Towards feminist health empowerment for self-testing apps : testing for dementia

Sammanfattning: Health empowerment, the idea to enable people to assume more control over their health decisions, has been a buzzword in health care organisation and has recently received even more attention through the popularisation of mobile health (mHealth) apps. One form of mHealth are self-testing apps, which offer users to test themselves for medical conditions as severe as dementia and Parkinson’s disease. Providing users with the possibility to take such a test independent of healthcare professionals has been advertised as empowering. Yet, it is not clear how the information supplied by self-testing apps empowers their users exactly. This problem alludes to the conceptual ambiguity around the term empowerment, which can raise false expectations. In this dissertation, I use a combination of theoretical analysis and qualitative methods to critically investigate self-testing apps in relation to current health empowerment narratives. For that, I use the example of CogniCheck, a self-testing app for changes in cognition indicative of mild neurocognitive disorder or dementia. Theory in philosophy of technology and feminist science and technology studies explains how CogniCheck mediates empowerment narratives, cultural images of dementia, and medical imperatives to test early. I investigate these mediations in their relation to empowerment from the starting point of a feminist conceptualisation of subjectivity and show how its key dimensions, i.e. relationality, embodiment, affect and intersectionality, structure the experience of the self-test and the kind of empowerment it affords. Building on these insights on subjectivity and technology, I suggest a feminist, phenomenological take on health empowerment in the context of self-testing apps.