Innovations permeate healthcare settings on an ever-increasing scale. Health technology innovations impact our perceptions and experiences of health, care, disease, etc. Because of the fast pace these HTIs are being introduced in different healthcare settings, there is a growing societal consensus that these HTIs need to be governed by ethical reflection. This paper reports a systematic review of argument-based literature which focused on articles reporting on ethical frameworks to screen or evaluate HTIs. To do this a four step methodology was (...) followed: Literature search conducted in five electronic literature databases; Identification of relevant articles; Development of data-extraction tool to analyze the included articles; Analysis, synthesis of data and reporting of results. Fifty-seven articles were included, each reporting on a specific ethical framework. These ethical frameworks existed out of characteristics which were grouped into five common ones: Motivations for development and use of frameworks; Objectives of using frameworks; Specific characteristics of frameworks ; Ethical approaches and concepts used in the frameworks; Methods to use the frameworks. Although this multiplicity of ethical frameworks shows an increasing importance of ethically analyzing HTIs, it remains unclear what the specific role is of these analyses. An ethics of caution, on which ethical frameworks rely, guides HTIs in their design, development, implementation, without questioning their technological paradigm. An ethics of desirability questions this paradigm, without guiding HTIs. In the end, a place needs to be found in-between, to critically assess HTIs. (shrink)

Socially Assistive Robots 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. (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)

In the early twenty-first century, we stand on the threshold of welcoming robots into domains of human activity that will expand their presence in our lives dramatically. One provocative new frontier in robotics, motivated by a convergence of demographic, economic, cultural, and institutional pressures, is the development of “carebots”—robots intended to assist or replace human caregivers in the practice of caring for vulnerable persons such as the elderly, young, sick, or disabled. I argue here that existing philosophical reflections on the (...) ethical implications of carebots neglect a critical dimension of the issue: namely, the potential moral value of caregiving practices for caregivers. This value, I argue, gives rise to considerations that must be weighed alongside consideration of the likely impact of carebots on care recipients. Focusing on the goods internal to caring practices, I then examine the potential impact of carebots on caregivers by means of three complementary ethical approaches: virtue ethics, care ethics, and the capabilities approach. Each of these, I argue, sheds new light on the contexts in which carebots might deprive potential caregivers of important moral goods central to caring practices, as well as those contexts in which carebots might help caregivers sustain or even enrich those practices, and their attendant goods. (shrink)

Healthcare is becoming increasingly automated with the development and deployment of care robots. There are many benefits to care robots but they also pose many challenging ethical issues. This paper takes care robots for the elderly as the subject of analysis, building on previous literature in the domain of the ethics and design of care robots. Using the value sensitive design approach to technology design, this paper extends its application to care robots by integrating the values of care, values that (...) are specific to AI, and higher-scale values such as the United Nations Sustainable Development Goals. The ethical issues specific to care robots for the elderly are discussed at length alongside examples of specific design requirements that work to ameliorate these ethical concerns. (shrink)

Current uses of robots in classrooms are reviewed and used to characterise four scenarios: Robot as Classroom Teacher; Robot as Companion and Peer; Robot as Care-eliciting Companion; and Telepresence Robot Teacher. The main ethical concerns associated with robot teachers are identified as: privacy; attachment, deception, and loss of human contact; and control and accountability. These are discussed in terms of the four identified scenarios. It is argued that classroom robots are likely to impact children’s’ privacy, especially when they masquerade as (...) their friends and companions, when sensors are used to measure children’s responses, and when records are kept. Social robots designed to appear as if they understand and care for humans necessarily involve some deception, and could increase the risk of reduced human contact. Children could form attachments to robot companions, or robot teachers and this could have a deleterious effect on their social development. There are also concerns about the ability, and use of robots to control or make decisions about children’s behaviour in the classroom. It is concluded that there are good reasons not to welcome fully fledged robot teachers, and that robot companions should be given a cautious welcome at best. The limited circumstances in which robots could be used in the classroom to improve the human condition by offering otherwise unavailable educational experiences are discussed. (shrink)

