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Self- Tracking
In mental health, the safety and risk concept refers to a complex phenomenon with strong connections to risk management strategies, simultaneously influenced by the ideals of patient involvement and empowerment. The aim of this paper is to analyze discourses linked to patient involvement and the management of risk and safety, as articulated in the protocol for the Early Recognition Method (ERM) risk management strategy. As an analytical tool, we have drawn inspiration from the discourse theory of Michel Foucault and utilized Hall's six elements for discourse analysis. Our analysis indicates that the ERM protocol rests its discursive authority upon two main discourses: one, a scientific medical discourse and the other, a discourse strongly linked to empowerment and patient involvement. These two discourses are interrelated in a complex fluctuation of power dynamics in which they sometimes complement each other and, at other times, are in conflict. We claim that by applying a Foucauldian angle on discourse, power, and knowledge, our analysis may facilitate a critical awareness of the power dynamics inherent in risk management discourses and provide valuable insights into how articulations of safety and risk – combined with ideals of participation and empowerment – contribute to reframing practices in mental health care.
Zusammenfassung
Das Self-Tracking – und natürlich auch das gesundheitsbezogene Self-Tracking – übt einen Einfluss auf diejenigen aus, die es betreiben. Dieser Einfluss kann (muss aber nicht notwendigerweise) eine Gefahr für die Autonomie der sich selbst trackenden Personen darstellen.
Die Wahrscheinlichkeit ist nicht gering, dass das Self-Tracking mit einer der drei Bedingungen in Konflikt gerät, die nach Beauchamp, Faden und Childress für Autonomie anzusetzen ist: mit der Freiwilligkeitsbedingung. Auf der Grundlage einer Unterscheidung zwischen verschiedenen Formen von manipulierenden Einflüssen – leicht kontrollierenden und substanziell kontrollierenden – argumentiere ich dafür, dass das gesundheitsbezogene Self-Tracking häufig einen leicht kontrollierend manipulativen Einfluss hat, dass dieser aber auch das Ausmaß eines substanziell kontrollierend manipulativen Einflusses und sogar Formen des Zwangs annehmen kann.
Substantiell manipulierendes sowie Self-Tracking, das mit Zwang verbunden ist, stellt eine Verletzung der Freiwilligkeitsbedingung von Autonomie dar. Diese Gefahr einer Autonomieverletzung gilt es bei der Beurteilung von gesundheitsbezogenem Self-Tracking zu berücksichtigen.
Zusammenfassung
Wenn Patient*innen die Fähigkeit verlieren, in klinische Maßnahmen einzuwilligen, aber keine Patient*innen-Verfügung vorliegt, ist der mutmaßliche Wille zu ermitteln. Um dies besser als bislang gewährleisten zu können, wird der Einsatz eines Patient Preference Predictors diskutiert: ein Instrument, das auf der Basis algorithmischer Korrelationen (PPP) bzw. mit Hilfe eines Large Language Models (personalisierter PPP (P4)) die mutmaßliche Präferenz einer Person ermitteln soll. Ein Einsatz von PPPs/P4s ist allerdings kritisch zu sehen, da sowohl von epistemischer als auch von normativer Seite Bedenken anzumelden sind. So stellen nämlich rein korrelative Zusammenhänge keine adäquate Grundlage für die Ermittlung zu respektierender individueller (kontrafaktisch) autonomer Präferenzen dar. Der PPP ist daher abzulehnen. Bei einem P4 ist es fraglich, ob die notwendige Individualität und hinreichende Qualität der Präferenzermittlung gewährleistet werden kann. Sollte ein Ersatz menschlicher Stellvertreter*innen durch einen P4 erwogen werden, so ist zu kritisieren, dass notwendige Bedingungen zur Erfüllung des Prinzips des Respekts vor der Autonomie nicht erfüllt werden bzw. der darauf basierende Standard für stellvertretende Entscheidungen nicht gut eingehalten werden kann. Ein P4 sollte daher, wenn überhaupt, nur zur Unterstützung bei der Entscheidungsfindung herangezogen werden – und dies auch nur dann, wenn nachprüfbare Begründungen für eine Präferenzbestimmung durch den P4 bereitgestellt werden.
