BackgroundSocially assistive devices (care robots, companions, smart screen assistants) have been advocated as a promising tool in elderly care in Western healthcare systems. Ethical debates indicate various challenges. One of the most prevalent arguments in the debate is the double-benefit argument claiming that socially assistive devices may not only provide benefits for autonomy and well-being of their users but might also be more efficient than other caring practices and might help to mitigate scarce resources in healthcare. Against this background, we (...) used a subset of comparative empirical studies from a comprehensive systematic review on effects and perceptions of human-machine interaction with socially assistive devices to gather and appraise all available evidence supporting this argument from the empirical side.MethodsElectronic databases and additional sources were queried using a comprehensive search strategy which generated 9851 records. Studies were screened independently by two authors. Methodological quality of studies was assessed. For 39 reports using a comparative study design, a narrative synthesis was performed.ResultsThe data shows positive evidential support to claim that some socially assistive devices (Paro) might be able to contribute to the well-being and autonomy of their users. However, results also indicate that these positive findings may be heavily dependent on the context of use and the population. In addition, we found evidence that socially assistive devices can have negative effects on certain populations. Evidence regarding the claim of efficiency is scarce. Existing results indicate that socially assistive devices can be more effective than standard of care but are far less effective than plush toys or placebo devices.DiscussionWe suggest using the double-benefit argument with great caution as it is not supported by the currently available evidence. The occurrence of potentially negative effects of socially assistive devices requires more research and indicates a more complex ethical calculus than suggested by the double-benefit argument. (shrink)

Twenty-five years ago, robotics guru Joseph Engelberger had a mission to motivate research teams all over the world to design the ‘Elderly Care Giver’, a multitasking personal robot assistant for everyday care needs in old age. In this article, we discuss how this vision of omnipotent care robots has influenced the design strategies of care robotics, the development of R&D initiatives and ethics research on use of care robots. Despite the expectations of robots revolutionizing care of older people, the role (...) of robots in human care has remained marginal. The value of world trade in service robots, including care robots, is rather small. We argue that the implementation of robots in care is not primarily due to negative user attitudes or ethical problems, but to problems in R&D and manufacturing. The care robots currently available on the market are capable of simple, repetitive tasks or colloquial interaction. Thus far, also research on care robots is mostly conducted using imaginary scenarios or small-scale tests built up for research purposes. To develop useful and affordable robot solutions that are ethically, socially and ecologically sustainable, we suggest that robot initiatives should be evaluated within the framework of care ecosystems. This implies that attention has to be paid to the social, emotional and practical contexts in which care is given and received. Also, the political, economic and ecological realities of organizing care and producing technological commodities have to be acknowledged. It is time to openly discuss the drivers behind care robot initiatives to outline the bigger picture of organizing care under conditions of limited resources. (shrink)

Different embodiments of technology permeate all layers of public and private domains in society. In the public domain of aged care, attention is increasingly focused on the use of socially assistive robots supporting caregivers and older adults to guarantee that older adults receive care. The introduction of SARs in aged-care contexts is joint by intensive empirical and philosophical research. Although these efforts merit praise, current empirical and philosophical research are still too far separated. Strengthening the connection between these two fields (...) is crucial to have a full understanding of the ethical impact of these technological artefacts. To bridge this gap, we propose a philosophical-ethical framework for SAR use, one that is grounded in the dialogue between empirical-ethical knowledge about and philosophical-ethical reflection on SAR use. We highlight the importance of considering the intuitions of older adults and their caregivers in this framework. Grounding philosophical-ethical reflection in these intuitions opens the ethics of SAR use in aged care to its own socio-historical contextualisation. Referring to the work of Margaret Urban Walker, Joan Tronto and Andrew Feenberg, it is argued that this socio-historical contextualisation of the ethics of SAR use already has strong philosophical underpinnings. Moreover, this contextualisation enables us to formulate a rudimentary decision-making process about SAR use in aged care which rests on three pillars: stakeholders’ intuitions about SAR use as sources of knowledge; interpretative dialogues as democratic spaces to discuss the ethics of SAR use; the concretisation of ethics in SAR use. (shrink)

Social isolation and loneliness are ongoing threats to health made worse by the coronavirus disease 2019 pandemic. During the pandemic, half the globe's population have been placed under strict physical distancing orders and many long-term care facilities serving older adults went into lockdown mode, restricting access to all visitors, including family members. Before the pandemic emerged, a 2020 National Academy of Sciences, Engineering and Medicine report warned of the underappreciated adverse effects of social isolation and loneliness on health, especially among (...) older populations. Social isolation and loneliness predict all-cause mortality at rates that rival clinical risk factors, such as obesity and smoking; they are associated with greater incidence of psychological, cognitive, and physical morbidities. This paper sets forth a proposal to design robots to function as companions and friends for socially isolated and lonely older people during pandemic emergencies and in aging societies more generally. “The proposal” section presents and defends the proposal. The “Replies to objections” section answers objections based on coercive design, replacement of humans with robots, privacy incursions, and counterfeit companionship. The “Conclusion” section submits that sociable robots offer a promising avenue for addressing social isolation and loneliness during pandemics and hold promise for aging societies more broadly. (shrink)

The ageing of the population is one of the most significant social transformations that the twenty first century is showcasing and a challenge that impacts society at large. The elderly, inasmuch as everybody else, are confronted with continuous transformations that are induced by technology, although they seldom benefit from the opportunities that technology entails. The digital divide amongst various segments of the population is often age-related and due to different reasons, including biological, psychological, social and financial ones. There is an (...) ongoing reflection pertaining to the factors that hinders the full adoption of ICTs by the elderly and a question regarding what can be done to overcome their poor involvement in technology. This article, based on the results of a recent research, which has been conducted in Italy, aims at highlighting the importance of engaging the elderly in the use of technology as a key to building bridges between generations. (shrink)

Of primary importance in formulating a response to the increasing prevalence and power of artificial intelligence (AI) applications in society are questions of ontology. Questions such as: What “are” these systems? How are they to be regarded? How does an algorithm come to be regarded as an agent? We discuss three factors which hinder discussion and obscure attempts to form a clear ontology of AI: (1) the various and evolving definitions of AI, (2) the tendency for pre-existing technologies to be (...) assimilated and regarded as “normal,” and (3) the tendency of human beings to anthropomorphize. This list is not intended as exhaustive, nor is it seen to preclude entirely a clear ontology, however, these challenges are a necessary set of topics for consideration. Each of these factors is seen to present a 'moving target' for discussion, which poses a challenge for both technical specialists and non-practitioners of AI systems development (e.g., philosophers and theologians) to speak meaningfully given that the corpus of AI structures and capabilities evolves at a rapid pace. Finally, we present avenues for moving forward, including opportunities for collaborative synthesis for scholars in philosophy and science. (shrink)