This paper explores the relationship between dignity and robot care for older people. It highlights the disquiet that is often expressed about failures to maintain the dignity of vulnerable older people, but points out some of the contradictory uses of the word ‘dignity’. Certain authors have resolved these contradictions by identifying different senses of dignity; contrasting the inviolable dignity inherent in human life to other forms of dignity which can be present to varying degrees. The Capability Approach (CA) is introduced (...) as a different but tangible account of what it means to live a life worthy of human dignity. It is used here as a framework for the assessment of the possible effects of eldercare robots on human dignity. The CA enables the identification of circumstances in which robots could enhance dignity by expanding the set of capabilities that are accessible to frail older people. At the same time, it is also possible within its framework to identify ways in which robots could have a negative impact, by impeding the access of older people to essential capabilities. It is concluded that the CA has some advantages over other accounts of dignity, but that further work and empirical study is needed in order to adapt it to the particular circumstances and concerns of those in the latter part of their lives. (shrink)

As robots are deployed in a widening range of situations, it is necessary to develop a clearer position about whether or not they can be trusted to make good moral decisions. In this paper, we take a realistic look at recent attempts to program and to train robots to develop some form of moral competence. Examples of implemented robot behaviours that have been described as 'ethical', or 'minimally ethical' are considered, although they are found to only operate in quite constrained (...) and limited application domains. There is a general recognition that current robots cannot be described as full moral agents, but it is less clear whether will always be the case. Concerns are raised about the insufficiently justified use of terms such as 'moral' and 'ethical' to describe the behaviours of robots that are often more related to safety considerations than to moral ones. Given the current state of the art, two possible responses are identified. The first involves continued efforts to develop robots that are capable of ethical behaviour. The second is to argue against, and to attempt to avoid, placing robots in situations that demand moral competence and an understanding of the surrounding social situation. There is something to be gained from both responses, but it is argued here that the second is the more responsible choice. (shrink)

One of the several reasons given in calls for the prohibition of autonomous weapons systems (AWS) is that they are against human dignity (Asaro, 2012; Docherty, 2014; Heyns, 2017; Ulgen, 2016). However there have been criticisms of the reliance on human dignity in arguments against AWS (Birnbacher, 2016; Pop, 2018; Saxton, 2016). This paper critically examines the relationship between human dignity and autonomous weapons systems. Three main types of objection to AWS are identified; (i) arguments based on technology and the (...) ability of AWS to conform to International Humanitarian Law; (ii) deontological arguments based on the need for human judgement and meaningful human control, including arguments based on human dignity; (iii) consequentialist reasons about their effects on global stability and the likelihood of going to war. An account is provided of the claims made about human dignity and AWS, of the criticisms of these claims, and of the several meanings of ‘dignity’. It is concluded that although there are several ways in which AWS can be said to be against human dignity, they are not unique in this respect. There are other weapons, and other technologies, that also compromise human dignity. Given this, and the ambiguities inherent in the concept, it is wiser to draw on several types of objections in arguments against AWS, and not to rely exclusively on human dignity. (shrink)

In this paper we discuss the social and ethical issues that arise as a result of digitization based on six dominant technologies: Internet of Things, robotics, biometrics, persuasive technology, virtual & augmented reality, and digital platforms. We highlight the many developments in the digitizing society that appear to be at odds with six recurring themes revealing from our analysis of the scientific literature on the dominant technologies: privacy, autonomy, security, human dignity, justice, and balance of power. This study shows that (...) the new wave of digitization is putting pressure on these public values. In order to effectively shape the digital society in a socially and ethically responsible way, stakeholders need to have a clear understanding of what such issues might be. Supervision has been developed the most in the areas of privacy and data protection. For other ethical issues concerning digitization such as discrimination, autonomy, human dignity and unequal balance of power, the supervision is not as well organized. (shrink)

