Abstract
Socially Assistive Robots (SARs) are increasingly conceived as applicable tools to be used in aged care. However, the use carries many negative and positive connotations. Negative connotations come forth out of romanticized views of care practices, disregarding their already established technological nature. Positive connotations are formulated out of techno-deterministic views on SAR use, presenting it as an inevitable and necessary next step in technological development to guarantee aged care. Ethical guidance of SAR use inspired by negative connotations tends to be over-restrictive whereas positive connotations tend to provide over-permissive guidance. To avoid these extremes, we report on the development and content of 21 ethical orientations regarding SAR use in aged care. These orientations resulted from a multi-phased project, which consisted of empirical-ethical research focusing on older adults’ intuitions regarding SAR use and philosophical-ethical research focusing on philosophical-ethical argumentations regarding SAR use. This project led to the Socio-historical contextualization of the ethics of SAR use, in which the ethical impact of SAR use is localized on three interrelated analysis levels: societal, organizational, and individual-relational. The 21 novel orientations regarding SAR use are structured according to these levels and further categorized into foundational and applied orientations. The first category leads to critical reflection on SAR use while the latter category inspires decision-making processes regarding this use. While going beyond the care-romantic and techno-deterministic gaze of SAR use in aged care, the described orientations balance themselves between their over-restrictiveness and over-permissiveness.
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There is a current ethical focus on technologies’, as SARs, design and development due to the increasing influence of mediation theories as exemplified by van Wynberghe’s care-centred-value-sensitive design (2013a, b, 2016) and Verbeek’s postphenomenology (2008, 2011). Valuable for their insights into the mutual influence between technologies and ethics, these approaches are unable to grasp their full ethical impact. Focusing on design and development predetermines technologies as devices that have to come into existence. Moreover, they solely focus on technologies’ social embeddedness in our westernized, societies, obscuring technologies’ mainly non-westernized social and environmental history before assemblage and implementation. Solely focusing on design and development comes with socio-environmental-technical blindness (Johnson & Verdicchio 2017). We focus on SAR use to differentiate ourselves from this predetermination and westernized lens although many orientations are relevant for SAR design and development.
Recently, robotethics has included a socio-environmental focus. For example, van Wynsberghe and Donhauser (2018) have discussed the need for an ethics of environmental robots in which the adjective “environmental” refers to the double effect robots can have regarding environmental, climate, and biodiversity changes. Robots can have positive effects, for example helping to mitigate these changes, but simultaneously they can exacerbate them.
One of the heaviest debated ethical topics regarding SAR use in aged-care settings is the topic of “deception” (Vandemeulebroucke et al., 2018b). Does the use of SARs with certain designs deceive older adults or not? And if so, does this incline a misrecognition of older adults’ dignity? Sparrow and Sparrow (2006) answer these questions in a firm positive way. Other authors as Sharkey and Sharkey (2011, 2012a, b), argue that being deceived can sometimes be an autonomous choice, as it can be a “willing suspension of disbelief”, and so does not risk older adults’ dignity.
References
Archibald, M. M., & Barnard, A. (2018). Futurism in nursing: Technology, robotics and the fundamentals of care. Journal of Clinical Nursing, 27(11–12), 2473–2480. https://doi.org/10.1111/jocn.14081
Barcaro, R., Mazzoleni, M., & Virgili, P. (2018). Ethics of care and robot caregivers. Prolegomena, 17(1), 71–80. https://doi.org/10.26362/20180204
Borenstein, J., & Pearson, Y. (2010). Robot caregivers: Harbingers of expanded freedom for all? Ethics and Information Technology, 12(3), 277–288. https://doi.org/10.1007/s10676-010-9236-4
Braunack-Mayer, A. J. (2006). Ethics and health technology assessment: Handmaiden and/or critic? International Journal of Technology Assessment in Health Care, 22(3), 307–312. https://doi.org/10.1017/S0266462306051191
Charmaz, K. (2000). Grounded Theory: objectivist and constructivist methods. In K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (2nd ed., pp. 509–536). Sage Publications.