In light of the challenges surrounding the conceptualization and definition of spatial justice within our increasingly data-driven society, this article commences an inquiry into the convergence of space, justice, and data within human geography literature and related disciplines, focusing notably on the urban field. The paper outlines theories concerning social justice-based rights to the city, especially emphasizing the significance of existing literature that bridges such theories with recent scholarship on data justice. It supplements these discussions by deriving a theoretical framework for digital spatial justice rooted in other space-based theories, exploring the more-than-human realms of non-human entities, affect, and information.
This article explores the ontogenesis of software (code) and law and how they are entangled and in-form bodies and urban space. Herein, I investigate how this process of in-forming creates ruptures, differences in the otherwise smooth experience of the urban. These remain largely invisible but surface when interruptions in the everyday use of technologies affect urbanites. These interruptions might be data breaches, frauds, invasive phishing emails and the likes. Information and affect play a key role as posthuman elements in the ontogenesis. Ruptures, differences may also open up lines of flight and resistance that highlight differences rather than conceal them. Taking an ontogenetic and new materialist perspective, this paper contributes to strengthening the theoretical dialogue between law, the science of space (geography) and philosophies of technology.
People’s encounters and entanglements with the personal digital data that they generate is a new and compelling area of research interest in this age of the ascendancy of digital data. Masses of personal information are constantly generated via people’s use of digital technologies and used for a variety of purposes by a range of actors. People are faced with the conundrum of how to interpret, control and make sense of their lively data. In this article, I explore the topic of how personal digital data and their circulations can be made more perceptible and therefore interpretable to people with the use of three-dimensional materialisations. These materialisations invite users to ‘feel your data’. As I show, ‘feeling your data’ has two meanings: the sensations of touching these three-dimensional objects and the visceral responses that are generated from these and other sensory encounters with data.
There is no question that anthropogenic processes have had planetary effects, in inter/intraaction with other processes and species, for as long as our species can be identified (a few tens of thousand years); and agriculture has been huge (a few thousand years). Of course, from the start the greatest planetary terraformers (and reformers) of all have been and still are bacteria and their kin, also in inter/intra-action of myriad kinds (including with people and their practices, technological and otherwise). 1 The spread of seed-dispersing plants millions of years before human agriculture was a planet-changing development, and so were many other revolutionary evolutionary ecological developmental historical events. People joined the bumptious fray early and dynamically, even before they/we were critters who were later named Homo sapiens. But I think the issues about naming relevant to the Anthropocene, Plantationocene, or Capitalocene have to do with scale, rate/speed, synchronicity, and complexity. The constant question when considering systemic phenomena has to be, when do changes in degree become changes in kind, and what are the effects of bioculturally, biotechnically, biopolitically, historically situated people (not Man) relative to, and combined with, the effects of other species assemblages and other biotic/abiotic forces? No species, not even our own arrogant one pretending to be good individuals in so-called modern Western scripts, acts alone; assemblages of organic species and of abiotic actors make history, the evolutionary kind and the other kinds too. But, is there an inflection point of consequence that changes the name of the “game” of life on earth for everybody and everything? It's more than climate change; it's also extraordinary burdens of toxic chemistry, mining, depletion of lakes and rivers under and above ground, ecosystem simplification, vast genocides of people and other critters, etc, etc, in systemically linked patterns that threaten major system collapse after major system collapse after major system collapse. Recursion can be a drag. Anna Tsing in a recent paper called “Feral Biologies” suggests that the inflection point between the Holocene and the Anthropocene might be the wiping out of most of the refugia from which diverse species assemblages (with or without people) can be reconstituted after major events (like desertification, or clear cutting, or, or, …). 2 This is kin to the World-Ecology
Over the last 5 years, wearable technology - comprising devices whose embedded sensors and analytic algorithms can track, analyze and guide wearers' behavior - has increasingly captured the attention of venture capitalists, technology startups, established electronics companies and consumers. Drawing on ethnographic fieldwork conducted 2 years running at the Consumer Electronics Show and its Digital Health Summit, this article explores the vision of technologically assisted self-regulation that drives the design of wearable tracking technology. As key artifacts in a new cultural convergence of sensor technology and self-care that I call 'data for life', wearables are marketed as digital compasses whose continuous tracking capacities and big-data analytics can help consumers navigate the field of everyday choice making and better control how their bites, sips, steps and minutes of sleep add up to affect their health. By offering consumers a way to simultaneously embrace and outsource the task of lifestyle management, I argue, such products at once exemplify and short-circuit cultural ideals for individual responsibility and self-regulation.
