Karola V. Kreitmair critically evaluates the notion of empowerment that has become pervasive in the discourse surrounding direct-to-consumer (DTC) mobile health technologies. The author argues that while these technologies claim to empower users by providing knowledge, enabling control, and fostering responsibility, the actual outcome is often not genuine empowerment but merely the perception of empowerment. This distinction has significant implications for individuals who might be seeking to affect behavior change and improve their health and well-being.
The paper meticulously breaks down the concept of empowerment into five key features: knowledgeability, control, responsibility, availability of good choices, and healthy desires. The author presents a thorough review of the evidence related to the efficacy, privacy, and security concerns surrounding the use of m-health technologies. They demonstrate that these technologies, while marketed as empowering tools, often fail to live up to their promises and, in some cases, even contribute to negative health outcomes or exacerbate existing issues such as disordered eating.
The core of the argument lies in the distinction between genuine empowerment and the mere perception of empowerment. The author posits that, rather than fostering true empowerment, DTC m-health technologies often create a psychological illusion of control and knowledgeability. This illusion can lead users to form unrealistic expectations and place undue burden on themselves to effect change when the necessary conditions for change are not met. This “empowerment paradox” ultimately calls into question the purported benefits of DTC m-health technologies and the societal narrative around personal responsibility and control over one’s health.
This paper’s findings resonate with broader philosophical discussions around individual autonomy, agency, and the role of technology in shaping our lives. The empowerment paradox highlights the complex interplay between the individual and the structural factors that shape health outcomes. It raises crucial questions about the ethical implications of profit-driven technologies and the responsibilities of technology developers, marketers, and users in navigating an increasingly technologically-driven healthcare landscape. The insights from this paper contribute to ongoing debates about the nature of empowerment and the limits of individual autonomy in an age where our lives are increasingly mediated by technology.
Future research should focus on the prevalence and consequences of the empowerment paradox in the context of DTC m-health technologies. A deeper understanding of how individuals make decisions around their health in the presence of perceived empowerment could inform the development of more effective and ethically responsible technologies. Additionally, examining the social and cultural factors that influence the marketing and adoption of these technologies may provide insight into how the industry can foster genuine empowerment, rather than perpetuating an illusion of control. Ultimately, a more nuanced understanding of the relationship between DTC m-health technologies and empowerment will pave the way for a more responsible and equitable approach to healthcare in the digital age.
Abstract
Mobile Health (m-health) technologies, such as wearables, apps, and smartwatches, are increasingly viewed as tools for improving health and well-being. In particular, such technologies are conceptualized as means for laypersons to master their own health, by becoming “engaged” and “empowered” “managers” of their bodies and minds. One notion that is especially prevalent in the discussions around m-health technology is that of empowerment. In this paper, I analyze the notion of empowerment at play in the m-health arena, identifying five elements that are required for empowerment. These are (1) knowledge, (2) control, (3) responsibility, (4) the availability of good choices, and (5) healthy desires. I argue that at least sometimes, these features are not present in the use of these technologies. I then argue that instead of empowerment, it is plausible that m-health technology merely facilitates a feeling of empowerment. I suggest this may be problematic, as it risks placing the burden of health and behavior change solely on the shoulders of individuals who may not be in a position to affect such change.
Mobile health technology and empowerment