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Design fictions: a tool for debating societal, legal and ethical aspects of personal and pervasive health systems

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The potential benefits offered by health-related technologies are counterpoised by the societal, legal and ethical challenges concomitant with the pervasive monitoring of people necessitated by such technological interventions. Through the ProtoPolicy research project we explored the production and use of design fictions as a tool for debating the societal, legal and ethical dimensions of personal health systems. Two design fictions were co-created and tested in a series of design workshops with community groups based in Lancashire and Cornwall, UK. A thematic analysis of a debate among older people from the Lancaster group on the Smart Object Therapist (SOT) design fiction highlighted societal and ethical issues relevant to personal health system design. We conclude that ethics like ‘usability’ may be usefully based on engagement with directly or indirectly implicated publics and should not be designed into innovation by experts alone.