SELF-TRACKING AS A SKETCH OF DIGITAL MEDICINE AND AN OBJECT OF EPISTEMIC ANALYSIS
DOI: 10.23951/2312-7899-2021-3-55-82
Self-tracking is a phenomenon of digital medicine that allows highlighting trends in the development of medicine as a science and a health care sector. Self-tracking as a sketch is an opportunity to see the features of a future picture already in a gesture drawing. Self-tracking is considered as a social practice of using digital technologies to collect, monitor and evaluate significant medical quantitative parameters of the bodily state and mental status. At the same time, self-tracking is one of the manifestations of the modern phenomenon of corporeality quantification. Against the background of the growing importance of self-control in medicine of the 21st century, digitalization is changing the practice of monitoring bodily states from the perspective of managing them. However, the key subjects of medicine are not uniformly related to self-tracking. Special devices and applications for self-tracking purposes have a wide range of applications, and the practice of using them for self-monitoring generates many contradictions and becomes the subject of analysis in various subject areas, from medicine to philosophy. An epistemic analysis of self-tracking is associated with the consideration of the status of knowledge that arises within the framework of digital self-monitoring and self-control. The result of self-tracking is a data pool characterized by such features as: connection with the individual body and the world of a specific person acting as a producer of knowledge; practical focus on self-management of the subject’s daily behavior; objectivity ascribed by the subject, which becomes the basis for legitimizing changes in behavior. Consideration of self-tracking in the context of civic science allows us to record the formation of new options for conceptualizing the relationship between science and society. Self-tracking has the features of a personal science and requires clarification of real and practical forms of interaction between civil and institutionalized science, as well as an assessment of the prospects for dialogue between them. The conditions for the existence of knowledge that arise as a result of self-tracking are associated with several basic positions. First, it is an analysis of the personal epistemic goals of the self-tracking subject, which vary widely from pragmatic medical indications to self-knowledge: a complex interweaving of goal-setting. With the self-identification of a person using digital technologies of self-examination and self-control, the basis of self-determination is replaced: from self-awareness to a quantitative determination that depends on the social, axiological context of measurement modes. The predominance of visuality with “quantified self” nevertheless leaves room for a departure from reductionism and a high level of understanding of the integrity of the subject in a wide cultural and social context. This actualizes the task of an adequate methodology and conceptual apparatus for combining quantitative and qualitative parameters. The knowledge that has become the result of self-tracking for the subject can be a factor and manifestation of a change in the model of communication between a doctor and a patient in the direction of antipaternalism when approving the interpretation of health as a management project. In the context of “opportunities-limitations”, self-tracking makes it possible to clearly record the request for conceptualizing the relationship between individual responsibility and the role of the state and society in matters of protecting individual and public health. Social practices of self-tracking are associated with an increased participation of subjects in obtaining meaningful medical information, which, on the one hand, opens up opportunities for self-control and management of their own health, and, on the other hand, leads to the emergence of additional channels for managing human behavior with an emphasis on social normativity. Gamification, visualization, involvement in target social groups increase the attractiveness of self-tracking practices, which in turn blurs the line between the private and the public. The inclusion of medical self-monitoring in the economic sphere leads to the emergence of the “digital labor” phenomenon. At the moment, arguments in favor of the development of digital medicine technologies, as well as concerns and fears, lie in the plane of potential benefits and potential risks; there is no sufficient empirical basis for generalizations; the positions of various stakeholders of the process are not explicitly indicated. A critical attitude to the development of self-control technologies is based on arguments about the impossibility of achieving the stated goals through self-tracking, about the availability of alternatives to digital self-control, about the threat to those fundamental values that underlie the bioethical regulation of biomedicine in the late 20th – early 21st centuries. The social practice of self-tracking is ahead of its epistemic analysis, which should include not only the analysis of the status of knowledge in the light of the declared and achieved goals, the means used for this and the real spheres of application of the results of self-description and self-control. Conceptualization should also be aimed at identifying the conditions for the possibility of obtaining and applying knowledge in a wide social context that arises during the medicalization of all spheres of society.