In the past few years, the ethical ramifications of AI technologies have been at the center of intense debates. Considerable attention has been devoted to understanding how a morally responsible practice of data science can be promoted and which values have to shape it. In this context, ethics and moral responsibility have been mainly conceptualized as compliance to widely shared principles. However, several scholars have highlighted the limitations of such a principled approach. Drawing from microethics and the virtue theory tradition, (...) in this paper, we formulate a different approach to ethics in data science which is based on a different conception of “being ethical” and, ultimately, of what it means to promote a morally responsible data science. First, we develop the idea that, rather than only compliance, ethical decision-making consists in using certain moral abilities, which are cultivated by practicing and exercising them in the data science process. An aspect of virtue development that we discuss here is moral attention, which is the ability of data scientists to identify the ethical relevance of their own technical decisions in data science activities. Next, by elaborating on the capability approach, we define a technical act as ethically relevant when it impacts one or more of the basic human capabilities of data subjects. Therefore, rather than “applying ethics”, data scientists should cultivate ethics as a form of reflection on how technical choices and ethical impacts shape one another. Finally, we show how this microethical framework concretely works, by dissecting the ethical dimension of the technical procedures involved in data understanding and preparation of electronic health records. (shrink)

In this article, the authors examine whether and how robot caregivers can contribute to the welfare of children with various cognitive and physical impairments by expanding recreational opportunities for these children. The capabilities approach is used as a basis for informing the relevant discussion. Though important in its own right, having the opportunity to play is essential to the development of other capabilities central to human flourishing. Drawing from empirical studies, the authors show that the use of various types of (...) robots has already helped some children with impairments. Recognizing the potential ethical pitfalls of robot caregiver intervention, however, the authors examine these concerns and conclude that an appropriately designed robot caregiver has the potential to contribute positively to the development of the capability to play while also enhancing the ability of human caregivers to understand and interact with care recipients. (shrink)

As we near a time when robots may serve a vital function by becoming caregivers, it is important to examine the ethical implications of this development. By applying the capabilities approach as a guide to both the design and use of robot caregivers, we hope that this will maximize opportunities to preserve or expand freedom for care recipients. We think the use of the capabilities approach will be especially valuable for improving the ability of impaired persons to interface more effectively (...) with their physical and social environments. (shrink)

The idea of the right to mobility has been fundamental to modern Western citizenship and is expressed in many legal and government documents. Although there is widespread acceptance regarding the importance of mobility in older adults, there have been few attempts to develop ethical and theoretical tools to portray mobility equalities in old age. This paper develops a novel conceptualisation of kinetic values focusing on older adults whose ability to move has been restricted for internal and external reasons. Informed by (...) the phenomenological theory of kinaesthesia, I suggest that kinetic values are related to four principal dimensions: self-motion, being-moved, co-motion, and forced movement. I assume that these dimensions can address the key dilemma of human dignity among older adults who suffer from losing their autonomy and agency through their mobility impairments and who are at risk of being confined to their homes. To concretise the formulation of kinetic values, I study movement as part of technological equipment and urban infrastructure to examine what kinds of kinetic values mobility services and assistive robots convey for older adults in smart urban environments. By bridging disciplines, the phenomenological approach provides a novel understanding of mobility and the interplay among assistive technologies, kinaesthesia, and urban technological infrastructure. The approach suggests that kinetic values should be interpreted more comprehensively so that kinaesthesia can become better identified as a positive life-promoting practice. (shrink)

Västvärldens åldrande befolkning anses ofta ställa krav på nya former av vård och omsorg. Olika typer av informations- och kommunikationstekniskt baserat vårdstöd framhålls ofta som en lösning. Tekniken medger en rad olika fördelar, exempelvis tätare tillsyn, kontinuerliga mätningar av vitala funktioner, med möjlighet att kontinuerligt ställa diagnos, och snabb respons på larm, men de tekniska lösningarna får också etiska implikationer. I den här artikeln beskrivs och exemplifieras IKT-baserad vård och omsorg och teknikens påverkan på centrala värden som personlig integritet, autonomi, (...) frivillighet och informerat samtycke diskuteras. Interaktiv etisk teknikvärdering föreslås för att bättre inkorporera alla berörda parters behov av och synpunkter på den här typen av vårdstöd.Nyckelord: autonomi, etik, frivillighet, informerat samtycke, interaktiv etisk teknikvärdering, IKT-baserat vårdstöd, hemvård, personlig integritet, robotteknik, sensorteknik, säkerhet, trygghet, valfrihetEnglish summary: When health care moves in – the ethics of mobile health careAn ageing population in the Western world is typically taken to require novel forms of health care. Different types of Information and Communication based services and functions are presented as a solution. Even if such technology imply benefits in terms of more frequent attendance, continuous monitoring and diagnoses of vital signs and quick response to alarms, the technology also gives raise to ethical concerns. This article describes and exemplifies ICT-based health care and discusses implications on central values like privacy, autonomy, freedom of choice and informed consent. Interactive ethical technology assessment is suggested as a means to better incorporate the needs of all concerned parties and their perspectives on this type of support. (shrink)

