Value-sensitive design & dementia technology

I came across the term “value-sensitive design” (VSD), which has been coined by Friedman in 1996, in Dahl & Holbö (2012) who discuss the values behind Safer Walking Technologies for people living with dementia. This framework is based on the premisse that “technology is not value-neutral” (van der Hoven & Manders-Huits, 2009, 478) . In the context of technology used in the care setting, Dahl and Holbö (2012, 572) state that technology “defines care” to some extent, which makes it important to understand the values expressed through the technology.

Value sensitive design seeks the “participation of direct and indirect stakeholders” (Forlano & Mathew, 2014, 9)” which can be used to ” improve our chances of designing solutions that are better adapted to the value-sensitive domain of dementia care.”(Dahl & Holbö, 2012, 573) It is based on “multiple, iterative investigations to probe different aspects of a project.” (Forlano & Mathew, 2014, 9)

Technology is not evaluated in terms of usability, usefulness or monetary gain through this framework, but “value-sensitive design focuses primarily on addressing values of moral import, such as privacy, trust and autonomy.” (van der Hoven & Manders-Huits, 2009, 477)  Dahl & Holbö (2012, 579) observe that: “Conflicts typically occur when there is a mismatch between value biases that the technology embodies and those held by relevant stakeholders.”

 With this framework comes the question of control over technology – and the user. Friedman (1996, 21) claims that “unlike with people with whom we can disagree about values, we cannot easily negotiate with the technology”, highlighting how technology could impose values onto the user. He outlines further that “autonomy is protected when users are given control over the right things at the right time.” (ibid, 18)

While Friedman acknowledges that the problem is to define what are the right things at the right time, this becomes an even more relevant question in regards to dementia where values and needs might change over time. Technology that is value-sensitive should be adaptable in these regards. For current Safer Walking Technologies Dahl & Holbö (2012, 577) found a lack of “granularity”; a problem that I have seen repeated throughout the literature. While Smart or Intelligent systems promise more help in this regards, current technology does not respond as individual as needed.

Another problem about technology use in dementia care is that stakeholders may hold different values, e.g. in regards to autonomy or privacy in the use of safer walking technologies. Even though the small or intelligent systems could be useful, they also become transparent decreasing the opportunities to discuss the underlying values.

A full bibliography (WIP) of the project can be found here.



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