Keywords: philosophy of medicine, digital medicine, digital healthcare, digital health, self-tracking, mobile healthcare
References:
Abend, P., & Fuchs, M. (2016). Quantified selves and statistical bodies. Digital Culture & Society, 2(1). http://digicults.org/files/2016/03/Abend-and-Fuchs-Eds.-Quantified-Selves_Cover-and-content.pdf (Accessed: 23.08.2020).
Andrejevic, M. (2014). The big data divide. International Journal of Communication, 8, 1673–1689.
Boyd, D., & Crawford, K. (2012). Critical questions for big data: provocations for a cultural, technological, and scholarly phenomenon. Information, Communication & Society, 15(5), pp. 662–679.
Bryzgalina, E. V. (2019). Medicine in the optics of artificial intelligence: The philosophical context of the future. Chelovek, 30(6), 54–71. (In Russian).
Chamorro-Premuzic, T. (2015). Wearable devices: Tracking your every step may not make you happier. The Guardian, 17 Jul 2015. https://www.theguardian.com/media-network/2015/jul/17/wearable-devices-technology-monitor-behaviour-wellbeing (Accessed: 23.08.2020).
Dhar, V. (2014). Healthcare and data: An interview with Peter Szolovits. Big Data, 2(4), 182–184.
Dickenson, D. (2013). Me medicine vs. We medicine: Reclaiming biotechnology for the common good. Columbia University Press.
Doc Tom. (2006). Tom Ferguson, M.D. Available online: http://www.doctom.com
Duttweiler, S., & Passoth, J. H. (2016). Self-tracking as an optimisation project? In S. Duttweiler, R. Gugutzer, J. H. Passoth, & J. Strübing (Eds.), Living by numbers. Self-tracking as an optimisation project? (pp. 9–42). Transcript.
European Commission. (2014). Green Paper on mobile health, COM 2014. https://ec.europa.eu/digital-single-market/en/news/green-paper-mobile-health-mhealth (Accessed: 28.08.2020).
Ferretti, F. (2019). Mapping do-it-yourself science. Life Sciences, Society and Policy, 15(1), 1–23.
Foucault, M. (1977). Discipline and punish: The birth of the prison. Translated from French by A. Sheridan. Allen Lane.
Grebenshchikova, E. (2019). Digital medicine: Bioethical assessment of challenges and opportunities. JAHR – European Jornal of Bioethics, 10(1), 211–223.
Grebenshchikova, E. G., & Tishchenko, P. D. (2020). Digitized Future of Medicine: Challenges for Bioethics. Filosofskie nauki – Russian Journal of Philosophical Sciences, 63(2), 83–103. (In Russian). https://doi.org/10.30727/0235-1188-2020-63-2-83-103
Heyen, N. B. (2016). Self-tracking as knowledge production: Quantified self between prosumption and citizen science. In S. Selke (Ed.), Lifelogging: Digital self-tracking and lifelogging – Between disruptive technology and cultural transformation (pp. 283–301.). Springer.
Heyen, N. B. (2020). From self-tracking to self-expertise: The production of self-related knowledge by doing personal science. Public Underst Science. 29(2), 124–138.
Kasperowski, D, & Kullenberg, C. (2019). The many modes of citizen science. Science & Technology Studies, 32(2), 2–7.
Klyayneberg, M. (2018). Illness and health in times of self-tracking, wellness and self-optimization. On the way to the health society? Vestnik SPbGU. Filosofiya i konfliktologiya – Vestnik of Saint Petersburg University. Philosophy and Conflict Studies, 34(1), 17–23. (In Russian). https://doi.org/10.21638/11701/spbu17.2018.102
Kodaneva, S. I. (2020). Tsifrovye tekhnologii v zdravookhranenii: zarubezhnyy opyt [Digital technologies in healthcare: Foreign experience]. Rossiya: tendentsii i perspektivy razvitiya, 15(1), 617–620.