Ambient assisted living 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: the value of the goals of AAL technologies, the special vulnerability of persons with dementia in their private homes, the complex question of informed consent for the usage of AAL technologies. (shrink)

In this paper, I examine the ethics of e - trust and e - trustworthiness in the context of health care, looking at direct computer-patient interfaces (DCPIs), information systems that provide medical information, diagnosis, advice, consenting and/or treatment directly to patients without clinicians as intermediaries. Designers, manufacturers and deployers of such systems have an ethical obligation to provide evidence of their trustworthiness to users. My argument for this claim is based on evidentialism about trust and trustworthiness: the idea that trust (...) should be based on sound evidence of trustworthiness. Evidence of trustworthiness is a broader notion than one might suppose, including not just information about the risks and performance of the system, but also interactional and context-based information. I suggest some sources of evidence in this broader sense that make it plausible that designers, manufacturers and deployers of DCPIs can provide evidence to users that is cognitively simple, easy to communicate, yet rationally connected with actual trustworthiness. (shrink)

In this paper, we first enumerate the problems that humans might face with a new type of technology such as robots with artificial intelligence (AI robots). Robotics entrepreneurs are calling for discussions about goals and values because AI robots, which are potentially more intelligent than humans, can no longer be fully understood and controlled by humans. AI robots could even develop into ethically “bad” agents and become very harmful. We consider these discussions as part of a process of developing responsible (...) innovations in AI robotics in order to prevent catastrophic risks on a global scale. To deal with these issues, we propose the capability-effectual approach, drawing on two bodies of research: the capability approach from ethics, and the effectual process model from entrepreneurship research. The capability approach provides central human capabilities, guiding the effectual process through individual goals and aspirations in the collaborative design process of stakeholders. More precisely, by assuming and understanding correspondences between goals, purposes, desires, and aspirations in the languages of different disciplines, the capability-effectual approach clarifies both how a capability list working globally could affect the aspirations and end-goals of individuals, and how local aspirations and end-goals could either energise or limit effectual processes. Theoretically, the capability-effectual approach links the collaboration of stakeholders and the design process in responsible innovation research. Practically, this approach could potentially contribute to the robust development of AI robots by providing robotics entrepreneurs with a tool for establishing a permissible action range within which to develop AI robotics. (shrink)

Intelligent environments aim to provide context-sensitive services to humans in the physical spaces in which they work and live. While the ethical dimensions of these systems have been considered, this is an aspect which requires further analysis. A literature review shows that these approaches are disconnected from each other, and that they are making little impact on real systems being built. This article provides a solution to both of these problems. It synthesises the ethical issues addressed by previous work and (...) highlights other important concerns which have been overlooked so far. Furthermore, it proposes an alternative, more holistic approach that can be used to guide the development of intelligent environments. The validity of the framework is demonstrated by its integration into an actual project. (shrink)

This article presents the framework Capability Sensitive Design (CSD), which consists of merging the design methodology Value Sensitive Design (VSD) with Martha Nussbaum's capability theory. CSD aims to normatively assess technology design in general, and technology design for health and wellbeing in particular. Unique to CSD is its ability to account for human diversity and to counter (structural) injustices that manifest in technology design. The basic framework of CSD is demonstrated by applying it to the hypothetical design case of a (...) therapy chatbot for mental health. By applying CSD to a design case, the merits of this new framework over the standard VSD approach become apparent. Also, the application demonstrates what a technology design would look like when attention is paid to capabilities right from the start of the design process. (shrink)

BackgroundArtificial intelligence has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have potential for advancing health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: (...) What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective?MethodsEight electronic databases were searched for peer reviewed and grey literature published before April 2018 using the concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data charting form, and a descriptive and thematic analysis was performed.ResultsUpon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability and responsibility, and bias. Largely missing from the literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries.ConclusionsThe ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere. (shrink)

