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Values are central to healthcare but hardly explicitly theorized. To understand the role of values in societal transitions, we examine how values are interpreted, enacted, and negotiated in real-world practices. We present an interdisciplinary framework to study values and value conflicts in situ.

Paper long abstract

Values are at the core of healthcare, fundamentally shaping how caregiving is organized, priorities are set, what finds resonance, and what is resisted. Despite their omnipresence, values are hardly explicitly theorized. Often conflated with stated preferences or abstracted to broad principles few would disagree with (i.e. “solidarity”), such abstractions or simplifications obscure value dynamics in concrete practices (Oldenhof et al., 2025).

The role of value dynamics become particularly urgent to understand in relation to societal transformations like ‘ageing in place’. As the principles of welfare states globally are under pressure as they are struggling with ageing populations, increasing percentages of chronically ill patients and declined workforce, governments, technology firms and expert bodies are enacting imaginaries of ‘future-proof’ care systems for ageing adults. Such enactments mobilize promissory tropes regarding technological solutions or emphasize the importance of informal care networks.

To effectively understand the role of values in societal transitions, it is essential to move beyond abstractions and examine how values are interpreted, enacted, and negotiated in real-world practices. We present the contours of an interdisciplinary framework to study values and value conflicts in situ, integrating theoretical and empirical insights from empirical philosophy (Mol, 2008; Pols, 2012), valuation studies (Dussauge et al., 2015; Kornberger, 2017), pragmatist sociology (Boltanski & Thévenot, 2006; Oldenhof et al., 2022), empirical bioethics, history and speculative design. Presenting some empirical vignettes, we illustrate how this framework can provide a robust analytical lens for understanding and addressing value dynamics, including value complexities and value changes, in societal transitions.

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This paper presents the findings of a discourse analysis of existing future visions of elderly care in the Netherlands and reflects on the experience of incorporating deconstructive analysis into participatory futuring and design research processes.

Paper long abstract

As populations age and the gap between care demand and carer supply grows, futures of care are becoming a topic of public and political concern. There is a sense that current care systems are headed for crisis or set to collapse unless a radical reconceptualization of care takes place, coupled with the reimagining of care arrangements and the construction of new visions of possible, preferable futures. But before this reimagining can begin some form of deconstruction needs to take place to reduce the risk that design and futuring processes intervening in this space do not unintentionally reaffirm the status quo ideas, assumptions and imaginaries they seek to move away from.

This paper reports the findings of a discourse analysis of existing future visions of elderly care in the Netherlands that serves as a grounding for multiple design and futuring projects. Combining analysis of 30 existing texts created by policymakers, healthcare organisations and other actors with interviews and participatory futuring workshops, this research asks: What futures of elderly care are currently being imagined in the Netherlands? And how are different imaginaries and practices shaping these futures? It also reflects methodologically on doing critical discourse analysis within design research projects. As STS scholars move into more applied settings, they must find ways to balance the need for deconstructive and generative modes, and consider how to involve other project partners, stakeholders and publics in their analytical processes so that they may attend to both the politics of imagination and participation in futuring.

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This presentation examines how digital healthcare in Portugal is being (re)shaped through collaborative practices. It explores how these transformations give rise to an emergent ethics of care, enabling participatory, relational, and more-than-now approaches to co-constructing healthcare futures.

Paper long abstract

Portuguese healthcare is being transformed as digital technologies intersect with institutional infrastructures, professional practices, and patient experiences. These shifts are not simply imposed but unfold through everyday negotiations, improvisations, and collaborative work among healthcare professionals, system designers, policymakers, and patients.

Drawing on ethnographic engagement and participatory, speculative methods, this presentation explores how actors experiment with care in ways that generate a new, emergent ethics. Unlike traditional ethical frameworks—principlism, virtue ethics, consequentialism, or classical ethics of care—this ethics arises through situated practice, mediated by digital infrastructures, data flows, and collaborative decision-making. It emphasizes responsiveness, relationality, and collective moral reasoning enacted in real time.

From an STS perspective, these practices reveal how healthcare futures are actively co-produced in the present. Speculative interventions—such as design experiments—make visible the contingency of socio-technical arrangements and open alternative pathways for more just, equitable, and resilient care across various stakeholders’ standpoints.

Aligned with the panel’s focus on speculative and design-based approaches to caring world-making, this contribution demonstrates how digital transformations do not just implement care but reshape what ethical responsibility looks like, creating new modes of reflection, collaboration, and experimentation in healthcare.

