Health as a Means Towards Profitable Ends: mHealth Apps, User Autonomy, and Unfair Commercial Practices

Abstract

In this article, we discuss mHealth apps and their potential to influence the user's behaviour in increasingly persuasive ways. More specifically, we call attention to the fact that mHealth apps often seek to not only influence the health behaviour of users but also their economic behaviour by merging health and commercial content in ways that are hard to detect. We argue that (1) such merging of health and commercial content raises specific questions concerning the autonomy of mHealth app users, and (2) consumer law offers a promising legal lens to address questions concerning user protection in this context. Based on an empirically informed ethical analysis of autonomy, we develop a fine-grained framework that incorporates three different requirements for autonomy that we call "independence," "authenticity," and "options." This framework also differentiates between three different stages of mHealth app use, namely installing, starting to use, and continuing to use an app. As a result, user autonomy can be analysed in a nuanced and precise manner. Since the concept of autonomy plays a prominent, yet poorly understood role in unfair commercial practice law, we utilize the ethical analysis of autonomy to guide our legal analysis of the proper application of unfair commercial practice law in the mHealth app domain.

Health technology assessment for digital technologies that manage chronic disease: a systematic review

“…The identification of DHT-specific content for the technical characteristics in TEC, the estimation of DHT-specific resource utilization and costs in ECO, and the DHT-specific changes to work processes in ORG were expected. The large amount of DHT-specific content identified in ETH is warranted when we consider the description by Sax et al (28) of the unique risks of DHTs that collect a large amount of personal data to develop predictive algorithms of behavior. Consequently, there are ethical issues in terms of the potential for DHTs to influence the behavior of susceptible persons at critical times for commercial purposes.…”

10 Rethinking consent in mHealth: (A) Moment to process

“…With the developments of persuasive mHealth systems, to be downloaded directly onto users' personal mobile devices, the possibility for more data intensive data collection, and thus more personalization, opens up. According to Sax et al (2018) it is to be expected that these personalization strategies will become more frequent and more powerful.…”

“…The idea that the user's goals may change during the process of using mHealth apps is also emphasized by Sax et al (2018) who identify three distinct stages of mHealth apps usage. These are: "(1) the decision to install an mHealth app; (2) the decision to start using an mHealth app; (3) and the decision to continue using mHealth apps for longer periods of time" (Sax et al 2018, p. 114).…”

Negodīgas komercprakses aizlieguma regulējuma izaicinājums – patērētāja lēmuma autonomijas nosargāšana digitālajā vidē

“…Negodīgas komercprakses direktīvas mērķis ir veicināt Eiropas iekšējā tirgus pienācīgu darbību un nodrošināt augsta līmeņa patērētāju aizsardzību no negodīgas komercprakses. 6 Patērētāja lēmuma autonomijas nodrošināšana ir Eiropas negodīgas komercprakses aizlieguma regulējuma pamats. 7 Līdz ar to patērētāja lēmuma autonomijas nosargāšanas panākumi vai, tieši otrādi, neveiksmes būtiski var ietekmēt Eiropas iekšē jā tirgus darbību, stabilitāti, attīstību un konkurētspēju pasaules tirgū.…”