Mediating Loving Care and Vital Signs: the Sociality of Care Technologies

1. Mediating Loving Care and Vital Signs: the Sociality of Care Technologies Utrecht September20-21 2007 Jeannette Pols* & Ingunn Moser** *Academic Medical Centre, Amsterdam **Centre for Technology, Innovation and Culture, Oslo

2. Structure of talk • Aim: contribute to understanding of the social relations of care technologies • Examples of new care technologies • Some tools to think with • Two examples of explicit social and affective design • Concluding argument: technologies don’t work unless they are entangled in relations that are necessarily both material, social and emotional

3. Homely technology: the example of the HealthBuddy

4. The HealthBuddy – in theory • Typical telecare system: medical approach, monitoring and education • Aim and intention: to monitor health indicators of people with chronic conditions, and to educate and train them to monitor and manage their own health • Improve selfmanagement of patient • Prevent exacerbations • Prevent hospital admissions (costs, QoL). • Original timeplan: 3 months

5. The HealthBuddy – in practice • Patients valued the HealthBuddy: it links them to health care apparatus, expertise, nurses • Patients became attached to/dependent upon the HealthBuddy because it makes them feel safe and looked after. They want to keep it! • Success in some terms, but not the predefined intentions and criteria

6. So how to think about these findings? How to explain the success? • HB as rational medical technology vs social and affective relations • Intention: limit social and affective relations: more independent, self-managed patients (more care work and responsibility) • New norm for what it takes/means to be a good elderly person and or patient • HB still allowed for and created new attachments -even while the intention was the opposite (to limit relations)

7. Tools to think with : technologies in relation and technologies with scripts • technologies don’t work by themselves but only in relations – material, social, cultural, affective, aesthetic… • Technologies come with a social programme or ’script’ that outline and define needs, norms, relations and potential users • What social/ emotional relations technologies offer? What scripts do they come with and should come with? • Question: to what extent do these ’built in’ users fit with real users? How do real users find ways of creatively negotiating the script to meet their wishes?

8. Designing for and building in relations and emotions: the example of Aibo the robodog • Aibo.com

9. Designing for and building in relations and emotions: the example of I-cat • Philips.com

10. To start: stroke the cat

11. What does I-cat enable, what is its script and how does it configure its users? • I-cat is designed as an assistant-servant: (cat-human) butler • restricted relation with its user, who is configured as a mixture of master and dependent care-receiver • allows for the enactment of tasks or services for the user /patient • Limited interactions, relations, attachments and affections with the cat • Tries to add emotionality on to functionality • User identity: dependence and patienthood

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13. What does Aibo enable – what is it’s script and how does it configure e-care? • Aibo is designed to generate new relations, attachments, and also affection • Affords or invites a wide variety of relations: interaction, communication, affection, compassion, humour, play, liveliness, care… • Configures its users as companions and carers • Opens positions /identities other than patient/ dependent • Dog allows and facilitates attention and communication.

14. Cats and dogs: differences • In order to be used, technology should bring something of Value to the user • Dog: dog-friendship, fun, play, talk, resistance, mind of his own, interaction, affection. • I-cat: enacts tasks - value is: comfort, maybe ’health’. • Health buddy: independence – or safety?

15. Differences; individuality • Robotdog is ‘individual’ (programmed to learn and adapt to user), is unpredictable and shows a variety of emotions. Sometimes refuses to do something (has a mind of his own). • I-cat is basically polite and neutral, and emotions serve to underline this politeness and neutrality.

16. Differences; structure of interaction • Aibo: structures, but not too much. It does not talk. It allows for dog-like interactions. No failures. People use A. as dog and machine. • Cat: particular and functional/ rational interactions. Limited use. No cat-like interactions. Cognitive charachteristics, communication breakdowns. • Cat remains machine: no function apart from the ones programmed. • HealthBuddy: structures, but allowed for alternative norm/ideal and negotiation

17. Care • User has to care for Aibo: help yourself by helping ‘others’ • I-cat cares for user: reinforcement of patient position. • HealthBuddy cares for user on a distance and helps user care for her- or himself

18. Critical and ethical questions • What needs and desires are taken into account? • How is agency, work and responsibility shifted and distributed? • What positions, identities and relations are afforded? • What attachments and detachments does the technology open up for? • What norms for being human, elderly, patient, care receiver and carer does the technology enact?

19. Conclusions • Take technologies’ social relations, emotional bonds, scripts and configuring of users into account • Take technologies prescriptions /norms for what it takes to be human, patient, elderly, care receiver and carer into account • Take the multifaceted needs and desires of potential users into account • Technology brings values and allows for stronger or weaker social and emotional connections