Embodying Autonomy in a Home Telecare Service

Abstract

possibility of disembodied care arises in which the users feel that their control over their needs could increase, while at the same time any vestige of disciplining their lifestyle disappears. Nevertheless, this is not an ideal scenario for users and caregivers, nor is telecare, in practice, a disembodied care. On the one hand, users and caregivers insist that even though telecare is transforming the way care is delivered, this would not be possible by removing hands-on caretelecare is not a substitute (Percival and Hanson, 2006;Mort et al., 2008). And on the other hand, as Armstrong (1995) and Brown and Webster (2004) have suggested, although the increasing relevance of information in e-health and telecare might imply the possibility of a deinstitutionalization of care delivery and an informatization of the body (see Nettleton, 2004), this does not necessarily result in a disembodied care. 4 Indeed, as we are going to show, specific forms of being an autonomous user are embodied in the functioning of these informational technologies.Our aim is, specifically, to discuss how autonomy is embodied through the use of a telecare device. What kind of bodies are autonomous bodies? How are they constructed? By means of what practices and materials have they been built up? And by trying to answer these questions, we would also like to critically discuss the idea of autonomy that is implicit to telecare advertisements and policies that foster telecare as a new care solution: autonomy is achieved when disciplining interventions over the body and its habits are not necessary to live safely. In fact, as we suggest in what follows, the use and appropriation of a telecare system implies not only embodiment processes and struggles within it, but also the enactment of different bodies and the emergence of competing definitions and practices of being autonomous when using telecare.We draw on phenomenology, especially on The Phenomenology of Perception by Merleau-Ponty (1962), where body is defined not as an external object or a mental construct, but as a mediator that situates us as a being-in-the-world. Additionally, we draw on other phenomenological contributions concerning how pain (Leder, 1990) and disability (Seymour, 1998) are embodied. Contributions from Actor-Network Theory (ANT) are also taken into account as they enable us to think about the body as a heterogeneous compound where technological and human elements are equally important and as an entity that extends further the individual self. As Moser has said, 'the most recent generation of ANT has moved from "outer nature" to "inner nature", to subjectivity and embodiment, and has demonstrated that inner nature is no less inner than outer nature is outer' (Moser, 2006: 376). Thus our aim is to explore from a relational or material semiotic perspective how autonomy is embodied by telecare users.To illustrate our point we use empirical material extracted from our fieldwork in a 12-month ethnographic research study in a Catalan Telecare Service. During the study period w...

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