Keyword: autonomy

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

Sax, M.
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}, }

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

Sax, M.
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}, }

Health as a Means Towards Profitable Ends: mHealth Apps, User Autonomy, and Unfair Commercial Practices external link

Sax, M., Helberger, N. & Bol, N.
Journal of Consumer Policy, vol. 41, num: 2, pp: 103-134, 2018

Abstract

In this article, we discuss mHealth apps and their potential to influence the user’s behaviour in increasingly persuasive ways. More specifically, we call attention to the fact that mHealth apps often seek to not only influence the health behaviour of users but also their economic behaviour by merging health and commercial content in ways that are hard to detect. We argue that (1) such merging of health and commercial content raises specific questions concerning the autonomy of mHealth app users, and (2) consumer law offers a promising legal lens to address questions concerning user protection in this context. Based on an empirically informed ethical analysis of autonomy, we develop a fine-grained framework that incorporates three different requirements for autonomy that we call “independence,” “authenticity,” and “options.” This framework also differentiates between three different stages of mHealth app use, namely installing, starting to use, and continuing to use an app. As a result, user autonomy can be analysed in a nuanced and precise manner. Since the concept of autonomy plays a prominent, yet poorly understood role in unfair commercial practice law, we utilize the ethical analysis of autonomy to guide our legal analysis of the proper application of unfair commercial practice law in the mHealth app domain.

autonomy, frontpage, manipulation, mHealth apps, Oneerlijke mededinging, representative survey data, unfair commercial practices

Bibtex

Article{Sax2018, title = {Health as a Means Towards Profitable Ends: mHealth Apps, User Autonomy, and Unfair Commercial Practices}, author = {Sax, M. and Helberger, N. and Bol, N.}, url = {https://link.springer.com/article/10.1007/s10603-018-9374-3}, doi = {https://doi.org/10.1007/s10603-018-9374-3}, year = {0522}, date = {2018-05-22}, journal = {Journal of Consumer Policy}, volume = {41}, number = {2}, pages = {103-134}, abstract = {In this article, we discuss mHealth apps and their potential to influence the user’s behaviour in increasingly persuasive ways. More specifically, we call attention to the fact that mHealth apps often seek to not only influence the health behaviour of users but also their economic behaviour by merging health and commercial content in ways that are hard to detect. We argue that (1) such merging of health and commercial content raises specific questions concerning the autonomy of mHealth app users, and (2) consumer law offers a promising legal lens to address questions concerning user protection in this context. Based on an empirically informed ethical analysis of autonomy, we develop a fine-grained framework that incorporates three different requirements for autonomy that we call “independence,” “authenticity,” and “options.” This framework also differentiates between three different stages of mHealth app use, namely installing, starting to use, and continuing to use an app. As a result, user autonomy can be analysed in a nuanced and precise manner. Since the concept of autonomy plays a prominent, yet poorly understood role in unfair commercial practice law, we utilize the ethical analysis of autonomy to guide our legal analysis of the proper application of unfair commercial practice law in the mHealth app domain.}, keywords = {autonomy, frontpage, manipulation, mHealth apps, Oneerlijke mededinging, representative survey data, unfair commercial practices}, }

Exposure diversity as a design principle for recommender systems external link

Helberger, N., Karppinen, K. & D'Acunto, L.
Information, Communication and Society, vol. 2018, num: 2, 2017

Abstract

Personalized recommendations in search engines, social media and also in more traditional media increasingly raise concerns over potentially negative consequences for diversity and the quality of public discourse. The algorithmic filtering and adaption of online content to personal preferences and interests is often associated with a decrease in the diversity of information to which users are exposed. Notwithstanding the question of whether these claims are correct or not, this article discusses whether and how recommendations can also be designed to stimulate more diverse exposure to information and to break potential ‘filter bubbles’ rather than create them. Combining insights from democratic theory, computer science and law, the article makes suggestions for design principles and explores the potential and possible limits of ‘diversity sensitive design’.

autonomy, exposure diversity, filter bubbles, filtering, frontpage, information diversity, medial law, nudging, recommender systems, search enginges, Social media

Bibtex

Article{Helberger2017, title = {Exposure diversity as a design principle for recommender systems}, author = {Helberger, N. and Karppinen, K. and D\'Acunto, L.}, url = {https://www.ivir.nl/publicaties/download/ICS_2016.pdf}, doi = {https://doi.org/10.1080/1369118X.2016.1271900}, year = {0119}, date = {2017-01-19}, journal = {Information, Communication and Society}, volume = {2018}, number = {2}, pages = {}, abstract = {Personalized recommendations in search engines, social media and also in more traditional media increasingly raise concerns over potentially negative consequences for diversity and the quality of public discourse. The algorithmic filtering and adaption of online content to personal preferences and interests is often associated with a decrease in the diversity of information to which users are exposed. Notwithstanding the question of whether these claims are correct or not, this article discusses whether and how recommendations can also be designed to stimulate more diverse exposure to information and to break potential ‘filter bubbles’ rather than create them. Combining insights from democratic theory, computer science and law, the article makes suggestions for design principles and explores the potential and possible limits of ‘diversity sensitive design’.}, keywords = {autonomy, exposure diversity, filter bubbles, filtering, frontpage, information diversity, medial law, nudging, recommender systems, search enginges, Social media}, }