Trouble with autonomy in behavioral insurance

In this article, we study how people define, negotiate, and perform autonomy in relation to digital technologies, specifically in connection with behavioral insurance policies that involve forms of data tracking and health services. The article builds on focus group discussions, which we treat as a dynamic site of ethico-political deliberation to test ideas, talk about boundaries of acceptable control, and envision future scenarios. The ethico-political deliberations assess the legitimacy and usability of new behavioral tools. Concern over the nature and limits of autonomy is activated when people discuss how wellbeing-related decisions are delegated to algorithmically controlled systems. We argue for appreciating autonomy as a relational and ambiguous notion that is sensed and enacted in collaborations with devices in the form of distributed autonomy. Moreover, as reflected by the experiences of the insured, “autonomy” cannot be analyzed solely in the form transmitted by the liberal tradition; that is, as a clear-cut entity that can simply be “had”, “exerted”, or “controlled”. Consequently, research, ethical considerations, and governance initiatives should pay attention to how values are “done” in the affect-laden technologically mediated relations and practices.