Send message to Author

Paper short abstract

To what extent can participatory design meaningfully address health inequalities and structural injustice and what additional methods or epistemic practices are required when PD alone reaches its limits? Explored through the co-development of an app for people with COPD living in low SEP.

Paper long abstract

Digital health technologies (DHTs) are widely promoted as promising vehicles for integrating AI into healthcare. Yet, their envisioned benefits often fail to reach those who could benefit the most, particularly people living in low socio economic positions. Within STS, participatory design (PD) has long been positioned as a key method for addressing justice issues, frequently celebrated as the “gold standard” for co-developing inclusive innovation together with patients. Yet PD is frequently applied in a pragmatic manner, with insufficient attention to the deeper structural injustices that shape both health and technology development.

Centring justice not as an ethical add on but as a condition of possibility for technological futures this paper asks: (1) To what extent can PD meaningfully address health inequalities and structural injustice? (2) What additional methods or epistemic practices are required when PD alone reaches its limits? These questions are explored through an empirical case study of the DACIL project, which aims to develop an inclusive wearable device for people with chronic obstructive pulmonary disease (COPD) living in low socio economic circumstances in the Netherlands.

Building on participatory co-design activities with patients, clinicians, technologists, and interdisciplinary researchers and supplemented by reflexive monitoring in action, I present data on: (a) how developers and patients envision desirable, situated, and just digital health futures; and (b) which attempts to counter structural injustice succeeded and which fell short. I conclude by outlining implications for the development of AI based DHTs that enable the articulation and realisation of minoritised and just technological futures.