Empowered yet accountable? Digitalisation and the shifting boundaries of responsibility in healthcare a qualitative investigation with patients and healthcare professionals.

Responsibility for illness management is being reconfigured changing professional practices and increasing expectations of patient self-management, e.g. through digitalisation. This article examines how responsibility is produced, distributed and enacted between patients, healthcare professionals and healthcare institutions. This study draws upon 54 qualitative interviews with 38 patients and 16 healthcare professionals in Danish hospital settings. The work utilizes abductive thematic analysis informed by perspectives on governmentality and responsibilisation (Foucault, Lupton) and Bourdieu's concepts of capital and habitus. The findings show that digitalisation redistributes not only access to health information, but also the interpretive and coordinative work required to manage illness. Patients are increasingly expected to monitor, interpret and act upon information, while professional authority over legitimate knowledge and treatment largely remains intact. This produces an important tension between roles and responsibilities. Moreover, patients' capacity to act responsibly is shaped by their social positions and available economic, cultural, health and digital capital. We conceptualise responsibility as an organisational and relational effect emerging at the intersection of patients, professionals and digital healthcare infrastructures. Digitalisation may consequently enable participation and agency while simultaneously intensifying burdens and reproducing existing social inequalities.