In this paper I describe a future in which persons in advanced old age are cared for entirely by robots and suggest that this would be a dystopia, which we would be well advised to avoid if we can. Paying attention to the objective elements of welfare rather than to people’s happiness reveals the central importance of respect and recognition, which robots cannot provide, to the practice of aged care. A realistic appreciation of the current economics of the aged care (...) sector suggests that the introduction of robots into an aged care setting will most likely threaten rather than enhance these goods. I argue that, as a result, the development of robotics is likely to transform aged care in accordance with a trajectory of development that leads towards this dystopian future even when this is not the intention of the engineers working to develop robots for aged care. While an argument can be made for the use of robots in aged care where the people being cared for have chosen to allow robots in this role, I suggest that over-emphasising this possibility risks rendering it a self-fulfilling prophecy, depriving those being cared for of valuable social recognition, and failing to provide respect for older persons by allowing the options available to them to be shaped by the design choices of others. (shrink)

This paper offers an ethical framework for the development of robots as home companions that are intended to address the isolation and reduced physical functioning of frail older people with capacity, especially those living alone in a noninstitutional setting. Our ethical framework gives autonomy priority in a list of purposes served by assistive technology in general, and carebots in particular. It first introduces the notion of “presence” and draws a distinction between humanoid multi-function robots and non-humanoid robots to suggest that (...) the former provide a more sophisticated presence than the latter. It then looks at the difference between lower-tech assistive technological support for older people and its benefits, and contrasts these with what robots can offer. This provides some context for the ethical assessment of robotic assistive technology. We then consider what might need to be added to presence to produce care from a companion robot that deals with older people’s reduced functioning and isolation. Finally, we outline and explain our ethical framework. We discuss how it combines sometimes conflicting values that the design of a carebot might incorporate, if informed by an analysis of the different roles that can be served by a companion robot. (shrink)

This paper explores the ambiguous impact of new information and communications technologies on the cultivation of moral skills in human beings. Just as twentieth century advances in machine automation resulted in the economic devaluation of practical knowledge and skillsets historically cultivated by machinists, artisans, and other highly trained workers , while also driving the cultivation of new skills in a variety of engineering and white collar occupations, ICTs are also recognized as potential causes of a complex pattern of economic deskilling, (...) reskilling, and upskilling. In this paper, I adapt the conceptual apparatus of sociological debates over economic deskilling to illuminate a different potential for technological deskilling/upskilling, namely the ability of ICTs to contribute to the moral deskilling of human users, a potential that exists alongside rich but currently underrealized possibilities for moral reskilling and/or upskilling. I flesh out this general hypothesis by means of examples involving automated weapons technology, new media practices, and social robotics. I conclude that since moral skills are essential prerequisites for the effective development of practical wisdom and virtuous character, and since market and cultural forces are not presently aligned to bring about the more salutary of the ambiguous potentials presented here, the future shape of these developments warrants our close attention—and perhaps active intervention. (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)

“Care robots” offer technological solutions to increasing needs for care just as economic imperatives increasingly regulate the care sector. Ethical critiques of this technology cannot succeed without situating themselves within the crisis of social reproduction under neoliberal capitalism. What, however, constitutes “care” and its status as a potential critical resource, and how might care robots damage this potential? Although robots might threaten norms of care, I argue that they are by no means necessarily damaging. Critiques of care robots must not (...) entrench exclusionary images of the ideal carer. Instead, critical reflection on their use should trouble dominant paradigms of care. (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 (SARs) 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: (1) stakeholders’ intuitions about SAR use as sources of knowledge; (2) interpretative dialogues as democratic spaces to discuss the ethics of SAR use; (3) the concretisation of ethics in SAR use. (shrink)

Service and personal care robots are starting to cross the threshold into the wilderness of everyday life, where they are supposed to interact with inexperienced lay users in a changing environment. In order to function as intended, robots must become independent entities that monitor themselves and improve their own behaviours based on learning outcomes in practice. This poses a great challenge to robotics, which we are calling the “autonomy-safety-paradox” (ASP). The integration of robot applications into society requires the reconciliation of (...) two conflicting aspects: increasing machine autonomy and ensuring safety in end-use. As the level of robot autonomy grows, the risk of accidents will increase, and it will become more and more difficult to identify who is responsible for any damage incurred. However, emphasizing safety impairs the autonomous functioning of the robot. This problem implies the need for a broadened concept of product safety. Our comparative study shows that the institutional framing of the ASP as well as concrete solutions to this problem differs between Europe and Japan in two respects: (1) the understanding of robot agency and (2) the concept of “appropriate” user–robot interaction. (shrink)

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)

