Designing For Democracy: Using Design Activism to Re-negotiate the Roles and Rights for Patients

In this paper we focus on ‘patient-democracy’ and ‘shared decision-making’ seen from the perspective of design practice and design research. In the research on democracy in healthcare it is rarely questioned what forms of democracy underlies these concepts. We have examined three different theories of democracy and the democratic practices that belong to each of these.
For designers working to increase patient democracy it is of vital importance to be able to distinguish different structures underlying democratic practices and to work out methods for prototyping democracy. In design research there are already a number of approaches available which in one way or the other address the relationship between design, democracy and power.
We provide an account of participatory design, adversarial design and design activism thereby pointing towards design’s potential for re-distributing power and authority in healthcare. Positioning ourselves within design activism, we have set up a series of disruptive design experiments at a Danish Hospital. The aim of these experiments is to make inquiries into the hospital’s own conception of democracy and to use design activism to re-negotiate the roles and rights for patients thereby exploring various disruptive realities wherein the patient becomes a citizen with democratic rights.