Mobile health (mHealth) technologies for self-monitoring health-relevant parameters such as heart frequency, sleeping patterns or exercise regimes aim at fostering healthy behavior change and increasing the individual users to promote and maintain their health. We argue that this aspect of mHealth supports healthism, the increasing shift from institutional responsibility for public health toward individual engagement in maintaining health as well as mitigating health risks. Moreover, this healthist paradigm leads to a shift from understanding health as the absence of illness to (...) regarding health as the performance of certain rituals in order to project healthiness. By drawing from the analogy between healthiness and traditional virtues, we evaluate the promises made by proponents of mHealth technologies for self-monitoring. We argue that the implementation and use of mHealth risk entrenching existing inequalities and, more particularly, tend to exclude populations situated at the losing end of those inequalities from participating in the quasi-virtue of healthiness. Consequently, the implementation and use of mHealth technologies not only present challenges for social justice but also undermine their primary societal goal—to promote public health. Finally, we offer several suggestions on how to realize the potential benefit of mHealth. (shrink)

Dark patterns have received significant attention in literature as interface design practices which undermine users’ autonomy by coercing, misleading or manipulating their decision making and behavior. Individual autonomy has been argued to be one of the normative lenses for the evaluation of dark patterns. However, theoretical perspectives on autonomy have not been sufficiently adapted in literature to identify the ethical concerns raised by dark patterns. The aim of this paper is to conceptualize user autonomy within the context of dark patterns. (...) In this paper, we systematically review 151 dark patterns from 16 taxonomies to understand how dark patterns threaten users’ autonomy. We demonstrate through this analysis that implications for autonomy arise along four dimensions, because autonomy itself can be understood as subsuming several distinguishable concepts. These are agency, freedom of choice, control and independence. We argue that an assessment of whether a design pattern qualifies as ‘dark’ should account for the sense in which autonomy is threatened, as individuals’ rights and expectations of autonomy vary in various contexts and depend upon the interpretation of autonomy. This paper aims to contribute to the development of the normative lens of individual autonomy for the evaluation of dark patterns, as well as for persuasive design more broadly. (shrink)