Background: The debate over the ethical implications of care robots has raised a range of concerns, including the possibility that such technologies could disrupt caregiving as a core human moral activity. At the same time, academics in information ethics have argued that we should extend our ideas of moral agency and rights to include intelligent machines. Research objectives: This article explores issues of the moral status and limitations of machines in the context of care. Design: A conceptual argument is developed, (...) through a four-part scheme derived from the work of Alasdair MacIntyre. No empirical data are used. Ethical consideration: No primary data were gathered for this study. Secondary sources and authorship have been acknowledged throughout. Findings / discussion: Certain kinds of social experience, including the narrative unity of a life, and the giving and receiving of care, are essential for moral development. Machines, no matter how advanced, cannot participate in such experiences in key respects, and thus cannot develop as practical reasoners. Conclusion: It follows that they cannot be moral agents and that they cannot care. There are, it seems, no such things as care robots. In view of the institutional power of tech companies and commissioning bodies, care practitioners need to take more of a lead in developing new assistive technologies which are appropriate to their practice. (shrink)

Artificially Intelligent robotic technologies increasingly reflect a language of interaction and relationship and this vocabulary is part and parcel of the meanings now attached to machines. No longer are they inert, but interconnected, responsive and engaging. As machines become more sophisticated, they are predicted to be a “direct object” of an interaction for a human, but what kinds of human would that give rise to? Before robots, animals played the role of the relational other, what can stories of feral children (...) tell us about what it means to be human? What of ‘relationship’ do AI and robotic scientists draw on to generate ideas about their relational others? I will address these questions by reference to the work of Martin Buber in I and Thou. (shrink)

The purpose of this study was to investigate the attitudes of decision-makers toward the use of care robots in welfare services. We investigated their knowledge regarding the use of care robots in welfare services as well as their attitudes toward using robots in their own care and in the care of various user groups, for example, children, youths, and older people. We conducted an online survey with a range of Finnish decision-makers as respondents. The respondents were divided into two groups: (...) service actors and research and development actors. The respondents did not regard themselves as having much knowledge about robotics; however, the results showed that the R&D actors had more overall knowledge of the use of robots than the service actors. The R&D actors were found to be more willing to accept a robot as part of their own care as well as part of the care for various user groups. The contribution of this study is a better understanding of the views of the decision-makers who are or will be in charge of the acquisition of technological devices in welfare services. (shrink)

Background Advances in artificial intelligence, robotics and wearable computing are creating novel technological opportunities for mitigating the global burden of population ageing and improving the quality of care for older adults with dementia and/or age-related disability. Intelligent assistive technology is the umbrella term defining this ever-evolving spectrum of intelligent applications for the older and disabled population. However, the implementation of IATs has been observed to be sub-optimal due to a number of barriers in the translation of novel applications from the (...) designing labs to the bedside. Furthermore, since these technologies are designed to be used by vulnerable individuals with age- and multi-morbidity-related frailty and cognitive disability, they are perceived to raise important ethical challenges, especially when they involve machine intelligence, collect sensitive data or operate in close proximity to the human body. Thus, the goal of this paper is to explore and assess the ethical issues that professional stakeholders perceive in the development and use of IATs in elderly and dementia care. Methods We conducted a multi-site study involving semi-structured qualitative interviews with researchers and health professionals. We analyzed the interview data using a descriptive thematic analysis to inductively explore relevant ethical challenges. Results Our findings indicate that professional stakeholders find issues of patient autonomy and informed consent, quality of data management, distributive justice and human contact as ethical priorities. Divergences emerged in relation to how these ethical issues are interpreted, how conflicts between different ethical principles are resolved and what solutions should be implemented to overcome current challenges. Conclusions Our findings indicate a general agreement among professional stakeholders on the ethical promises and challenges raised by the use of IATs among older and disabled users. Yet, notable divergences persist regarding how these ethical challenges can be overcome and what strategies should be implemented for the safe and effective implementation of IATs. These findings provide technology developers with useful information about unmet ethical needs. Study results may guide policy makers with firsthand information from relevant stakeholders about possible solutions for ethically-aligned technology governance. (shrink)

The aim of this study was to present the functionality and design of nursing care robots as depicted in pictures posted on social media. A netnographic study was conducted using social media postings over a period of 3 years. One hundred and Seventy‐two images were analyzed using netnographic methodology. The findings show that nursing care robots exist in various designs and functionalities, all with a common denominator of supporting the care of one's own and others’ health and/or well‐being as a (...) main function. The results also show that functionality and design are influenced by recent popular sci‐fi/cartoon contexts as portrayed in blockbuster movies, for example. Robots'designs seem more influenced by popular sci‐fi/cartoon culture than professional nursing culture. We therefore stress that it is relevant for nursing researchers to critically reflect upon the development of nursing care robots as a thoughtful discussion about embracing technology also might generate a range of epistemological possibilities when entering a postmodern era of science and practice. (shrink)