Design as a Form of Care
Care extends far beyond the domains of healthcare and wellbeing, as argued by the political and ethical framework of care ethics. The various projects within the 4TU Health & Wellbeing program demonstrate that design research not only builds bridges to healthcare but can also constitute a form of care in itself.
The student projects aim to promote health and wellbeing in a wide range of contexts: from enabling faster detection of skin diseases in rural Uganda to encouraging physical activity among hospitalized children, and from making thumb braces more accessible to people with arthritis in low-income countries to helping blind and visually impaired people navigate railway stations. The connection between care and design research also lies in their shared foundation of empathy: the ability to put oneself in another person's position. In design thinking, empathizing is the first and most important stage, during which one's own assumptions are set aside. The aim is to gain a deeper understanding of the people one is designing for. In a sense, it involves building a bridge into someone else's lived experience.
This is closely connected to recognizing the importance of context. Every design process involves specific circumstances shaped by the needs and experiences of a particular target group. As in care ethics, the starting point is not a set of absolute principles, but concrete, context-dependent experiences centered on the question: 'What is needed in this particular situation?' Taking these circumstances seriously can help reduce inequalities, as demonstrated by the DCPA Care Scan, a compact scanning device that uses AI to detect skin diseases. The scanner operates entirely offline, allowing it to deliver reliable results even during prolonged power outages. That medical technology need not be confined to high-tech laboratories in wealthy countries is also demonstrated by Democratising Assistive Wearables. Using a modified 3D printer, healthcare workers can produce inflatable thumb braces for people with arthritis without the need for expensive scanners or design software.
However, sensitivity to differences in people's circumstances and positions remains essential: a bridge does not eliminate distance, but makes it possible to cross. POLARIS explored what people with visual impairments need to navigate a railway station. The resulting auditory and haptic navigation system responds to users' need for reassurance at specific points along their route, rather than simply providing more directions. In doing so, it strengthens their sense of orientation and confidence.
As in healthcare practice, autonomy is a key concept in care ethics, particularly relational autonomy: the understanding that autonomy develops and takes shape through relationships with others. Learn Like a Coach is a tool for sports education in which a digital mirror uses the coach's instructions as a visual reference, helping beginners develop a better understanding of their own movements without replacing the coach. Fostering relational autonomy is also central to OverDeTop and Moefy, both designed for children in hospital. With OverDeTop, passive patients become active participants. This interactive, bridge-shaped staircase invites children to play and move together with their parents or healthcare professionals. Moefy, a multisensory play companion designed for emergency departments, similarly creates a sense of agency and connection between the child and the hospital environment.
Yet technology can also undermine autonomy, as Here Now critically reveals. In this speculative installation, users exchange sensitive personal data for mental health support offered by a fictional, free AI app. The project raises the question of what price we pay when we entrust our health to digital technologies.
The 4TU Health & Wellbeing projects demonstrate that designing to promote health is inherently an act of care. They build bridges across disciplines and national borders, but sustaining these connections requires sufficient resources. After all, the current state of bridges in the Netherlands reminds us that building a bridge is not something you do alone. And once built, a bridge needs to be maintained. It needs to be cared for.