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- Convenors:
-
Jannis Steinke
(TU Braunschweig)
Anja Trittelvitz (Hochschule EmdenLeer)
Heike Gerdes (University of Applied Sciences)
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- Chair:
-
Jannis Steinke
(TU Braunschweig)
- Format:
- Traditional Open Panel
Short Abstract:
The uprising of digital devices in medical care transforms the concepts of health, human-machine ontologies, self-efficacy etc. A sociotechnical scholarship can help to avoid binary codifications of technosciences into technooptimism on the one hand and technopessimism on the other.
Long Abstract:
Symptom Assessment applications strive to be a contribution for medical care, in terms of an “informed patient” who can improve their health literacy before approaching a consultation with a doctor. Several transformations take place by this digitalization of diagnostic practices: Patients turn into users, medical knowledge translates to technical knowledge and the haptics of bodies shifts to statistical data.
From the users´s point of view, these new tools are obstacle and chance at the same time: Being dissected into data-fragments and reassembled into discourses about their conditions, users have to navigate their own self-efficacy vs. their disciplining. This renders the digital device´s ontology as a surgical tool that operates by algorithmic diffraction. It also displays a ‘magical’ opacity whose purpose oftentimes remains obfuscated.
Developers are guided by technosolutionist aspirations such as the idea to overcome death. This reproduces not only colonialist timeframes that supposedly only know one direction: a positivist progression towards the future. It also restores anthropocentric transhumanist ideas of human immortality, where the autonomous subject resides at the core of every notion and concept. This transformation is therefore an ontological one, that expands into areas such as objectivity, aesthetics and concepts of health, life and death.
Therefore, this panel kindly invites presentations in a traditional form that (not exclusively) cover the following fields:
- Digital transformation of health care
- Discussions about practices of objectivation in terms of digital diagnostic tools
- New and different conceptions of ‘the human’, ‘the machine’, ‘subject’ and ‘agency’ that are implicated by artificial intelligence
- Empirical studies about biases and discrimination in digital health technologies
- (F)STS-informed critiques of conceptions such as health, life and death
- F-STS and new materialist informed proposals for another conception of human-machine interactions and relations (example can but must not be digital health care technologies)
Accepted papers:
Session 1José da Costa (CRIA - Centre for Research in Anthropology)
Long abstract:
This presentation seeks to present an understanding of how visions of the future influence present actions, exploring the impact of imagined future sociotechnical systems on contemporary social practices. Based on Reinhart Koselleck's philosophy of historical time and focusing on the heuristic value of the interaction between experience and expectation, it argues in favor of adopting an anticipatory approach in anthropology as a means to conduct a critical analysis of social practices.
By examining the process of implementing digital health in Portugal through an analysis of the discourse uttered by various stakeholders involved, the presentation provides a comprehensive view of the potential impacts of digitization on sociotechnical systems in the healthcare domain. The results will highlight the primary concerns of the different stakeholders, encompassing the various aspects related to the utilization, reconfiguration, and evolution of healthcare.
Safak Kilictepe (Kirsehir Ahi Evran University)
Long abstract:
This research endeavors to examine the dynamic correlation between digital technologies and the knowledge production about menopause in Turkiye. There has been a discernible change in the production, consumption, and dissemination of menopause-related information with the growing ubiquity of digital platforms in the country. This has reshaped our understandings about menopause in new and various ways. I employ a mixed-methods approach, and intersectionality framework, to examine the various narratives around menopause by examining Internet forums, social media conversations, healthcare websites, and social media accounts posting menopause related content. This research reveals the complex interactions that exist between digital technologies, cultural norms, and the knowledge production about menopause. Doing so, this study contributes to the theories of STS about technology and the body, enhancing our comprehension of the influence of digital technologies on the distribution of body-related information and the development of viewpoints regarding menopause within the Turkish milieu.
