Between Empowerment and Manipulation: The Ethics and Regulation of For-Profit Health Apps external link

Wolters Kluwer, 2021, Series: Information Law Series, ISBN: 9789403537917

Abstract

Between Empowerment and Manipulation is an extensive ethical analysis with novel interpretations of European unfair commercial practices law on health apps and commercial digital choice environment. Health apps are incredibly compelling in their own right. Despite the promise of empowerment they offer, the tensions introduced by their data-driven, dynamically adjustable digital environments engender a potential for manipulation to which their designers and operators can easily succumb. In this important book, the author develops an ethical framework on how apps use their complete power over the design and operation of the digital environments to shape user-app relationships.

Consumer law, health apps, Kluwer Information Law Series, manipulation, unfair commercial practices

Bibtex

Book{Sax2021f, title = {Between Empowerment and Manipulation: The Ethics and Regulation of For-Profit Health Apps}, author = {Sax, M.}, url = {https://www.ivir.nl/sax_info_47-2/}, year = {2021}, date = {2021-09-30}, abstract = {Between Empowerment and Manipulation is an extensive ethical analysis with novel interpretations of European unfair commercial practices law on health apps and commercial digital choice environment. Health apps are incredibly compelling in their own right. Despite the promise of empowerment they offer, the tensions introduced by their data-driven, dynamically adjustable digital environments engender a potential for manipulation to which their designers and operators can easily succumb. In this important book, the author develops an ethical framework on how apps use their complete power over the design and operation of the digital environments to shape user-app relationships.}, keywords = {Consumer law, health apps, Kluwer Information Law Series, manipulation, unfair commercial practices}, }

Between Empowerment and Manipulation: The Ethics and Regulation of For-Profit Health Apps external link

2021

Abstract

In the digital society, many of our everyday activities take place within digital choice architectures that become increasingly good at understanding and shaping our behavior. Health apps are a perfect example of this trend: they are easy to download and use and promise user empowerment. By collecting and analyzing user data, health apps promise to be able to ‘get to know’ their users and deliver personalized feedback and suggestions for better health outcomes. But this promise of user empowerment also comes with a risk of user manipulation. Most of the popular health apps are for-profit services. To monetize their userbase, they can rely on the very same user data collection, data analysis, and targeting techniques to shape the behavior of health app users in ways that benefit the health app provider, rather than the users themselves. As it turns out, the very conditions for empowerment largely overlap with the conditions for manipulation. This dissertation offers an ethical and legal analysis of the tension between empowerment and manipulation in for-profit health apps, and digital choice architectures more generally. Building on ethical theories of personal autonomy and manipulation, the dissertation develops an ethical framework to evaluate the design and commercial practices of health apps. This ethical framework is then used to develop novel interpretations of key concepts in the Unfair Commercial Practices Directive (UCPD). Based on these novel interpretations of key concepts, it is argued that the UCPD has an important role to play in addressing consumer manipulation.

autonomy, Consumer law, health apps, manipulation, nudging

Bibtex

PhD Thesis{Sax2021bb, title = {Between Empowerment and Manipulation: The Ethics and Regulation of For-Profit Health Apps}, author = {Sax, M.}, url = {https://dare.uva.nl/search?identifier=52225d37-e7e1-4883-9dab-a3f5d3a063d8}, year = {0326}, date = {2021-03-26}, abstract = {In the digital society, many of our everyday activities take place within digital choice architectures that become increasingly good at understanding and shaping our behavior. Health apps are a perfect example of this trend: they are easy to download and use and promise user empowerment. By collecting and analyzing user data, health apps promise to be able to ‘get to know’ their users and deliver personalized feedback and suggestions for better health outcomes. But this promise of user empowerment also comes with a risk of user manipulation. Most of the popular health apps are for-profit services. To monetize their userbase, they can rely on the very same user data collection, data analysis, and targeting techniques to shape the behavior of health app users in ways that benefit the health app provider, rather than the users themselves. As it turns out, the very conditions for empowerment largely overlap with the conditions for manipulation. This dissertation offers an ethical and legal analysis of the tension between empowerment and manipulation in for-profit health apps, and digital choice architectures more generally. Building on ethical theories of personal autonomy and manipulation, the dissertation develops an ethical framework to evaluate the design and commercial practices of health apps. This ethical framework is then used to develop novel interpretations of key concepts in the Unfair Commercial Practices Directive (UCPD). Based on these novel interpretations of key concepts, it is argued that the UCPD has an important role to play in addressing consumer manipulation.}, keywords = {autonomy, Consumer law, health apps, manipulation, nudging}, }

