SSM: Qualitative Research in Health (Dec 2022)
What a mediminder does: Arranging autonomy through technology
Abstract
This article interrogates the use of technology to organize carework at an independent living program for adults with intellectual disabilities. Drawing on 15 months of ethnographic observation, I explain how technologies enable staff at the program to label participants as autonomous, even amidst their dependence on others. One technology in particular, a pill box the program calls a mediminder, illustrates how technologies mediate interactions between staff and participants. The mediminder simultaneously performs carework for staff and autonomy for participants. Through my analysis of these two functions of the mediminder, I argue that technologies make the arrangement of agency flexibility and therefore enable staff to interpret participants as autonomous. Autonomy, however, in not inevitable. When agency is flexible, it is also ambiguous and the institutional values driving the social construction of autonomy becomes ever more important. Future research should thus consider the interactional process of assigning agency and identifying the responsibility for action in socio-technical systems.
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