Or, can we find a balance between care (accounting for a compositional self (Rapp and Tirassa, 2017)) and control?

Ashcroft, R., Van Katwyk, T., 2016. An Examination of the Biomedical Paradigm: A View of Social Work. Soc. Work Public Health 31, 140-152. https://doi.org/10.1080/19371918.2015.1087918
Rapp, A., Tirassa, M., 2017. Know Thyself: A Theory of the Self for Personal Informatics. Human-Computer Interact. 0, null. https://doi.org/10.1080/07370024.2017.1285704
Singleton, V., 2010. Good farming: control or care?, in: Mol, A., Moser, I., Pols, J. (Eds.), Care in Practice: On Tinkering in Clinics, Homes and Farms. Transcript-Verlag, Bielefeld, p. 326.

Authors

• Robyn Schimmer, Department of Informatics, Umeå university

• Karin Danielsson, Department of Informatics, Umeå university