Levanov, V. M., & Kutsik, E. A. (2019). Awareness and motivation of medical university students in respect of digital medicine – The five-year-trend. Meditsinskiy al’manakh – Medical Almanac, 1(58), 14–18. (In Russian).
Lupton, D. (2012). M-health and health promotion: the digital cyborg and surveillance society. Social Theory & Health, 10(3), 229–244.
Lupton, D. (2013). Quantifying the body: monitoring and measuring health in the age of mHealth technologies. Critical Public Health, 23 (August), 393–403.
Lupton, D. (2015). Quantified sex: a critical analysis of sexual and reproductive self-tracking using apps. Culture, Health and Sexuality, 17(4), 1–14.
Lupton, D. (2016). The quantified self: A sociology of self-tracking. Polity Press; Neff and Nafus.
Lyall, B., & Robards, B. (2017). Tool, toy and tutor: Subjective experiences of digital self-tracking. Journal of Sociology, 54(1), 108–124.
Markeeva, A. V. (2015). Lifelogging: The ways of using and the social consequences of development. Russian Journal of Education and Psychology, 7(51), 123–138. (In Russian). http://dx.doi.org/10.12731/2218-7405-2015-7-9
Marks, P. (2014). Hacked to death. New Scientist, 224(2994), 19.
McGregor, J. (2014). Fitness trackers chase after the corporate market. The Washington Post, December 18, 2014. http://www.washingtonpost.com/blogs/on-leadership/wp/2014/12/18/fitness-trackers-chase-after-the-corporate-market/ (Accessed: 23.08.2020).
Meskó, B., Drobni, Z., Bényei, É., Gergely, B., & Győrffy, Z. (2017). Digital health is a cultural transformation of traditional healthcare. MHealth 3(38). http://mhealth.amegroups.com/article/view/16494/16601 (Accessed: 23.08.2020).
Nafus, D., & Sherman, J. (2014). This one does not go up to 11: the quantified self movement as an alternative big data practice. International Journal of Communication, 8, 1784–1794.
Neff, G., & Nafus, D. (2016). Self-tracking. MIT Press.
Nim, E. G. (2018). Self-tracking as a practice of quantifying the body: Conceptual outlines. Antropologicheskiy forum, 38. https://cyberleninka.ru/article/n/self-treking-kak-praktika-kvantifikatsii-telesnosti-kontseptualnye-kontury (Accessed: 09.08.2020). (In Russian).
Nim, E. G. (2020). Student discourse on digital self-tracking: rhetorics and practices. Monitoring obshchestvennogo mneniya: ekonomicheskie i sotsial’nye peremeny – Monitoring of Public Opinion: Economic and Social Changes, 2(156), 191–211. (In Russian). https://doi.org/10.14515/monitoring.2020.2.989
Olson, P. (2014a). Wearable tech is plugging into health insurance. Forbes, Jun 19, 2014. http://www.forbes.com/sites/parmyolson/2014/06/19/wearable-tech-health-insurance/ (Accessed: 23.08.2020).
Olson, P. (2014b). The quantified other: Nest and Fitbit chase a lucrative side business. Forbes, Apr 17, 2014. http://www.forbes.com/sites/parmyolson/2014/04/17/the-quantified-other-nest-and-fitbit-chase-a-lucrative-side-business/ (Accessed: 23.08.2020).
Ritter, S. (2015). Apple’s research kit development framework for Iphone apps enables innovative approaches to medical research data collection. Clinical Trials, 5(2), e.120.
Rooksby, J., Rost, M., Morrison. A., & Chalmers, M. (2014). Personal Tracking as Lived Informatics. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. ACM. pp. 1163–1172
Ruckenstein, M. (2014). Visualized and interacted life: personal analytics and engagements with data doubles. Societies, 4, 68–84.
Ruckenstein, M., & Schüll, N. D. (2017). The datafication of health. Annual Review of Anthropology, 46(1), 261–278.
Schork, N. J. (2015). Time for one-person trials. Nature, 520(7549), 609–611
Selke, S. (Ed.) (2016). Lifelogging: Digital self-tracking and lifelogging – Between disruptive technology and cultural transformation. Springer.