Opinie: ‘Let op de subtiele vermenging van commercie en adviezen in gezondheidsapps’ external link

2017

gezondheidsapps, health apps

Bibtex

Newspaper article{Sax2017b, title = {Opinie: ‘Let op de subtiele vermenging van commercie en adviezen in gezondheidsapps’}, author = {Sax, M.}, url = {https://www.volkskrant.nl/columns-opinie/let-op-de-subtiele-vermenging-van-commercie-en-adviezen-in-gezondheidsapps~b2fe4387/}, year = {0325}, date = {2017-03-25}, keywords = {gezondheidsapps, health apps}, }

Optimization of what? For-profit health apps as manipulative digital environments external link

Ethics and Information Technology, vol. 23, num: 3, pp: 345-361, 2021

Abstract

Mobile health applications (‘health apps’) that promise the user to help her with some aspect of her health are very popular: for-profit apps such as MyFitnessPal, Fitbit, or Headspace have tens of millions of users each. For-profit health apps are designed and run as optimization systems. One would expect that these health apps aim to optimize the health of the user, but in reality they aim to optimize user engagement and, in effect, conversion. This is problematic, I argue, because digital health environments that aim to optimize user engagement risk being manipulative. To develop this argument, I first provide a brief analysis of the underlying business models and the resulting designs of the digital environments provided by popular for-profit health apps. In a second step, I present a concept of manipulation that can help analyze digital environments such as health apps. In the last part of the article, I use my concept of manipulation to analyze the manipulative potential of for-profit health apps. Although for-profit health can certainly empower their users, the conditions for empowerment also largely overlap with the conditions for manipulation. As a result, we should be cautious when embracing the empowerment discourse surrounding health apps. An additional aim of this article is to contribute to the rapidly growing literature on digital choice architectures and the ethics of influencing behavior through such choice architectures. I take health apps to be a paradigmatic example of digital choice architectures that give rise to ethical questions, so my analysis of the manipulative potential of health apps can also inform the larger literature on digital choice architectures.

autonomy, choice architectures, health apps, manipulation, mhealh

Bibtex

Article{Sax2021, title = {Optimization of what? For-profit health apps as manipulative digital environments}, author = {Sax, M.}, url = {https://link.springer.com/article/10.1007/s10676-020-09576-6}, doi = {https://doi.org/10.1007/s10676-020-09576-6}, year = {0103}, date = {2021-01-03}, journal = {Ethics and Information Technology}, volume = {23}, number = {3}, pages = {345-361}, abstract = {Mobile health applications (‘health apps’) that promise the user to help her with some aspect of her health are very popular: for-profit apps such as MyFitnessPal, Fitbit, or Headspace have tens of millions of users each. For-profit health apps are designed and run as optimization systems. One would expect that these health apps aim to optimize the health of the user, but in reality they aim to optimize user engagement and, in effect, conversion. This is problematic, I argue, because digital health environments that aim to optimize user engagement risk being manipulative. To develop this argument, I first provide a brief analysis of the underlying business models and the resulting designs of the digital environments provided by popular for-profit health apps. In a second step, I present a concept of manipulation that can help analyze digital environments such as health apps. In the last part of the article, I use my concept of manipulation to analyze the manipulative potential of for-profit health apps. Although for-profit health can certainly empower their users, the conditions for empowerment also largely overlap with the conditions for manipulation. As a result, we should be cautious when embracing the empowerment discourse surrounding health apps. An additional aim of this article is to contribute to the rapidly growing literature on digital choice architectures and the ethics of influencing behavior through such choice architectures. I take health apps to be a paradigmatic example of digital choice architectures that give rise to ethical questions, so my analysis of the manipulative potential of health apps can also inform the larger literature on digital choice architectures.}, keywords = {autonomy, choice architectures, health apps, manipulation, mhealh}, }