Ann Kristin Augst (TU Dortmund)
Long abstract:
People who use health apps and fitness trackers generally do so in order to better understand their own bodies. The aim is often to objectify physical sensations. While this also applies to people with chronic illnesses, this specific group of users tends to draw on digital health devices not so much in pursuit of reaching best marks or highest fitness ratings, but in a much more essential manner. Their primary aim is to manage their disease by organising everyday life in such a way that warning signs are recognised early on, so-called crashes are avoided and/or their overall quality of life is improved.
Based on interviews conducted with both patients and doctors in Germany as part of the research project “Digital body knowledge. Conflict lines of problematic popularity in health care” (funded by the German Research Foundation), this presentation aims to answer the following questions: What knowledge do health trackers offer that helps patients and particularly people with chronic diseases to better understand their illness and their bodies? To what extent does digital self-measurement help them manage life with their (chronic) illness? And how do doctors assess digital health device usage and the repercussions of it for doctor-patient relations, as well as for people’s broader perception of their own state of health? This presentation will demonstrate how patients and people with chronic diseases are taking matters of health and illness into their own hands with the help of fitness trackers – and how (their) doctors relate to this individualistic approach.
Karin Bogdanova (TU Delft)
Long abstract:
Compared to other medical fields, psychiatry was falling behind in developing objective quantifiable measures (Barron, 2021). This has changed with the rise of computational and AI methods in psychiatry. Advocates of digital phenotyping in mental health proposed voice as a generative site for detecting symptoms and signs of distress (Fagherazzi et al., 2021). Complexity and valence of words used, pause length, intonation, rate of vocal fold vibration and other markers are used to determine mood fluctuations, distress, and the onset of a clinical condition.
Vocal biomarker analysis has been mostly critiqued as a successor of discriminatory scientific practices and universalising concepts (Ma et al., 2023; Semel, 2020). In this paper, instead of viewing it as a controversial tool, I argue that vocal biomarker-detecting algorithms are aesthetic (relating to sensible experience) and moral agents. In labelling and training, algorithms acquire aesthetic skills to perform aesthetic judgments. Sensors render perceivable, organise, categorise, and relate sensory knowledge about how the voice “appears” to non-human listening. Algorithms thus produce “hyper-aestheticised articulations” (Fuller & Weizman, 2021) of mental health. In addition, as mental health always carries a moral dimension (Vidal & Ortega, 2019), algorithmic judgements of (predicted) deviance, responsibility, and corrective actions assign normative values to the expression of affect, behaviour, and (ill) health.
The aesthetic lens provides a generative view on the emerging body-mind-technology relationships in digital mental health and transformations in the expression and experience of mental health. It also provides opportunities for alternative design models for AI for vocal biomarkers detection.
Frederique Bone (Fraunhofer ISI) Nils B. Heyen (Fraunhofer ISI) Tanja Kaufmann Piret Fischer Tanja Bratan
Long abstract:
Given the multiplicity of both endogenous (e.g. aging of the population) and external pressures (e.g. climate change) towards the sustainability of healthcare systems, academic understanding of transformation processes and policy solutions are urgently needed. Digital tools can play an important role in addressing the current challenges. Our presentation will specifically explore the case of video-consultation in European healthcare systems. It takes a holistic view of transformation using transition theory (Geels 2002; Geels and Schot 2007) to understand landscape pressures, niche development, stakeholder's roles, and transition processes. We highlight systemic specificities of healthcare systems, using a cross-country comparison between Germany, France and the UK. The results show the complexity of the sociotechnical transformation process in the three countries, and that transformation in healthcare systems is a slow process, where many stakeholders, such as physicians, policy makers and to some extent patients, shape the introduction of the video-consultation niche. The imperative of the COVID-19 pandemic was a turning point in the adoption of the technology, enabled by pre-existing policies. However, since the end of the pandemic its use has slowed down, indicating that new practices will not replace the incumbent regime. This hints at a co-existence and partial integration of the new niche, as digital technologies cannot completely substitute the social imperative of healthcare, based on the relation of trust and care between physician and patient built through a face-to-face relationship.