Rubeis Giovanni
Department General Health Studies, Division Biomedical and Public Health Ethics, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria.
Soc Sci Med. 2023 Apr;322:115810. doi: 10.1016/j.socscimed.2023.115810. Epub 2023 Feb 25.
Digital health technologies transform practices, roles, and relationships in medicine. New possibilities for a ubiquitous and constant data collection and the processing of data in real-time enable more personalized health services. These technologies might also allow users to actively participate in health practices, thus potentially changing the role of patients from passive receivers of healthcare to active agents. The crucial driving force of this transformation is the implementation of data-intensive surveillance and monitoring as well as self-monitoring technologies. Some commentators use terms like revolution, democratization, and empowerment to describe the aforementioned transformation process in medicine. The public debate as well as most of the ethical discourse on digital health tends to focus on the technologies themselves, mostly ignoring the economic framework of their design and implementation. Analyzing the transformation process connected to digital health technologies needs an epistemic lens that also considers said economic framework, which I argue is surveillance capitalism. This paper introduces the concept of liquid health as such an epistemic lens. Liquid health is based on Zygmunt Bauman's framing of modernity as a process of liquefaction that dissolves traditional norms and standards, roles, and relations. By using liquid health as an epistemic lens, I aim to show how digital health technologies reshape concepts of health and illness, change the scope of the medical domain, and liquify roles and relationships that surround health and healthcare. The basic hypothesis is that although digital health technologies can lead to personalization of treatment and empowerment of users, their economic framework of surveillance capitalism may undermine these very goals. Using liquid health as a concept allows us to better understand and describe practices of health and healthcare that are shaped by digital technologies and the specific economic practices they are inseparably attached to.
数字健康技术改变了医学中的实践、角色和关系。无处不在且持续进行数据收集以及实时处理数据的新可能性，使得更个性化的健康服务成为可能。这些技术还可能让用户积极参与健康实践，从而有可能将患者的角色从医疗保健的被动接受者转变为积极参与者。这种转变的关键驱动力是数据密集型监测和自我监测技术的实施。一些评论家使用革命、民主化和赋权等术语来描述医学中的上述转变过程。关于数字健康的公众辩论以及大多数伦理话语往往聚焦于技术本身，大多忽视了其设计和实施的经济框架。分析与数字健康技术相关的转变过程需要一个认知视角，这个视角也要考虑到我所说的作为监控资本主义的经济框架。本文引入流动健康这一概念作为这样一个认知视角。流动健康基于齐格蒙特·鲍曼对现代性的界定，即现代性是一个溶解传统规范和标准、角色及关系的液化过程。通过将流动健康作为认知视角，我的目的是展示数字健康技术如何重塑健康和疾病的概念、改变医学领域的范围，以及使围绕健康和医疗保健的角色及关系变得流动化。基本假设是，尽管数字健康技术可以带来治疗的个性化和用户的赋权，但其监控资本主义的经济框架可能会破坏这些目标。使用流动健康这一概念能让我们更好地理解和描述由数字技术及其不可分割地依附的特定经济实践所塑造的健康和医疗保健实践。
