Cited by 436Ethics and bioethics in healthcareInnovative Human-Technology InteractionMobile Health and mHealth Applications

The DOI matches its Crossref record; 78 of the 90 references it cites were found in a registry or an index; none of the 44 sources its claims cite is checked for support yet.

Self-Tracking for Health and the Quantified Self: Re-Articulating Autonomy, Solidarity, and Authenticity in an Age of Personalized Healthcare

Open access
Sharon, Tamar·2017·Philosophy & Technology

Abstract

Self-tracking devices point to a future in which individuals will be more involved in the management of their health and will generate data that will benefit clinical decision making and research. They have thus attracted enthusiasm from medical and public health professionals as key players in the move toward participatory and personalized healthcare. Critics, however, have begun to articulate a number of broader societal and ethical concerns regarding self-tracking, foregrounding their disciplining, and disempowering effects. This paper has two aims: first, to analyze some of the key promises and concerns that inform this polarized debate. I argue that far from being solely about health outcomes, this debate is very much about fundamental values that are at stake in the move toward personalized healthcare, namely, the values of autonomy, solidarity, and authenticity. The second aim is to provide a framework within which an alternative approach to self-tracking for health can be developed. I suggest that a practice-based approach, which studies how values are enacted in specific practices, can open the way for a new set of theoretical questions. In the last part of the paper, I sketch out how this can work by describing various enactments of autonomy, solidarity, and authenticity among self-trackers in the Quantified Self community. These examples show that shifting attention to practices can render visible alternative and sometimes unexpected enactments of values. Insofar as these may challenge both the promises and concerns in the debate on self-tracking for health, they can lay the groundwork for new conceptual interventions in future research.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

The paper analyzes the polarized debate over self-tracking for health and personalized healthcare, arguing that it is fundamentally about the values of autonomy, solidarity, and authenticity. It proposes a practice-based approach and uses examples from the Quantified Self community to show alternative, sometimes unexpected, enactments of those values.

Key findings

  • The debate is structured by three polarizations: empowerment vs. surveillance and discipline; improved overall health vs. the disintegration of state and collective responsibility for health; and greater self-knowledge vs. reductionism and the non-impartiality of numbers.
  • Both advocates and critics appeal to the same values—autonomy, solidarity, and authenticity—so reframing the debate around values clarifies the stakes and ties it to broader socio-political transformations.
  • A practice-based approach shows Quantified Self self-trackers enact autonomy through n = 1 self-experiments, custom categories, and resistance to being tracked by others; solidarity through sharing data, communal/confessional meetings, and group studies or public data contributions; and authenticity through data as a supplement to storytelling and a “qualified self,” rather than pure data fetishism.
  • The paper reports contextual numbers: a 2013 Pew study found 1 in 5 Americans use technology to track their health; almost 2 billion people worldwide were estimated to use digital devices to track health by 2017; some 97,000 mobile health apps existed; 485 million wearable devices were expected to be released annually by 2018; and the Quantified Self community had over 60,000 members in over 200 groups with two international conferences a year.

Methods

  • Design: conceptual and philosophical analysis of the promises and concerns surrounding self-tracking for health and personalized healthcare, followed by a proposed practice-based framework.
  • Data or sample: observations and interviews carried out within the Quantified Self community at various meetings and international conferences between 2013 and 2015, including QSEU14 and QSEU15.
  • Main analysis: identifies three key polarizations, reframes them in terms of autonomy, solidarity, and authenticity, and uses ethnographic examples to describe how those values are enacted in specific self-tracking practices.

Limitations

  • The paper states that the debate remains highly speculative, tends to configure users unrealistically—either as rational consumers making autonomous health choices or as victims oblivious to insidious forces—and is detached from the everyday experiences of people actually using self-tracking devices.
  • The paper states that its examples are drawn from the Quantified Self, a very specific group of “early adopters,” which limits broader conclusions; it calls for other empirical sites such as chronic patients, people who stop using self-tracking devices, non-users, and older people.
  • Evident from the text: the empirical basis is illustrative rather than systematically described; no sample size, recruitment strategy, or coding/analysis procedure for the observations and interviews is reported, and the paper does not resolve which enactments of values should be normatively preferred, leaving that to future research.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s13347-016-0215-5

Cites

78 of 78 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

58 Own interpretation · 36 No basis given · 29 Not checked yet · 3 Own method · 3 Own result

Verify all 44 references — free account

Show all 46 claims

  • Probably not a substantial claim. 71
  • It may state two separate claims as one. 22
83 of 83
  • The paper relies on this without support.

    Public healthcare systems in the industrialized West are in crisis due to spiraling costs, an ageing population, and the rise of chronic diseases.

    “In recent decades, spiraling costs, an ageing population, and the rise of chronic diseases have propelled public healthcare systems in the industrialized West into crisis.”
  • The paper relies on this without support.

    The Quantified Self community and its meetings, presentations, and members' self-reports provide a valid and sufficiently representative basis for drawing conclusions about self-tracking for health practices in the move toward personalized healthcare.

    “based on observations and interviews carried out within the Quantified Self community of self-trackers at various meetings and international conferences between 2013 and 2015, where members demonstrate, describe, and discuss their self-tracking practices.”
    “Yet, for members of QS, and arguably for many selftrackers beyond QS, a crucial aspect of self-tracking is the opportunity to share their data with others and to participate in self-tracking communities of various sorts.”
2 of 2

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Citations

Cites

Show all 90 references

Research works printed but not linked: 6

  1. ABI research (2013) Wearable computing devices, like Apple’s iWatch, will exceed 485 million annual shipments by 2018. Retrieved from https://www.abiresearch.com/press/wearable-computing-devices-like-apples-iwatch-will . Accessed 25.2.2015.
  2. Foreman, A., et al. (2011). Just text me: using SMS technology for collaborative patient mood charting. Journal of Participatory Medicine, 3, e45.
  3. Fox, S., & Duggan, M. (2013). Tracking for health. Washington, DC: Pew Research Center.
  4. Kelly, K. (2012) The quantified century. Retrieved from http://quantifiedself.com/conference/Palo-Alto-2012 .
  5. Nicolini, D. (2012). Practice theory, work, and organization. Oxford: Oxford University Press.
  6. Swierstra, T. (2013). Nanotechnology and techno-moral change. Ethics & Politics, 15(1), 200–219.

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Metadata

Authors
Sharon, T.
Affiliations
Maastricht University (NL)
Corresponding author
Sharon, Tamar
Venue
Philosophy & Technology
Published
2016-04-18
Volume
30
Issue
1
Pages
93-121
ISSN
  • 2210-5433 (ISSN-L)
  • 2210-5441
OpenAlex
W2336246624
Cited by
428
References
90
Citations by year
2026: 30 · 2025: 37 · 2024: 48 · 2023: 66 · 2022: 60 · 2021: 57 · 2020: 50 · 2019: 36 · 2018: 27 · 2017: 17
FWCI
26.44
Type
journal article
Language
en
Open access
Locations
  • Philosophy & Technology (publishedVersion, cc-by)
  • Research Publications (Maastricht University) (publishedVersion, cc-by)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
Nederlandse Organisatie voor Wetenschappelijk Onderzoek (275-20-050)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
  • Physical Sciences › Computer Science › Human-Computer Interaction › Innovative Human-Technology Interaction
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
self-tracking, quantified self, personalized healthcare, autonomy, solidarity, authenticity, practice-oriented approach, clinical decision-making

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