As Artificial Intelligence technology seems poised for a major take-off and changing societal dynamics are creating a high demand for caregivers for elders, children and those infirmed-robotic caregivers, may well be used much more often. This article examines the ethical concerns raised by the use of AI caregivers and concludes that many of these concerns are avoided when AI caregivers operate as partners rather than substitutes. Furthermore, most of the remaining concerns are minor and are faced by human caregivers as (...) well. Nonetheless, because AI caregivers’ systems are learning systems, an AI caregiver could stray from its initial guidelines. Therefore, subjecting AI caregivers to an AI-based oversight system is proposed to ensure that their actions remain both legal and ethical. (shrink)

When should we use care robots? In this paper we endorse the shift from a simple normative approach to care robots ethics to a complex one: we think that one main task of a care robot ethics is that of analysing the different ways in which different care robots may affect the different values at stake in different care practices. We start filling a gap in the literature by showing how the philosophical analysis of the nature of healthcare activities can (...) contribute to robot ethics. We rely on the nature-of-activities approach recently proposed in the debate on human enhancement, and we apply it to the ethics of care robots. The nature-of-activities approach will help us to understand why certain practice-oriented activities in healthcare should arguably be left to humans, but certain goal-directed activities in healthcare can be fulfilled with the assistance of a robot. In relation to the latter, we aim to show that even though all healthcare activities can be considered as practice-oriented, when we understand the activity in terms of different legitimate ‘fine-grained’ descriptions, the same activities or at least certain components of them can be seen as clearly goal-directed. Insofar as it allows us to ethically assess specific functionalities of specific robots to be deployed in well-defined circumstances, we hold the nature-of-activities approach to be particularly helpful also from a design perspective, i.e. to realize the Value Sensitive Design approach. (shrink)

Nussbaum’s version of the capability approach is not only a helpful approach to development problems but can also be employed as a general ethical-anthropological framework in ‘advanced’ societies. This paper explores its normative force for evaluating information technologies, with a particular focus on the issue of human enhancement. It suggests that the capability approach can be a useful way of to specify a workable and adequate level of analysis in human enhancement discussions, but argues that any interpretation of what these (...) capabilities mean is itself dependent on (interpretations of) the techno-human practices under discussion. This challenges the capability approach’s means-end dualism concerning the relation between on the one hand technology and on the other hand humans and capabilities. It is argued that instead of facing a choice between development and enhancement, we better reflect on how we want to shape human-technological practices, for instance by using the language of capabilities. For this purpose, we have to engage in a cumbersome hermeneutics that interprets dynamic relations between unstable capabilities, technologies, practices, and values. This requires us to modify the capability approach by highlighting and interpreting its interpretative dimension. (shrink)

In this paper, two central questions will be addressed: ought we to implement medical AI technology in the medical domain? If yes, how ought we to implement this technology? I will critically engage with three options that exist with respect to these central questions: the Neo-Luddite option, the Assistive option, and the Substitutive option. I will first address key objections on behalf of the Neo-Luddite option: the Objection from Bias, the Objection from Artificial Autonomy, the Objection from Status Quo, and (...) the Objection from Inscrutability. I will thereafter present the Demographic Trends Argument and the Human Enhancement Argument in support of alternatives to the Neo-Luddite option. In the second half of the paper, I will argue against the Substitutive option and in favour of the Assistive option, given the existence of two chief formal deficits in medical AI technology: the causality deficit and the care deficit. (shrink)

I argue that the right to sexual satisfaction of severely physically and mentally disabled people and elderly people who suffer from neurodegenerative diseases can be fulfilled by deploying sex robots; this would enable us to satisfy the sexual needs of many who cannot provide for their own sexual satisfaction; without at the same time violating anybody’s right to sexual self-determination. I don’t offer a full-blown moral justification of deploying sex robots in such cases, as not all morally relevant concerns can (...) be addressed here; rather, I put forward a plausible way of fulfilling acute sexual needs without thereby violating anybody’s sexual rights. (shrink)