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“Focus on the Users”: Empathy, Anticipation, and Perspective-taking in Healthcare Architecture

Abstract

This dissertation is a phenomenological anthropology of intersubjectivity in the design of healthcare architecture. Based on 12 months of ethnographic fieldwork with architectural designers in the San Francisco Bay Area, this dissertation details how architectural designers derive and enact their understandings of the healthcare professionals and patients for whom they design. Since the 1960s, many architects have taken up an orientation toward design that I herein refer to as “Methodological User-Centricity” (MUC). The premise is simple: better design hinges on better empirical knowledge of the people being designed for, and that knowledge is best acquired by what are often social-science-inspired methods. One of the most influential encapsulations of this orientation in design today (in architecture and beyond) is “empathy”. The healthcare architects in this ethnographic study believed “empathic” knowledge of “users”—including patients, doctors, nurses—was essential to improving healthcare, and sought to develop this understanding of occupants through games, interviews, and other methods for learning about users’ needs, values, and experiences. Situated in this context, this dissertation examines the background premises and methods through which these architectural designers enact their specific forms of constituting others and intervening in the built environment on their behalf. Working from data running the gamut of architectural activities from initial stages of user research and conceptualization, to completion and retrospective evaluation by both designers and end-users, the dissertation analyzes the diverse modalities of experience by which members of architectural project teams orient themselves to users’ needs and possibilities. In doing so, the dissertation approaches architecture as a polymorphous response to others, one ultimately rooted in manifold forms intersubjectivity and degrees of social understanding. Nevertheless, this dissertation also presents a critical analysis of unintentional shortcomings arising through unequal user representation in architectural designers’ research with healthcare institutions.

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