Questions to ponder on the quantified self

Given as part of the BIONIC bioethical lunch series on the particular topic of “The Quantified Self”. September 24, 2019.

  1. What is the self being “quantified”? That is who are you? Who/What/Where is “your” “self”? And what in what way(s) can we measure it?
  2. A quantified self is said to have any number of facets – “self-knowledge through numbers”, “life-logging”, “patient-generated health data”, “data as a mirror into our own activities” – all of which require an immense amount of personal data to be collected. Things like your consumption habits, bodily functions, physical activity, medical symptoms, spatial information, physiological statistics, and mental health can all be tracked. Are there any forms of personal data that are particularly revelatory of a “self”?
  3. Are you comfortable with your quantified self existing in places you yourself have little control over?
  4. While life-tracking has been part of the human experience since the beginning – consider, cave painting, journaling, scratching heights into a door frame, etc. – it can now be done with an ever-increasing resolution into the particularities of one’s self: how many calories you (claim to) have eaten; the time you stood up last Tuesday; the last time you saw a friend. Resolution is needed to make use of focus, but is this the new hyperreality we want to prepare ourselves for?
  5. The reality of the wearable situation is much of the data can be a mess and the fidelity of biomedical data is at least questionable. To what extent should physicians act on consumer-grade data?
  6. What would an ideal wearable do?
  7. What would an ideal therable do?
  8. Happenstance and circumstance. It’s an old chestnut at this point that “your ZIP code often says as much or more than your genetic code.” It’s a modern reframing of nature v. nurture. Does a quantifiable self help tease out the effects of those two?
  9. Gamification has been inherent to the quantified self since inception. Humans, as naturally social animals, like to cooperate with, compete against, challenge each other. Making a game out of behaviors makes them fun(ner). But rarely are medical approaches made out to be games, nor are they generally fun. How does this impact the legitimacy of digital health as a tool of healthcare?
  10. I hold that the quantified self is who you see in the mirror of a panopticon. Metaphorically, of course. Thoughts?
  11. Several debates rage:
    1. Empowerment v. surveillance and discipline. Patients have gone from minimally informed to active participants in their own health; however, their literal every step can now be tracked. What benefits are worth what risks and what are the worst possible consequences of adverse effects?
    2. Improved health v. breakdown of responsibility for public health. Some individuals might see vast improvements to their personal health; however, decollectivizing (public) healthcare can have unintended long-term effects. How should quantified selves be situated within a public health schema?
    3. Great (self-)knowledge v. reductionism and non-impartiality. One can now numerically follow the Delphic command to “know thyself”; however, a number of steps and a heartbeat do not a soul make. How do we make biomedical data more revealing of our “selves”?
  12. What does the noble life of the good citizen of the great society look like?