Charmaz, K. (2008). Constructionism and the grounded theory. In J. A. Holstein & J. F. Gubrium (Eds.), Handbook of constructionist research (pp. 397–412). The Guildford Press.
Coeckelbergh, M. (2010). Health care, capabilities, and AI assistive technology. Ethical Theory and Moral Practice, 13(2), 181–190. https://doi.org/10.1007/s10677-009-9186-2
Coeckelbergh, M. (2015). Artificial agents, good care, and modernity. Theoretical Medicine and Bioethics, 36(4), 265–277. https://doi.org/10.1007/s11017-015-9331-y
Coeckelbergh, M. (2016). Care robots and the future of ICT-mediated elderly care: A response to doom scenarios. AI & Society, 31(4), 455–462. https://doi.org/10.1007/s00146-015-0626-3
d’Avack, L., Di Segni, R., Palazzani, L., Amato, L., Battaglia, L., Casonato, C., et al. (2017). Developments in robotics and roboethics (report). Presidency of the Council of Ministers; the Comitato Nazionale per la Bioetica (CNB) and the Comitato Nazionale per la Biosicurezza le Biotechnologie e le Scienze della Vita. Retrieved 10 June 2019 http://bioetica.governo.it/media/3641/5_p129_2017_developments-of-robotics-and-roboethics-joint-opinion-en.pdf
Feenberg, A. (2017). Technosystem. The social life of reason. Harvard University Press.
Feil-Seifer, D., & Matarić, M. J. (2011). Socially assistive robots. Ethical issues related to technology. IEEE Robotics & Automation Magazine, 18(1), 25–31. https://doi.org/10.1109/MRA.2010.940150
Decker, M. (2008). Caregiving robots and ethical reflection: The perspective of interdisciplinary technology assessment. AI & Society, 31(4), 455–462. https://doi.org/10.1007/s00146-007-0151-0
Gauvin, F. P., Abelson, J., Giacomini, M., Eyles, J., & Lavis, J. N. (2010). “It All Depends”: Conceptualizing public involvement in the context of health technology assessment agencies. Social Science & Medicine, 70(10), 1518–1526.
Ienca, M., Jotterand, F., Viča, C., & Elger, B. (2016). Social and assistive robots in dementia care: Ethical recommendations for research and practice. International Journal of Social Robotics, 8(4), 565–573. https://doi.org/10.1007/s12369-016-0336-7
Ihde, D. (1990). Technology and the lifeworld: From garden to earth. Indiana University Press.
Johnson, D. G., & Verdicchio, M. (2017). Reframing AI discourse. Minds and Machines, 27(4), 575–590. https://doi.org/10.1007/s11023-017-9417-6
Kornfield-Matte, R. (2017). Report of the independent expert on the enjoyment of all human rights by older persons (Report). Retrieved 10 June 2019 from https://age-platform.eu/sites/default/files/Report%20of%20the%20UN%20Independent%20Expert%20on%20digitalisation%20and%20use%20of%20robots_2017.pdf
Körtner, T. (2016). Ethical challenges in the use of social service robot for elderly people. ZeitschriftfürGerontologie und Geriatrie, 49(4), 303–307. https://doi.org/10.1007/s00391-016-1066-5
Lehoux, P., & Grimard, D. (2018). When robots care: Public deliberations on how technology and humans may support independent living for older adults. Social Science & Medicine, 211, 330–337. https://doi.org/10.1016/j.socscimed.2018.06.038
Matthias, A. (2015). Robot lies in health care: When is deception morally permissible? Kennedy Institute of Ethics Journal, 25(2), 169–192. https://doi.org/10.1353/ken.2015.0007
Misselhorn, C., Pompe, U., & Stapleton, M. (2013). Ethical considerations regarding the use of social robots in the fourth age. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 26(2), 121–133. https://doi.org/10.1024/1662-9647/a000088
