Ethical and cultural aspects of digital health and self-tracking in Turkey

The Orient-Institut Istanbul (in particular the research field “Human, Medicine and Society” led by Dr. Melike Şahinol) is collaborating as research partner on the research project “Digital Health Data between Empowerment and New Barriers” (original title: “Digitale Vulnerabilität zwischen Inklusion und sozialer Robustheit. Diversitätssensitive und risikoethische Abschätzung digitaler Selbstvermessung”) submitted by Prof. Dr. Stefan Selke at the University of Applied Sciences Furtwangen and approved at the end of 2017 by the Federal Ministry of Health.

About the project
The project investigates practices and technologies of digital self-tracking (i.e. health devices and apps, e.g. health tracking apps, robotic walking aids, wearables) and how these are embedded in social processes. The focus is on the social, ethical, and cultural dimensions of those health devices. The current trend is characterized by the fact that these applications should motivate users to work independently, preventively, and actively on the positive development of their own health and lifestyle via practices of self-quantification. However, such forms of health self-management and monitoring may entail new forms of discrimination against vulnerable groups, for example people with chronic diseases or children.

Based on it’s expertise in Turkey, the Orient-Institut Istanbul focuses in particular on  the different normative frameworks of digital self-tracking in Turkey and the ethical criteria derived from an intercultural perspective. The question of under which circumstances self and voluntarily collected digital data become a social stratifying good and which individual and societal effects are associated with it, is particularly relevant.

Main findings

Based on a document analysis on health care reform in Turkey made in 2019 and interviews with 35 participants that we conducted in 2019 and 2020 (follow-up study), detailed results of the study were documented in a report of 120 pages. The process of healthcare reform in Turkey and the accompanying increased use of digital self-tracking devices, equally increases the demand for digital health. Based on the statements of all of the interview partners, it becomes clear that Turkish citizens are very open-minded and technology-friendly towards the use of new digital devices for self-tracking. The use of self-tracking devices for both both chronic diseases and prevention is an important source of empowerment for them. They view this user experience as a quality of life, healthier living, and an important empowerment process to raise awareness of their health issues. Meanwhile, they tend to ignore digital data security and privacy issues. Almost all respondents indicate they have no problems with health data sharing. Respondents believe that self-monitoring devices enable them to be self-disciplined and self-controlled about their health.

Related publications

Şahinol, M., Başkavak, G. Contested Daily Routines, Contested Care. Children with Type 1 Diabetes in Covid-19 Times. Childhood Vulnerability (2021). https://doi.org/10.1007/s41255-021-00017-0

Şahinol, M., & Başkavak, G. (2021). Sosyo-Biyo-Teknik Bakım Kompleksi: Tip 1 Diyabette Dijital Sağlık Takibi [Socio-Bio-Technical Care Complex: Digital Health Tracking In Type 1 Diabetes]. Sosyoloji Araştırmaları Dergisi [Journal of Sociological Research] 24(1), 110-145 (open access).

Şahinol, M., & Achatz, J. (2021). Digitale Selbstvermessung im türkischen Gesundheitssystem. Zugluft. Öffentliche Wissenschaft in Forschung, Lehre und Gesellschaft(1), 96-101.

Şahinol, M., Başkavak, G. (2020). Türkiye’de Biyomedikalizasyon: Sağlığın Dijitalleşmesi ve Öz-Takip Pratikleri. In A. Turanlı, A. U. Aydınoğlu & M. Şahinol  (Eds.), Türkiye’de STS: Bilim ve Teknoloji Çalışmalarına Giriş (pp. 103-117). Istanbul: İTÜ (open access: https://polen.itu.edu.tr/handle/11527/18483).

Related presentations

September 11, 2019: Türkiye’de E-Sağlık ve Öz-Takip Teknolojileri with Gülşah Başkavak (Orient-Institut İstanbul), STS TURKEY 2019 conference 10-12 September 2019, Istanbul Technical University

April 18, 2018: Enhancement und Vulnerabilität. Die Befragung von Kindern mit Prothesen aus dem 3D-Drucker, Kick-Off Meeting „Digitale Selbstvermessung zwischen Empowerment und neuen Barrieren“ of the project “Digitale Vulnerabilität zwischen Inklusion und sozialer Robustheit”, Hochschule Furtwangen University & Schrader Stiftung (Darmstadt, Germany)