The Limits of Empowerment: How to Reframe the Role of mHealth Tools in the Healthcare Ecosystem

Abstract

This article highlights the limitations of the tendency to frame health-and wellbeing-related digital tools (mHealth technologies) as empowering devices, especially as they play an increasingly important role in the National Health Service (NHS) in the UK. It argues that mHealth technologies should instead be framed as digital companions. This shift from empowerment to companionship is advocated by showing the conceptual, ethical, and methodological issues challenging the narrative of empowerment, and by arguing that such challenges, as well as the risk of medical paternalism, can be overcome by focusing on the potential for mHealth tools to mediate the relationship between recipients of clinical advice and givers of clinical advice, in ways that allow for contextual flexibility in the balance between patiency and agency. The article concludes by stressing that reframing the narrative cannot be the only means for avoiding harm caused to the NHS as a healthcare system by the introduction of mHealth tools. Future discussion will be needed on the overarching role of responsible design.

Maximising the Opportunities of Artificial Intelligence for People Living With Cancer

“…Also, oncologists need to be wary of the language of 'empowering' patients using such digital tools. There is a risk that rather than allowing patients to take truly autonomous decisions about their health, these tools could 'nudge' patients to behave how healthcare practitioners expect them to, imposing a normative, monolithic framework of behaviour on individuals rather than respecting their unique needs, drives and expectations [38].…”

Hva synes eldre om å bruke videokommunikasjon?

“…Der de ser en utfordring, er de klar for å finne en løsning til det beste for pasienten. Samtidig har helsepersonellet kunnskap om pasientenes behov, og kan vurdere hvorvidt en ny tjeneste eller teknologi kan bidra til bedre helsetjeneste for den enkelte (13). De trenger imidlertid støtte fra flere hold, og dette er et større samfunnsansvar (14).…”

Empowerment or Engagement? Digital Health Technologies for Mental Healthcare

“…However, it is not sufficient to restrict our focus in this paper to the issues of decisional capacity alone-understanding and critically evaluating the concept of empowerment requires a broader focus. A key concern is that so-called 'empowering technologies' focus too narrowly on monitoring and providing information to an individual, on the assumption that a more informed process of deliberation is sufficient for empowerment (Morley & Floridi, 2019). However, there are many problems with this assumption.…”

“…This is primarily because, despite its common use, empowerment is a term that is used both loosely and inconsistently (Roberts, 1999) and is, consequently, embedded in a range of competing discourses that have highly variable aims: from the need to give people choice to the importance of providing people with an opportunity to change their position in society (Starkey, 2003). All these variable conceptualizations are in use in the wider health promotion discourse (Sheehan, 2014) but, as has been highlighted elsewhere (Morley & Floridi, 2019), the narrative that is used in the context of digitising healthcare services (including mental health services) positions empowerment as a self-reflexive and transformative process (Garcia et al, 2014).…”

“…In(Morley & Floridi, 2019), one of the authors defends a view of framing DHTs as 'digital companions', which can have significant (positive and negative) effects on relationships key to maintaining positive mental health, such as those between: (a) clinical advice and behaviour change; (b) perception of self and behaviour change; (c) need for social interaction and desire to socialise.…”