Moyle, W. (2019). The promise of technology in the future of dementia care. Nature Reviews Neurology, 15(6), 353–359. https://doi.org/10.1038/s41582-019-0188-y
Owen, R., Macnaghten, P., & Stilgoe, J. (2012). Responsible research and innovation: From science in society to science for society, with society. Science and Public Policy, 39(6), 751–760. https://doi.org/10.1093/scipol/scs093
Palmerini, E., Azzarri, F., Battaglia, F., Bertolini, A., Carnevale, A. Carpaneto, J., et al. (2014). Robolaw. Guidelines on regulating emerging robotic technologies in Europe: robotics facing law and ethics (report). Retrieved 10 June 2019 from http://www.robolaw.eu/RoboLaw_files/documents/robolaw_d6.2_guidelinesregulatingrobotics_20140922.pdf
Papadopoulous, I., Koulouglioti, C., & Alis, S. (2018). Views of nurses and other health and social care workers on the use of assistive humanoid and animal-like robots in health and social care: A scoping review. Contemporary Nurse, 54(4–5), 425–442. https://doi.org/10.1080/10376178.2018.1519374
Parks, J. A. (2010). Lifting the burden of women’s care work: should robots replace the human touch? Hypatia – A Journal of Feminist Philosophy, 25(1), 100–120. https://doi.org/10.1111/j.1527-2001.2009.01086.x
Preuβ, D., & Legal, F. (2016). Living with the animals: Animal or robotic companions for the elderly in smart homes? Journal of Medical Ethics, 43(6), 407–410. https://doi.org/10.1136/medethics-2016-103603
Santoni de Sio, F., & van Wynsberghe, A. (2016). When should we use care robots? The nature-of-activities approach. Science & Engineering Ethics, 22(6), 1745–1760. https://doi.org/10.1007/s11948-015-9715-4
Sharkey, A., & Sharkey, N. (2011). Children, the elderly, and interactive robots. Anthropomorphism and deception in robot care and companionship. IEEE Robotics & Automation Magazine, 18(1), 32–38. https://doi.org/10.1109/MRA.2010.940151
Sharkey, A., & Sharkey, N. (2012a). Granny and the robots: Ethical issues in robot care for the elderly. Ethics and Information Technology, 14(1), 27–40. https://doi.org/10.1159/000329483
Sharkey, N., & Sharkey, A. (2012b). The eldercare factory. Gerontology, 58(3), 282–288. https://doi.org/10.1159/000329483
Sorell, T., & Draper, H. (2014). Robot carers, ethics, and older people. Ethics and Information Technology, 16(3), 183–195. https://doi.org/10.1007/s10676-014-9344-7
Sparrow, R. (2015). Robots in aged care: A dystopian future? AI & Society, 31(4), 445–454. https://doi.org/10.1007/s001469-015-0625-4
Sparrow, R., & Sparrow, L. (2006). In the hands of machines? The future of aged care. Minds & Machines, 16(2), 141–161. https://doi.org/10.1007/s11023-006-9030-6
Stahl, B. C., & Coeckelbergh, M. (2016). Ethics of healthcare robotics: Towards responsible research and innovation. Robotics and Autonomous Systems, 86, 152–161. https://doi.org/10.1016/j.robot.2016.08.018
Swedish National Council on Medical Ethics [SMER]. (2017). Robots and surveillance in health care of the elderly – ethical aspects. JahrbuckfürWissenschaft und Ethik, 21(1), 445–452. https://doi.org/10.1515/jwiet-2017-0125
Ten Have, H. (2004). Ethical perspectives on health technology assessment. International Journal of Technology Assessment in health Care, 20(1), 71–76. https://doi.org/10.1017/s0266462304000819
Ten Have, H. A. M. J., ter Meulen, R. H. J., & van Leeuwen, E. (2013). Leerboekmedischeethiek (4th ed.). Springer.
Tronto, J. C. (1993). Moral boundaries. A political argument for an ethic of care. Routledge.
Tronto, J. C. (2013). Caring Democracy. Markets, Equality, and Justice. New York University Press.
