This research aims to increase understanding of how engineers can anticipate conflicting norms concerning surveillance and autonomy implied by the use of telemonitoring technologies. These ICT technologies can be used to monitor or diagnose patients at home and are widely claimed to have the potential to improve the quality of health care. Telemonitoring technologies are an important innovation because they can contribute to closing the gap between the growing demand of care and the scarcity of health-care professionals by delegating certain tasks, normally conducted by doctors, to nurses, to patients and their informal networks of carers and to ICT systems. The adoption of these technologies implies a transition in health care because they challenge existing distributions of tasks and responsibilities, including norms of care. On the one hand, telemonitoring technologies aim to increase the responsibility of patients and nurses for monitoring diseases, thus bringing more control and autonomy to patients’ lives and nurses’ work. On the other hand, telemonitoring applications are expected to replace people and take over responsibilities and control for monitoring diseases.
These conflicting norms play an important role in the acceptance of these innovativetechnologies. The central question of the proposed research is therefore: How can telemonitoring technologies be developed to achieve a careful balance between surveillance by technological devices and control and autonomy of patients and nurses? To answer this question, we will conduct a constructive, ethical technology assessment in which we investigate the design and use practices relating to use of telemonitoring devices in chronic care that are currently developed and implemented in Europe. Based on these insights, we will develop tools that can support engineers to find a balance between these conflicting norms.