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Short abstract:

This contribution argues for the merits of investigating how co-designed AI/ML-based technologies are enacted by the practices and interpretations of different stakeholders within co-design processes.

Long abstract:

Today eHealth interventions are often provided through digital platforms, i.e., unneutral, infrastructural elements, with specific socio-cultural norms, business goals and political relations embedded in their architecture (Schwennesen, 2019; Pronzato, 2023; Torenholt and Langstrup, 2023). The current expansion of AI/ML-based systems in healthcare is no exception in this regard, as partial and discriminative accounts of social life can be reproduced by these technologies (Crawford, 2021).

Recently, co-design has emerged as a widespread participatory method to produce eHealth technologies that can empower patients and caregivers (Dietrich et al., 2021). However, participation in technological development can be considered as a “matter of concern” (Andersen, 2015, c.f., Latour, 2004), and not considering “the micro-politics of the relations that are built-in co-design” (Huybrechts et al., 2020, p. 3) may risk reproducing rather than overcoming power asymmetries (Donia and Shaw, 2021).

Starting from the co-design of an e-learning platform for informal caregivers of patients with dementia (project AGE-IT, PNRR PE8 “Age-It”), this contribution bridges perspectives from STS, health sociology, critical algorithm studies and co-design. Specifically, drawing on Seaver’s (2017, c.f. Mol, 2002) conceptualization of algorithmic technologies as artifacts “culturally enacted by the practices people use to engage with them” (p. 5), it argues for the merits of investigating how co-designed AI/ML-based technologies are enacted by the practices and interpretations of different stakeholders, e.g., IT designers, caregivers, patients, doctors, etc.

In this scenario, a re-politicization of co-design emerges as essential to help respond to value conflicts and translate STS to more robust participatory practices.