Donna Haraway’s recent volume, Manifestly Haraway, offers the opportunity not only to compare two of her most influential writings side-by-side but also to revisit some of the enduring themes of her work over the past several decades. In this interview with Haraway, feminist science studies scholar Sarah Franklin explores some of the key terms in her work, looking back to some of her early work on embryology and primatology as well as exploring the more recent themes of her latest book, Staying with the Trouble.
In this chapter I discuss the ways in which people engage with the data that are generated from their interactions with online technologies and digital sensing and communication devices. Due to the reactive and responsive nature of computer software and the ubiquity of the devices that people carry with them or that sense their movements, the lives of humans have become increasingly entangled with digital technologies. People are confronted with attempting to gain some purchase on information about themselves which is not only continually generated but is also used by other actors and agencies in ways of which they may not be fully aware. They are also dealing with the ways in which their data are announced to themselves, such as the push notifications and targeted advertising based on their browsing or online purchasing habits that they receive when using apps and online platforms. I address the the topics of personal data practices in response to lively data with reference to several of my own current research projects.
In Vibrant Matter the political theorist Jane Bennett, renowned for her work on nature, ethics, and affect, shifts her focus from the human experience of things to things themselves. Bennett argues that political theory needs to do a better job of recognizing the active participation of nonhuman forces in events. Toward that end, she theorizes a “vital materiality” that runs through and across bodies, both human and nonhuman. Bennett explores how political analyses of public events might change were we to acknowledge that agency always emerges as theeffect of ad hoc configurations of human and nonhuman forces. She suggests that recognizing that agency is distributed this way, and is not solely the province of humans, might spur the cultivation of a more responsible, ecologically sound politics: a politics less devoted to blaming and condemning individuals than to discerning the web of forces affecting situations and events.
Bennett examines the political and theoretical implications of vital materialism through extended discussions of commonplace things and physical phenomena including stem cells, fish oils, electricity, metal, and trash. She reflects on the vital power of material formations such as landfills, which generate lively streams of chemicals, and omega-3 fatty acids, which can transform brain chemistry and mood. Along the way, she engages with the concepts and claims of Spinoza, Nietzsche, Thoreau, Darwin, Adorno, and Deleuze, disclosing a long history of thinking about vibrant matter in Western philosophy, including attempts by Kant, Bergson, and the embryologist Hans Driesch to name the “vital force” inherent in material forms. Bennett concludes by sketching the contours of a “green materialist” ecophilosophy.
This essay seeks to give philosophical expression to the vitality, willfullness, and recalcitrance possessed by nonhuman entities and forces. It also considers the ethico-political import of an enhanced awareness of “thing-power.” Drawing from Lucretius, Spinoza, Gilles Deleuze, Bruno Latour, and others, it describes a materialism of lively matter, to be placed in conversation with the historical materialism of Marx and the body materialism of feminist and cultural studies. Thing-power materialism is a speculative onto-story, an admittedly presumptuous attempt to depict the nonhumanity that flows around and through humans. The essay concludes with a preliminary discussion of the ecological implications of thing-power.
The UK Home Office and the US Transportation Security Administration have made substantial recent investment in new Backscatter X-ray scanners to screen bodies at securitised border checkpoints. Promising to make the invisible visualisable, these devices project an image of a naked body onto a screen to identify concealed 'risk'. Contemporary security practices which seek to fix identity at the border through biometrics, datamining, and profiling-of which the 'whole body scanner' is part-have their genealogy in efforts in aesthetics and medical science to mine the body for certainties and reveal something of the unknown future. The scan is revealed as a simultaneous partitioning and projection, the body 'digitally dissected' into its component parts, from which a specific, securitised visualisation is shaped. Drawing on the entangled histories of 'body knowledge' in art, science, and anatomy-their techniques of abstraction and technologies of visualisation-we explore what light may be shed on the Backscatter scan and, more importantly, what ramifications this may have for a critical response. Challenges to the biometric border have tended to centre on surveillance, making appeals to privacy and bodily integrity. However, if border disclosures which 'take apart' the body are more precisely understood as visualisations, then there are more fundamental issues than recourse to rights of privacy can counteract.
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