Digital iatrogenesis and workplace marginalization: some ethical issues involving self-tracking medical technologies

ABSTRACT

This paper addresses the ethical dimensions of the complex and evolving relationships between individuals and health-related self-tracking devices in the context of workplace systems. Many self-tracking initiatives can indeed have useful medical applications, aiding individuals and healthcare professionals in diagnosis and treatment. However, in some contexts the systems can also perpetuate economic discrimination and workplace marginalization as well as influence negatively the wellbeing and privacy of participants. The paper explores the concepts behind ‘pushed’ medical self-tracking devices and examines how the notion of the protection of ‘mental and physical integrity’ can be applied in analyses of organizational activities using such devices. Individuals’ capacities to make valid medical decisions concerning use of the devices can be diminished by the addictive and gamified aspects of the systems or through rhetorical promotion of specific philanthropic objectives, engendering a ‘data farming’ approach; the anxieties and addictions often involved may compound forms of workplace marginalization and be used in conjunction with other surveillance efforts. The paper also examines the roles of various medical and managerial authorities in perpetuating the conditions that can lead to marginalization. Self-tracking devices’ reflection capabilities can foster an apparent voluntariness and high level of user control that can make them seem less threatening in terms of employee wellbeing, even when sensitive and potentially stigmatizing areas such as weight and menstrual cycles are being tracked and externally surveilled. The paper explores how device manufacturers and system developers along with data brokers often benefit from the coupling of devices with organizational initiatives.

KEYWORDS:

• Healthcare technology
• privacy
• autonomy
• organizational ethics
• data analysis
• information economics

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Jo Ann Oravec is a full professor in the College of Business and Economics at the University of Wisconsin at Whitewater in the Department of Information Technology and Supply Chain Management; she is also affiliated with the Robert F. and Jean E. Holtz Center for Science, Technology, & Society Studies, University of Wisconsin at Madison. She received her MBA, MS, MA, and PhD degrees at the University of Wisconsin at Madison. She taught computer information systems and public policy at Baruch College of the City University of New York; she also taught in the School of Business and the Computer Sciences Department at UW-Madison as well as at Ball State University. She chaired the Privacy Council of the State of Wisconsin, the nation's first state-level council dealing with information technology and privacy issues. She has written books (including Virtual Individuals, Virtual Groups: Human Dimensions of Groupware and Computer Networking, Cambridge University Press) and dozens of articles on futurism, film, artificial intelligence, disability, mental health, technological design, privacy, computing technology, management, and public policy issues. She has worked for public television and developed software along with her academic ventures. She has held visiting fellow positions at both Cambridge and Oxford, was interviewed in BBC News, and was recently a featured speaker at conferences in Japan and Australia.