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This contribution examines collective care arrangements in the Netherlands as prefigurative experiments in collective self-reliance (samenredzaamheid). It explores how communities organise care and how participatory design-based methods can help imagine more sustainable and just futures of care.

Paper long abstract

Amid increasing welfare residualisation and a decentralisation of care responsibilities – from national government to municipalities and from municipalities to citizens – communities in the Netherlands are increasingly called upon to become more samenredzaam, i.e. collectively self-reliant. Yet how collective care practices emerge, and how they might be sustained, remains underexplored.

Taking existing care initiatives as prefigurative sites of experimentation (Botha et al., 2025; Monticelli, 2021; Schiller-Merkens, 2022), we explore how such initiatives attempt to enact alternative caring relations and infrastructures in the present. These initiatives not only respond to changing welfare arrangements but also actively imagine and experiment with possible futures of care.

We present findings from an exploratory study mapping such initiatives in Rotterdam, the Netherlands, examining how they understand and organise care collectively, and how their efforts are shaped by existing policy and governance frameworks. Building on this empirical groundwork, we outline a forthcoming study that will employ participatory design-based methods, including participatory futuring and backcasting (Quist & Vergragt, 2006). In collaboration with care initiatives and municipal policy actors, this study will explore how alternative arrangements of care might be scaled beyond prefigurative initiatives.

By bringing together research on prefigurative care arrangements and design-based methods, this work contributes to debates on how communities and institutions might collectively imagine and cultivate more caring futures.

Key words: collective care, collective self-reliance, prefiguration, participatory backcasting

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This paper discusses the experience of developing a research agenda on ‘responsible' AI using agenda-setting and LEGO Serious Play workshops with people with chronic conditions, exploring feminist co-design as a way of shaping technology to fit user needs as a “matter of care” (Bellacasa 2017).

Paper long abstract

Recent advances in AI, such as predictive analytics and personalised health monitoring, offer possibilities for proactive management of chronic conditions. However, most digital solutions still fail to support long-term person-centred care and participatory co-design -- essential for trust, accessibility, and usability -- remains underused. This project explored taking ‘responsible innovation’ seriously by incorporating people with lived experience (PWLE) of chronic conditions into co-design activities at the pre-proposal stage of research. We did this in a series of stages, beginning with inviting PWLE to agenda-setting workshops for an applied research proposal on AI-driven applications for chronic care, examining use of existing tools, challenges, and unmet needs. Themes from these workshops were then taken forward with the same group using LEGO® Serious Play, a guided method for group strategising, to formulate research questions and potential application pathways. Finally, we convened a multi-stakeholder roundtable (including technology developers, policymakers, local authorities, and practitioners) to help refine those outcomes into a large grant proposal. The paper discusses this process and its potential and pitfalls as a methodology for enabling PWLE-led research through the lens of Bellacasa’s “matters of care” (2017). We examine the intractably messy tensions of both creating and using AI-based technologies for “care”, and of trying to develop a feminist co-design methodology to incorporate people with a diversity of lived experiences into the precarious early stages of technical research. The results should be of interest to those working on social studies of robotics and AI, health technologies, and feminist STS more broadly.

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Animal-shaped social robots are increasingly introduced in elder care to address loneliness and staff shortages. Drawing on ethnography in Dutch nursing homes, this paper examines how these robots are adopted and resisted, revealing tensions and competing imaginaries of good care.

Paper long abstract

In the Netherlands, as elswhere around the world, aging populations place increasing pressure on health and long-term care systems, prompting policymakers to pursue technological innovations to support care provision. Among these innovations are social robots—devices designed to engage users through social interaction and companionship. In elder care, animal-shaped robots are often introduced to alleviate loneliness and reduce caregiver workload. Yet their integration into care practices remains contested. Care professionals and residents frequently perceive such technologies as “cold” or incompatible with the relational and moral dimensions of care.

This paper examines how animal-shaped social robots are negotiated, adopted, and resisted in everyday care practices in Dutch nursing homes. Drawing on ongoing ethnographic research, it explores how these robots become part of the socio-material arrangements of care, shaping interactions between residents, caregivers, and institutional infrastructures. Rather than viewing resistance as a barrier to innovation, the paper analyzes moments of hesitation, critique, and refusal as practices through which actors articulate competing practices and imaginaries of good care.

By foregrounding these tensions, the study contributes to STS and care scholarship that understands care as a situated practice of continual tinkering with values, technologies, and responsibilities. Encounters with social robots open debates about the boundaries of human and technological care, the moral expectations of caregiving, and the organization of future care infrastructures. In doing so, the paper reflects on how ethnographic insights into everyday care practices can inform more reflexive and inclusive approaches to designing and governing technological futures of care.

