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

Abstract

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.