Vandemeulebroucke, T., Dierckx de Casterlé, B., & Gastmans, C. (2018a). How do older adults experience and perceive socially assistive robots in aged care: a systematic review of qualitative evidence. Aging & Mental Health, 22(2), 149–167. https://doi.org/10.1080/13607863.2017.1286455
Vandemeulebroucke, T., Dierckx de Casterlé, B., & Gastmans, C. (2018b). The use of care robots in aged care: a systematic review of arguments-based ethics literature. Archives of Gerontology and Geriatrics, 74, 15–25. https://doi.org/10.1016/j.archger.2017.08.014
Vandemeulebroucke, T., Dierckx de Casterlé, B., & Gastmans, C. (2020a). The ethics of socially assistive robots in aged care: a socio-historical contextualization. The Journal of Medical Ethics, 46, 128–136. https://doi.org/10.1136/medethics-2019-105615
Vandemeulebroucke, T., Dierckx de Casterlé, B., Welbergen, L., Massart, M., & Gastmans, C. (2020b). The ethics of socially assistive robots in aged care. A focus group study with older adults in Flanders, Belgium. The Journals of Gerontology: Series B, 75(9), 1996–2007. https://doi.org/10.1093/geronb/gbz070
Van Est, R., Kool, L. & Gerritsen, J. (2017). Human rights in the robot age: challenges arising from the use of robotics, artificial intelligence, and virtual and augmented reality – Expert report written for the Committee on Culture, Science, Education and Media of the Parliamentary Assembly of the Council of Europe (PACE) (Report). The Hague: Rathenau Instituut. Retrieved 10 June 2019 from https://www.rathenau.nl/sites/default/files/2018-02/Human%20Rights%20in%20the%20Robot%20Age-Rathenau%20Instituut-2017.pdf
Vanlaere, L., & Van Ooteghem, L. (2012). ‘(G)een robot aanmijn bed’. Eenzorgethischperspectief op de inzet can robots in de zorgvoorkwetsbareouderen. TGE: TijdschriftvoorGezondheid & Ethiek, 3, 85–90.
van Wynsberghe, A. (2013a). A method for integrating ethics into the design of robots. Industrial Robot: An International Journal, 40(5), 433–440. https://doi.org/10.1108/IR-12-2012-451
van Wynsberghe, A. (2013b). Designing robots for care: Care centered value-sensitive design. Science and Engineering Ethics, 19(2), 407–433. https://doi.org/10.1007/s11948-011-9343-6
van Wynsberghe, A. (2016). Service robots, care ethics, and design. Ethics of Information Technology, 18(4), 311–321. https://doi.org/10.1007/s10676-016-9409-x
Van Wynsberghe, A., & Donhauser, J. (2018). The dawning of the ethics of environmental robots. Science & Engineering Ethics, 24(6), 1777–1800. https://doi.org/10.1007/s11948-017-9990-3
Verbeek, P.-P. (2008). Obstetric ultrasound and the technological mediation of morality: A postphenomenological analysis. Human Studies, 31(1), 11–26. https://doi.org/10.1007/s10746-007-9079-0
Verbeek, P.-P. (2011). Moralizing technology. Understanding and designing the morality of things. University of Chicago Press.
Walker, M. U. (1998). Moral Understandings. Routledge.
Walker, M. U. (2003). Moral Contexts. Rowman & Littlefield Publishers.
World Commission on the Ethics of Scientific Knowledge and Technology [COMEST] (2017). Report of COMEST on robotics ethics (Report). Retrieved 10 June 2019 from https://unesdoc.unesco.org/ark:/48223/pf0000253952
World Health Organization [WHO]. (2015). World report on ageing and health. WHO Document Production Services.
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Vandemeulebroucke, T., Dierckx de Casterlé, B. & Gastmans, C. Socially Assistive Robots in Aged Care: Ethical Orientations Beyond the Care-Romantic and Technology-Deterministic Gaze. Sci Eng Ethics 27, 17 (2021). https://doi.org/10.1007/s11948-021-00296-8
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DOI: https://doi.org/10.1007/s11948-021-00296-8