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This paper proposes using design fiction to surface competing sociotechnical imaginaries of "quality robotic care" in China's eldercare sector. It will explore how industry, policy, and care workers construct divergent and often incommensurable, visions of what robotic care should look like.

Paper long abstract

As China accelerates the development of care robots in eldercare settings, driven by demographic pressure, state-led technological ambition, and market logics, the question of what constitutes "good" or "quality" robotic care remains deeply unsettled. This paper proposes an inquiry into how different stakeholders, including robotics companies, policymakers, eldercare facility managers, and frontline care workers, construct competing imaginaries of robotic care futures.

This paper examines a layered vocabulary for analysing competing care futures. Rather than applying sociotechnical imaginaries uniformly across all stakeholders, it argues that different analytical concepts are needed for different registers of future-making: sociotechnical imaginaries for state and industry visions; radical imaginaries (Castoriadis, 1987; Vallès-Peris and Domènech, 2020) for emergent counter-visions; and hope, fear, and affect (Groves, 2011) for the individual orientations of care recipients. Extending Hess’s (2016) concept of ‘undone science’, the paper introduces the notion of undone imaginaries, which is, future orientations that are never given institutional scaffolding, not because they lack coherence, but because the actors who hold them lack power.

Methodologically, the paper will employ a combination of ethnographic methods and speculative approaches. Alongside interviews and participant observation across care settings and industry sites, design fiction will be used as a participatory tool: near-future narrative scenarios involving care robots will be co-constructed with stakeholders to render implicit assumptions explicit and open to contestation (Dunne & Raby, 2013; Auger, 2013). This multi-method approach presents reflexive, participatory methods for caring world-making, while contributing a distinctly non-Western context underrepresented in STS care scholarship.

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Paper short abstract

AI for ageing in place risks reinforcing ageism when older adults are not involved in design. This research explores how older adults envision AI in their future care and lives. Through co-creation, it examines explainability, daily practices, and inclusion of older adults in responsible AI design.

Paper long abstract

Artificial Intelligence (AI) can support personalized care and ageing in place. However, knowledge about users and their practices is necessary to reach responsible care embedding. Designers and researchers often exclude older adults from the design processes, resulting in ageist systems less suitable to the needed care and practices of older adults. Design processes can benefit from involving older adults to overcome ageism and possible biases incorporated into AI systems. In my previous work I explore the necessities and notions regarding explainable AI (XAI). What is explainability in the context of care and lives of older adults? It is not a simple topic, and needed levels of explainability differ for individuals and in different care contexts, it varies from knowing the algorithm towards practical knowledge. My research shows how care providers argue that explainability is probably not needed, and how older adults value XAI. To further explore how older adults understand and envision (X)AI in care and daily practices, and contribute to inclusive design of (X)AI, I applied co-creation. Co-creation can provide an environment for open collaboration and generation of new perspectives from actual end-users. I apply this approach to explore how older adults envision AI and XAI. “Where do you visualize and position AI in your life and care while ageing in our digital society?” This question is leading during a creative session in which the older adults learn about AI, co-create personal scenarios, and discuss about AI in their future lives, including care and daily practices.

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We developed a participatory method for co-creating gender equality indicators in Faridabad, India, enabling diverse groups to deliberate despite contentious conflict, fostering inclusive, reflexive governance of SDG indicators for just and livable futures.

Paper long abstract

Indicators are widely used as a governance tool to create just and livable futures (Rottenburg & Merry, 2015), with the Sustainable Development Goals (SDGs) as a prime example. Yet several Science and Technology Studies (STS) scholars show that indicators are socio-materially co-produced through values, power relations, and infrastructures. When existing asymmetries go unchallenged, indicators risk reinforcing inequality. Studies therefore developed participatory methods of indicator development based on direct deliberation (e.g. Marres & De Rijcke, 2020). However, these may be difficult to use in highly contentious settings where socio-material barriers hinder direct deliberation.

This article develops and tests a method for participatory indicator development designed for these challenging contentious contexts. We applied and tested this method in co-creating gender equality indicators under the SDGs in Faridabad district, India, through a series of workshops. We collected and analyzed data of eight workshop sessions, interviews with all 20 participants prior and after each session, six expert interviews, facilitator meeting notes, and workshop outputs.

Our findings show that combining geographically and temporally dispersed participation with reflexive co-design grounded in care principles, enables different groups that otherwise do not see eye to eye to deliberate about gender equality and develop indicators. This facilitates more inclusive development of indicators in contentious settings such as equality and sustainability. By collaboratively reshaping when, where, and how participation occurs, the method facilitates more inclusive and reflexive indicator governance, in order to foster the building of just and livable futures.

