Medicine is increasingly focusing on the prevention of diseases. The digital twin (DT) is considered to be an important technological development for realizing this transition. Broadly speaking, a DT is an in silico representation of an individual that dynamically reflects molecular and physiological status, which makes it possible to monitor precisely health status over time. Currently, DTs are more of an abstract ideal than a concrete technological reality, which makes it possible to actively imagine the different ways in which DTs might materialize. This article develops an approach to imagining the different ways in which DTs can be integrated into the lives of people. It focuses on how potential users want to be cared for by means of DTs and how care practices might be changed through the introduction of DTs. The article shows that a shift towards preventive medicine is taking place and situates DT in this context. Then, drawing on the insights of Gilbert Simondon, it suggests that the notion of technical milieu can be a helpful tool for designers to imagine the practices of valuing to which DTs give rise. Subsequently, it explains how our philosophical approach helps inform what kinds of DTs can be imagined. Then, based on interviews with people likely to relate to DTs in the (near) future, it develops six conceptions of DTs and fleshes out some of the implications of our approach for the design of DTs.@en

In this Conversation session we explored the two contrasting philosophical perspectives of Pragmatism and Inventivism. Pragmatism tends to focus on technical objects as fulfilling a purpose for mankind in a concrete situational context. In contrast, the French philosopher Gilbert Simondon introduces an Inventivist philosophical position in which technical objects a) have their own mode of being called technicity, b) are becoming more open, and c) should not be reduced to a purpose, as that hinders their co-emergence with mankind - a problematic position with regards to design. The Conversation took the form of exploring an imaginary design case revolving around using the technology of a wildlife camera to design for a dinner table setting. Two imaginary design teams were formed, each operating in a philosophical 'clearing' representing one of the perspectives. Moderators supported each team. Each team had a wildlife camera at their disposal to work with, which at the same time captured each session at selected points. Four participants joined the Conversation session, two per clearing. Halfway through the session the participants reflected intermediately and then one each swapped clearings. The last 10 minutes were spent on a joint reflection. This exploration indicates how the differences in philosophical positions play out when entering concrete design consideration.@en

A first exploration is conducted to what the French biological philosophy of technology perspective has to offer to the field of design methodology. If this French perspective is combined with contemporary speculative pragmatism a generative design methodology emerges offering novelty in what is sensed as important in a design situation. Within this perspective, drawing upon the late French philosopher Gilbert Simondon, technical objects have their own mode of existence and their own trajectory of development apart from human intention.

Designers working with such a generative design methodology follow the constitutive value of openness and attune to the regulative value of techno-aesthetic judgments. By way of a 'vignette+', a paradigmatic example from a real case, a more encompassing argument is made towards design situations where a sophisticated machine is 'inserted' into a domestic setting.

The example taken is the use of an artificial kidney machine in a domestic setting and the development of a novel machine with a design team. Four aspects were sensed as important in the unfolding design situation and directions for further research are discussed.@en

The notion of technical mentality and transductive reasoning described by the French philosopher Gilbert Simondon is applied on a concrete design case in order to investigate responsibility and design. The design case relates to the development of a portable artificial kidney. The historic invention of the artificial kidney is woven into the philosophy of Simondon in order to mobilize his work. For designers, the risk of reduction is at stake when applying the technical mentality to domains beyond the technical such as the psycho-social. This risk can be avoided by transductive reasoning, i.e. reasoning by means of analogy, but this is not sufficient as additional research is needed on responsibility and taking action. Correlating machines remains a human responsibility. Designers cannot hide behind the borders of their task or project when it comes to responsibility. Suggestions for further research are shared a.o. on aesthetics, ways of reasoning in design and design education.@en