Mobile health applications (‘health apps’) that promise the user to help her with some aspect of her health are very popular: for-profit apps such as MyFitnessPal, Fitbit, or Headspace have tens of millions of users each. For-profit health apps are designed and run as optimization systems. One would expect that these health apps aim to optimize the health of the user, but in reality they aim to optimize user engagement and, in effect, conversion. This is problematic, I argue, because digital health environments that aim to optimize user engagement risk being manipulative. To develop this argument, I first provide a brief analysis of the underlying business models and the resulting designs of the digital environments provided by popular for-profit health apps. In a second step, I present a concept of manipulation that can help analyze digital environments such as health apps. In the last part of the article, I use my concept of manipulation to analyze the manipulative potential of for-profit health apps. Although for-profit health can certainly empower their users, the conditions for empowerment also largely overlap with the conditions for manipulation. As a result, we should be cautious when embracing the empowerment discourse surrounding health apps. An additional aim of this article is to contribute to the rapidly growing literature on digital choice architectures and the ethics of influencing behavior through such choice architectures. I take health apps to be a paradigmatic example of digital choice architectures that give rise to ethical questions, so my analysis of the manipulative potential of health apps can also inform the larger literature on digital choice architectures.

承诺用户在健康方面提供帮助的移动健康应用程序（“健康应用程序”）非常受欢迎：诸如MyFitnessPal，Fitbit或Headspace之类的营利性应用程序每个都有数千万用户。营利性健康应用程序被设计为优化系统并运行。人们会期望这些健康应用旨在优化用户的健康，但实际上，它们旨在优化用户的参与度，实际上是转化。我认为这是有问题的，因为旨在优化用户参与度的数字医疗环境存在操纵风险。为了阐明这一论点，我首先简要分析了流行的营利性医疗应用程序提供的基本业务模型和数字环境的最终设计。在第二步中，我提出了一种操纵的概念，可以帮助分析诸如健康应用程序之类的数字环境。在本文的最后部分，我将使用操纵的概念来分析营利性医疗应用程序的操纵潜力。虽然以营利为目的的健康肯定能赋予他们的用户，对于条件赋权在很大程度上还与操纵条件重叠。因此，在围绕健康应用程序进行授权讨论时，我们应谨慎行事。本文的另一个目的是为数字选择体系结构以及通过这种选择体系结构影响行为的伦理学方面迅速发展的文献做出贡献。我将健康应用程序视为引发道德问题的数字选择架构的典范示例，因此我对健康应用程序的操纵潜力的分析也可以为有关数字选择架构的大量文献提供参考。