The Quantified Self and the Evolution of Neoliberal Self-Government: An Exploratory Qualitative Study

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

“…This paradigm shift coincided with the Internet becoming commercially available, leading to 'info-liberal' arguments (Catlaw and Sandberg 2018) that the amount of health information available on the Internet would lead to the emergence of a new generation of 'expert patients' (Henwood et al 2003). The information would increase the self-esteem of these experts, empowering them to become active participants in their own healthcare (Wilson 2001), and resulting in them having a better quality of life (Fox et al 2005).…”

“…The individual uses this process of reflection to determine whether their digital self would be perceived by a medic as healthy or unhealthy. Second, this close interrogation (Catlaw and Sandberg 2018) acts as a trigger for intervention (Ruckenstein 2014) by the individual on her or his self to shift the self in the desired 'healthy' direction.…”

“…From this perspective, allegedly empowering mHealth tools can be seen as technologies of the self (Floridi 2014). Subsequently, the act of reflecting on one's self through the digital medical gaze can be seen as a Foucauldian practice of care of self, where one's faults and limitations are observed, and attempts are made to transcend them (Catlaw and Sandberg 2018). Michel Foucault notes that this process of surveying faults is one that is inherently linked to power.…”

“…In order to highlight to the individual what their faults and limitations are, with the intention of encouraging attempts to transcend them (Catlaw and Sandberg 2018) most mHealth tools, leveraged in the 'Empower the Person' narrative, work by establishing a baseline for 'health' in one domain (e.g. number of calories to be consumed in a day, or number of steps to be made) and highlighting to the individual how far their self is away from that baseline, through the digital medical gaze.…”

“…This is based on a rather narrow definition of autonomy, known as procedural autonomy, and it puts all the attention on the decision rather than the action that follows the decision (Owens and Cribb 2017). In reality, for mHealth tools to be 'empowering' they have to result in some form of behaviour modification intended to improve the self (Catlaw and Sandberg 2018). This puts the emphasis on the broader relational autonomy, which centres on action rather than decision 13 (Owens and Cribb 2017).…”