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Drawing on participatory humanitarian design workshops in Colombia, this paper examines how speculative, reflexive futuring practices generate 'promissory capital' to re-imagine continuity of care and sustain caring futures amid humanitarian withdrawal.

Paper long abstract

Amid aid cuts and withdrawal of international humanitarian organizations in the Colombian Caribbean, continuity of care is increasingly shaped by provisional arrangements and uncertain technological futures. We examine how speculative and participatory design methods can support the re-imagination of care in such contexts, while remaining oriented toward concrete technological intervention.

Drawing on ethnographically informed co-design workshops conducted in two settings of humanitarian emergency, Necoclí and Barranquilla, with local health actors and international researchers, we conceptualise ReTooling Care as a process of participatory futuring grounded in situated humanitarian and local health expertise. The (ongoing) workshops work toward the development of a care-support tool (e.g. a chatbot), using case studies, design prompts, and provisional prototypes exploring what such a technology should do, for whom, and under which ethical and institutional conditions.

We conceptualize care as an affective socio-technical practice sustained through relationships among people, infrastructures, knowledge, and expectations. Within the workshops, speculative humanitarian design explores the complex terrain of negotiating tensions between continuity and interruption, local expertise and humanitarians, and technological promise and institutional fragility. We argue that encounters require and generate ‘promissory capital’ (Strathern 2012), an anticipatory and interdisciplinary force that sustains collaboration, commitment, and opens up imagination amid the global care crisis.

By tracing how promissory capital circulates through participatory design processes oriented toward technological intervention, we contribute to STS debates on speculative design, world-making, care, and global health. It shows how caring futures are not simply designed, but collectively negotiated at the intersection of ethnography, technology, and humanitarian governance.

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With the project "Digitale Daseinsvorsorge", we are currently exploring emergent communities of care in the German-Polish border region, and in the fringes of Germany's digital welfare state. Our contribution focuses on the design-based, co-creative methods we are using or planning to use.

Paper long abstract

The proposed contribution is a work-in-progress report from the T!-Raum AlterPerimentale project „Digitale Daseinsvorsorge“ (funding: BMFTR). The project is deliberately built around a set of speculative and design-based methods for exploring emergent communities of care in the fringes of the digital welfare state. The project is set in three districts lying across two German states along the Polish border. Here, imaginaries of care are transported through post-reunification narratives of de-industrialization, population ageing, broken promises of the welfare state and, most recently, the datafication of welfare that is perceived of as top-down, intransparent, uneven and lacking participation. Working with and sometimes against those narratives, actors from within local government, traditional welfare organisations, civil society and the private sector are developing new practices, socio-technical infrastructures and imaginaries of care. Our contribution details the design-based, co-creative methods that we are using or planning to use for exploring emergent communities of care.

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Lagares do Alvará is an interactive piece that reimagines Mouraria, in Lisbon, as a self-sufficient community, using Fortnite in conjunction with 3D scans. In doing so, it provides a speculative sandbox for imagining alternatives to neoliberal urbanism through tangible site-specific fabulations.

Paper long abstract

How might fabulatory practices inspired by critical speculative design expand collective capacities to imagine alternatives to neoliberal urbanism?

This paper presents Lagares do Alvará, a site-specific virtual environment built within Fortnite using re-appropriated game assets and 3D scans captured in Mouraria, Lisbon. This historically marginalized neighborhood is undergoing accelerating transformation driven by tourism and municipal renewal. Grounded in conversations with local actors engaged in documenting gentrification's effects, the project seeks to propose a counter-imaginary, one in which Mouraria is self-sufficient and flourishing, or at the very least in which its residents are finding ways to affirm their right to the city and resist what Harvey calls the governance of visibility imposed by the city. The project seeks to explore how the staging of care, and cooperation in virtual site-specific environments, might participate in bringing such a reality closer.

We argue that this fabulation functions as a sandbox in which active tinkering with relations, values, and the contestation of urban spaces can be encouraged. Drawing on Le Guin's carrier bag theory of fiction, we propose that site-specific virtual environments can serve to hold residents' spatial knowledge, relational histories, and alternative visions of the future against the "urban smoothing". In doing so, they open speculative possibilities that resist short-term profiteering and imagine new social infrastructures for collective interdependence.

While the project's participatory dimensions remain in development, we reflect critically on its potential as a method for caring world-making at the intersection of speculative design, urban governance, and community-based futures thinking.