Ethics By Design

Your smartphone vibrates, displays notifications and makes different sounds. Time to take the pill prescribed by the doctor; go to the gym to burn a specific number of calories; walk for an hour to supplement insufficient level of vitamin D; go to bed to sleep long enough; start meditating to reduce stress. Can the apps of the future be beneficial, but also transparent, ethical, and based on values important for people instead of using psychological tricks?

Dopamine as a source of market success

An effective app does not let you forget about itself. It must fight for our limited attention because the competition from other apps is growing rapidly.

The most successful apps use the principles of behavioral psychology to get us hooked. Dopamine increases automatically every time someone likes our photo on Facebook or Instagram. The level of this happiness neurotransmitter is regulated in the brain by the dopamine system. The more “likes” under a selfie, the higher the satisfaction. When a message on Twitter gets popular, it increases our self-estimate and strengthens the impression of social acceptance. This is the main reason behind the success of social media. Mobile apps must also play on our emotions and needs. Otherwise, they end up being forgotten or deleted.

The power of technology over us is ethically ambiguous and can lead to many adverse effects in real life. It is slightly different in the case of health apps. They are mainly about turning a single healthy behavior into a permanent habit. Our mobile phone should become a source of motivation and discipline, helping us to maintain proper weight and regularly run or go to the gym. On the other hand, for the apps developers, our health is not necessarily a priority. They have to survive on the competitive market. Hence they must make the apps attractive in the meaning of “used as frequently as possible.” So, where is the balance between profits and ethics?

Fixing errors of the technological revolution

Unhealthy habits are not easy to change. Our brain does not feel equal pleasure from eating a hamburger with fries and having a salad. The first option provides a hefty dose of energy and rewards us with a feeling of happiness. For many of us, an evening in front of the TV is more attractive than exercising in the gym. Both a healthy meal and training give results after a few weeks, which does not motivate enough. The eternal hunger of the brain has its advantages – the evolution programmed this energy-absorbing organ to consume calories that guarantee survival and development. But calories were not so easy to obtain in the past – you had to hunt for meat or look for and gather edible plants. Today, we can get everything in the store across the street, without restrictions, which leads to energy imbalance, causing an epidemic of obesity and overweight.

The same goes for sleep. Scientists recommend that a healthy rest should last 7 to 9 hours. But in the world of many possibilities and artificial light, sleep has become a waste of time. However, we still need it as much as 10,000 years ago. We are built this way as humans. This new technology is to help us return to healthy habits. In other words: we are trying to fix the harmful effects of the first (steam energy), second (electricity), and third (computerization) industrial revolution with the innovations of the fourth industrial revolution (artificial intelligence). As it turns out, all shortcuts and trends are as illusory as the incredible power of vitamin supplements. Are digital therapies in the form of apps, with no direct side effects like medicines, a solution?

Coach or manipulator?

Today, the physical activity of an average city dweller is negligible. We don’t have to walk – we drive cars. We don’t have to hunt – we spend the whole day working at our desk, and spend the money earned on food and other goods. We don’t have to go to sleep when it gets dark – the Internet and television ensure our entertainment in artificial light. Progress will continue to disturb the structure of the human body and brain, which just cannot keep up. Like in the case of climate change, nobody expects that everyone will stop eating meat, drive cars, and fly on vacation all of a sudden. Damage that has already been done can be repaired by creating alternative energy sources, human and environmentally-friendly smart technologies. It is a pity that we have realized this so late.

The process should be similar in healthcare, and there is still time to develop new solutions wisely. Technologies that primarily help to maintain health and preventing disease should be made responsibly and in harmony with human nature, their autonomy as a social unit, and freedom. Without resorting to dubious psychological tricks and mechanisms that control us instead of helping us. Ethically, with the participation of doctors and teams of medical experts in a given field.

What would an ethically developed mobile app look like to optimally care about physical activity? Should it sense our emotions and ask about our needs, moods, and worries? Understand our laziness and convince us instead of imposing daily limits to complete, often leading to frustration when the objective was not achieved? Or maybe it would allow you to compete not only virtually, but also in the real world, making it easier to find a partner for morning jogging or the gym? Ultimately, it would decide by itself to enter the sleep mode after the new sporting habit has been established for good. So as not to unnecessarily burden the user with digital noise. Perhaps it should include other responsibilities, such as looking after children and suggest different alternatives to the gym? There are countless ideas. Many of them could also become a market advantage for app developers. For the healthcare industry, it’s time to get out of the thinking in a box.

The balance between human and technology. More than just UX/UI

In the age of digitization, the most important is to ask ourselves what we expect from technology. We have to learn to anticipate the long-term effects of today’s decisions. There are plenty of examples of irresponsible revolutions, with the abovementioned climate change at the forefront. In my opinion, mobile apps designed responsibly and harmoniously will become more trusted over time. This is because they offer values that are relevant to us. These will be more and more important. In an increasingly complex world, people want to have control over technology instead of being controlled. There is nothing wrong with app developers making money on mobile health apps. But such tools should be transparent, based on scientific knowledge, instead of digital tricks.

The new generation of mobile apps can be compared to switching to healthy, high-quality organic food produced locally, which not only tastes better but also guarantees sustainable farming and supports sustainable entrepreneurship. So the mobile apps can also harmonize with our core values, needs. In the world tired of apps persistently fighting over our attention (and their survival on the market), “ethical digital health” is the future.

It goes much deeper than the user interface or user experience design. UX/UI should complete the solutions created following the principle “ethics by design.” Same as safety instructions for users only supplement the core, which is “privacy by design” or “privacy by default” fundamentals.

From the author: One of the oldest applications installed on my smartphone is Forest. Its function is to limit the time spent with the smartphone. The more time I spend offline without using my phone, the faster my virtual forest grows. A certain number of points finances the planting of a real tree. This is the real value that makes me go back to Forest with pleasure, without intrusive notifications, likes, or a false sense of social responsibility and acceptance.

The term “ethics by design” was described in the book “Digitale Ethik.” Soon I will publish an interview with the author, Prof. Sarah Spiekermann.

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