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A Review of Contemporary Work on the Ethics of Ambient Assisted Living Technologies for People with Dementia

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Abstract

Ambient assisted living (AAL) technologies can provide assistance and support to persons with dementia. They might allow them the possibility of living at home for longer whilst maintaining their comfort and security as well as offering a way towards reducing the huge economic and personal costs forecast as the incidence of dementia increases worldwide over coming decades. However, the development, introduction and use of AAL technologies also trigger serious ethical issues. This paper is a systematic literature review of the on-going scholarly debate about these issues. More specifically, we look at the ethical issues involved in research and development, clinical experimentation, and clinical application of AAL technologies for people with dementia and related stakeholders. In the discussion we focus on: (1) the value of the goals of AAL technologies, (2) the special vulnerability of persons with dementia in their private homes, (3) the complex question of informed consent for the usage of AAL technologies.

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Notes

  1. Accessible through: http://www.webofknowledge.com.

  2. SpringerLink website: http://www.springerlink.com.

  3. Scirus website: http://www.scirus.com.

  4. In the meta-database Scirus (Elsevier), the search was refined to Abstracts, Articles, Books, Conferences, only PDF articles, with subject areas: Computer Science; Engineering, Energy and Technology; Law; Life Sciences; Medicine; Social and Behavioral Sciences; Sociology. When the individual search phrase returned more than 500 results, the expression ethic* was added. If the results then yielded more than 200 results, the additional word dementia was added, further specifying the search phrases and subject matter of the literature review. The search was restricted to the end of 2012.

  5. Mepham’s methodology of ethical analysis is a practical framework that is designed to guide ethical analysis and discussion, which can lead to rational decision-making regarding competing requirements. However, the framework was not designed for prescriptive decision-making but rather as an ethical map. The framework involves the construction of a matrix, which first lists the interests of the various stakeholders (agents), then identifies the ethical requirements of these interests (based on three relevant prima facie principles: well-being, autonomy, fairness; representing the major traditional ethical theories: utilitarianism, deontological tradition, and modern social contract theory). Finally, the importance of each ethical requirement is rated (Mepham 2008).

  6. Remmers defines self-determination, based on the traditions of the Stoics, Cicero, later Thomism, the natural law tradition of Pufendorf, and Kantian philosophy as: ‘freedom from constraint’. Self-determination tightly linked with human dignity is normatively a basic right, however it is acquired on a genealogical level (biographical development of personal abilities) (Remmers, 2010).

  7. Hofmann defines welfare technology as a heterogeneous group of technologies which are “supposed to give better and more focused care, reduced risk and increased safety, increased coping and self-determination, make it possible to stay at home longer, avoid harm (from falling, fire, robbery), make more just resource allocation, and to promote technology development, commercialization and growth” (Hofmann, 2012, p. 391).

  8. Radio-frequency.

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This research has received funding from the European Community’s Seventh Framework Programme (FP7/2007-2013) under Grant Agreement 288199—Dem@Care.

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Novitzky, P., Smeaton, A.F., Chen, C. et al. A Review of Contemporary Work on the Ethics of Ambient Assisted Living Technologies for People with Dementia. Sci Eng Ethics 21, 707–765 (2015). https://doi.org/10.1007/s11948-014-9552-x

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