Currently we see a significant shift in public health recommendations regarding the responsibility of the state to support patients with chronic health conditions, like diabetes, or chronic obstructive lung disease. These patients are often able to live in their own home and surroundings with support from family and health professionals. Following such shift, discourses of 'patient-centered' health care practices, and 'patient schools' have intensified, expressing health politicians' and professioals' wish for more patient autonomy and liberations from biomedical hospital regimes. This liberation is often labeled ‘empowerment’. One ambition of such empowerment is for individual patients to be able to handle their disease in accordance with own values and desires. New personalized healthcare technologies are being researched and developed to help empower these patients, not least under headings such as 'patient 2.0', 'hometelecare medicine', and 'pervasive computing'. In the chapter, I discuss, from a sociotechnical, posthuman stance, how to interpret the shifting roles and agencies of patients with chronic diseases submitted to the conditions described above. New sociotechnical orders also bring new disorders, and we need terms to verbalize the altered states, so we are also able to verbalise unexpected transformations of the patients' role and environment. Based on case studies and literature reviews, I argue that health care policies to empower sufferes through sociotechnical strategies may not just transform, but also diminish intended agencies and powers of the individual patient. Well-intentioned arrangements to individualise health technologies may thus dilute conceptual boundaries between our notions of patient, user, client and citizen. A blurred, or vague notion of patient identity can easlily lead to a decrease in public responsibility towards the patient, because this identity is mixed up with notions of self-caring citizen.
Viden, Virkning Og Virke: Forslag Til Forståelser I Sundhedspraksis, 2010, p. 307-332