SELF-TRACKING AS A SKETCH OF DIGITAL MEDICINE AND AN OBJECT OF EPISTEMIC ANALYSIS
DOI: 10.23951/2312-7899-2021-3-55-82
Self-tracking is a phenomenon of digital medicine that allows highlighting trends in the development of medicine as a science and a health care sector. Self-tracking as a sketch is an opportunity to see the features of a future picture already in a gesture drawing. Self-tracking is considered as a social practice of using digital technologies to collect, monitor and evaluate significant medical quantitative parameters of the bodily state and mental status. At the same time, self-tracking is one of the manifestations of the modern phenomenon of corporeality quantification. Against the background of the growing importance of self-control in medicine of the 21st century, digitalization is changing the practice of monitoring bodily states from the perspective of managing them. However, the key subjects of medicine are not uniformly related to self-tracking. Special devices and applications for self-tracking purposes have a wide range of applications, and the practice of using them for self-monitoring generates many contradictions and becomes the subject of analysis in various subject areas, from medicine to philosophy. An epistemic analysis of self-tracking is associated with the consideration of the status of knowledge that arises within the framework of digital self-monitoring and self-control. The result of self-tracking is a data pool characterized by such features as: connection with the individual body and the world of a specific person acting as a producer of knowledge; practical focus on self-management of the subject’s daily behavior; objectivity ascribed by the subject, which becomes the basis for legitimizing changes in behavior. Consideration of self-tracking in the context of civic science allows us to record the formation of new options for conceptualizing the relationship between science and society. Self-tracking has the features of a personal science and requires clarification of real and practical forms of interaction between civil and institutionalized science, as well as an assessment of the prospects for dialogue between them. The conditions for the existence of knowledge that arise as a result of self-tracking are associated with several basic positions. First, it is an analysis of the personal epistemic goals of the self-tracking subject, which vary widely from pragmatic medical indications to self-knowledge: a complex interweaving of goal-setting. With the self-identification of a person using digital technologies of self-examination and self-control, the basis of self-determination is replaced: from self-awareness to a quantitative determination that depends on the social, axiological context of measurement modes. The predominance of visuality with “quantified self” nevertheless leaves room for a departure from reductionism and a high level of understanding of the integrity of the subject in a wide cultural and social context. This actualizes the task of an adequate methodology and conceptual apparatus for combining quantitative and qualitative parameters. The knowledge that has become the result of self-tracking for the subject can be a factor and manifestation of a change in the model of communication between a doctor and a patient in the direction of antipaternalism when approving the interpretation of health as a management project. In the context of “opportunities-limitations”, self-tracking makes it possible to clearly record the request for conceptualizing the relationship between individual responsibility and the role of the state and society in matters of protecting individual and public health. Social practices of self-tracking are associated with an increased participation of subjects in obtaining meaningful medical information, which, on the one hand, opens up opportunities for self-control and management of their own health, and, on the other hand, leads to the emergence of additional channels for managing human behavior with an emphasis on social normativity. Gamification, visualization, involvement in target social groups increase the attractiveness of self-tracking practices, which in turn blurs the line between the private and the public. The inclusion of medical self-monitoring in the economic sphere leads to the emergence of the “digital labor” phenomenon. At the moment, arguments in favor of the development of digital medicine technologies, as well as concerns and fears, lie in the plane of potential benefits and potential risks; there is no sufficient empirical basis for generalizations; the positions of various stakeholders of the process are not explicitly indicated. A critical attitude to the development of self-control technologies is based on arguments about the impossibility of achieving the stated goals through self-tracking, about the availability of alternatives to digital self-control, about the threat to those fundamental values that underlie the bioethical regulation of biomedicine in the late 20th – early 21st centuries. The social practice of self-tracking is ahead of its epistemic analysis, which should include not only the analysis of the status of knowledge in the light of the declared and achieved goals, the means used for this and the real spheres of application of the results of self-description and self-control. Conceptualization should also be aimed at identifying the conditions for the possibility of obtaining and applying knowledge in a wide social context that arises during the medicalization of all spheres of society.
Keywords: philosophy of medicine, digital medicine, digital healthcare, digital health, self-tracking, mobile healthcare
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Issue: 3, 2021
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