Between Empowerment and Manipulation: The Ethics and Regulation of For-Profit Health Apps

In the digital society, many of our everyday activities take place within digital choice architectures that become increasingly good at understanding and shaping our behavior. Health apps are a perfect example of this trend: they are easy to download and use and promise user empowerment. By collecting and analyzing user data, health apps promise to be able to ‘get to know’ their users and deliver personalized feedback and suggestions for better health outcomes. But this promise of user empowerment also comes with a risk of user manipulation. Most of the popular health apps are for-profit services. To monetize their userbase, they can rely on the very same user data collection, data analysis, and targeting techniques to shape the behavior of health app users in ways that benefit the health app provider, rather than the users themselves. As it turns out, the very conditions for empowerment largely overlap with the conditions for manipulation. This dissertation offers an ethical and legal analysis of the tension between empowerment and manipulation in for-profit health apps, and digital choice architectures more generally. Building on ethical theories of personal autonomy and manipulation, the dissertation develops an ethical framework to evaluate the design and commercial practices of health apps. This ethical framework is then used to develop novel interpretations of key concepts in the Unfair Commercial Practices Directive (UCPD). Based on these novel interpretations of key concepts, it is argued that the UCPD has an important role to play in addressing consumer manipulation.