Sharon, T. (2017). Self-tracking for health and the quantified self: Re-articulating autonomy, solidarity, and authenticity in an age of personalized healthcare. Philosophy & Technology, 30, 93–121.
Sørensen, K., Pelikan, J. M., & Rothlin, F. (2015). Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). European Jornal of Public Health, 25(6), 1053–1058.
Soshnikov, S. S. et al. (2017). Classification of mobile medical applications, principles and ethical standards for their implementation in clinical practice. Meditsinskie tekhnologii. Otsenka i vybor – Medical Technologies. Assessment and Choice, 3(29), 53–58. (In Russian).
Stilgoe, J., Lock, S. J., & Wilsdon, J. (2014). Why should we promote public engagement with science?Public Understanding of Science, 23(1), 4–15.
Strasser, B. J., Baudry, J., Mahr, D., Sanchez, G., & Tancoigne, E. (2019). “Citizen science”? Rethinking science and public participation. Science & Technology Studies, 32(2), 52–76.
Swan, M. (2009). Emerging patient-driven health care models: an examination of health social networks, consumer personalized medicine and quantified self-tracking. International Journal of Environmental Research and Public Health, 6, 492–525.
Swan, M. (2012). Health 2050: the realization of personalized medicine through crowdsourcing, the quantified self, and the participatory biocitizen, Journal of Personalized Medicine, 2, 93–118.
Sysling, F. (2020). Measurement, self-tracking and the history of science: An introduction. History of Science; An Annual Review of Literature, Research and Teaching, 58(2), 103–116.
Tarantova, E. S., Makarov, K. V., & Orlov, A. A. (2019). Survey on approaches and practical areas of human activity recognition application. Vestnik Yuzhno-ural’skogo gosudarstvennogo universiteta. Seriya: vychislitel’naya matematika i informatika – Bulletin of the South Ural State University. Computational Mathematics and Software Engineering, 3, 43–57. (In Russian). http://dx.doi.org/10.14529/cmse190303
Terranova, T. (2000). Free labor: producing culture for the digital economy. Social Text, 18(2), 33–58.
Till, C. (2014). Exercise as labour: quantified self and the transformation of exercise into labour. Societies, 4(3), 446–462.
Tishchenko, P. D., & Yudin, B. G. (2015). Finest hour of philosophy. Voprosy filosofii, 12, 198–203. (In Russian).
Topol, E. (2015). The patient will see you now: The future of medicine is in your hands. Basic Books.
Tsvetkova, A. B., & Shishkin, A. V. (2018). Evaluation of the digital medicine perception by the youth consumer segment. Statistika i ekonomika – Statistics and Economics, 6, 46–57. (In Russian). https://doi.org/10.21686/2500-3925-2018-6-46-57
Vladzimirskiy, A. V. (2016). Systematic review of efficiency and significance of wearables for a medical practice. Zhurnal telemeditsiny i elektronnogo zdravookhraneniya – Journal of Telemedicine and EHealth, 1(2), 6–17. (In Russian).
Wehling, P. (2012). From invited to uninvited participation (and back?): Rethinking civil society engagement in technology assessment and development. Poiesis & Praxis – International Journal of Ethics of Science and Technology Assessment, 9(1–2), 43–60.
Whitson, J. (2013). Gaming the quantified self. Surveillance & Society, 11(1/2), 163–176.
Wolf, G. (2010). The data-driven life. The New York Times Magazine. April 28, 2010. http://www.nytimes.com/2010/05/02/magazine/02self-measurement-t.html?pagewanted=all&_r=0 (Accessed: 23.08.2020).
Yudin, B. G. (2016). Technoscience and “human enhancement”. Epistemologiya i filosofiya nauki – Epistemology & Philosophy of Science, XLVIII(2), 18–27. (In Russian).
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Issue: 3, 2021
Series of issue: Issue 3
Rubric: ARTICLES
Pages: 55 — 82
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