Friendship is an important part of the good life. While many roboticists are eager to create friend-like robots, many philosophers and ethicists are concerned. They argue that robots cannot really be our friends. Robots can only fake the emotional and behavioural cues we associate with friendship. Consequently, we should resist the drive to create robot friends. In this article, I argue that the philosophical critics are wrong. Using the classic virtue-ideal of friendship, I argue that robots can plausibly be considered (...) our virtue friends - that to do so is philosophically reasonable. Furthermore, I argue that even if you do not think that robots can be our virtue friends, they can fulfil other important friendship roles, and can complement and enhance the virtue friendships between human beings. (shrink)

The prospective robots in healthcare intended to be included within the conclave of the nurse-patient relationship—what I refer to as care robots—require rigorous ethical reflection to ensure their design and introduction do not impede the promotion of values and the dignity of patients at such a vulnerable and sensitive time in their lives. The ethical evaluation of care robots requires insight into the values at stake in the healthcare tradition. What’s more, given the stage of their development and lack of (...) standards provided by the International Organization for Standardization to guide their development, ethics ought to be included into the design process of such robots. The manner in which this may be accomplished, as presented here, uses the blueprint of the Value-sensitive design approach as a means for creating a framework tailored to care contexts. Using care values as the foundational values to be integrated into a technology and using the elements in care, from the care ethics perspective, as the normative criteria, the resulting approach may be referred to as care centered value-sensitive design. The framework proposed here allows for the ethical evaluation of care robots both retrospectively and prospectively. By evaluating care robots in this way, we may ultimately ask what kind of care we, as a society, want to provide in the future. (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)

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)

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)

Sex robots are likely to play an important role in shaping public understandings of sex and of relations between the sexes in the future. This paper contributes to the larger project of understanding how they will do so by examining the ethics of the “rape” of robots. I argue that the design of realistic female robots that could explicitly refuse consent to sex in order to facilitate rape fantasy would be unethical because sex with robots in these circumstances is a (...) representation of the rape of a woman, which may increase the rate of rape, expresses disrespect for women, and demonstrates a significant character defect. Even when the intention is not to facilitate rape, the design of robots that can explicitly refuse consent is problematic due to the likelihood that some users will experiment with raping them. Designing robots that lack the capacity to explicitly refuse consent may be morally problematic depending on which of two accounts of the representational content of sex with realistic humanoid robots is correct. (shrink)

AI research is growing rapidly raising various ethical issues related to safety, risks, and other effects widely discussed in the literature. We believe that in order to adequately address those issues and engage in a productive normative discussion it is necessary to examine key concepts and categories. One such category is anthropomorphism. It is a well-known fact that AI’s functionalities and innovations are often anthropomorphized (i.e., described and conceived as characterized by human traits). The general public’s anthropomorphic attitudes and some (...) of their ethical consequences (particularly in the context of social robots and their interaction with humans) have been widely discussed in the literature. However, how anthropomorphism permeates AI research itself (i.e., in the very language of computer scientists, designers, and programmers), and what the epistemological and ethical consequences of this might be have received less attention. In this paper we explore this issue. We first set the methodological/theoretical stage, making a distinction between a normative and a conceptual approach to the issues. Next, after a brief analysis of anthropomorphism and its manifestations in the public, we explore its presence within AI research with a particular focus on brain-inspired AI. Finally, on the basis of our analysis, we identify some potential epistemological and ethical consequences of the use of anthropomorphic language and discourse within the AI research community, thus reinforcing the need of complementing the practical with a conceptual analysis. (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 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)

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)

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)

It should not be a surprise in the near future to encounter either a personal or a professional service robot in our homes and/or our work places: according to the International Federation for Robots, there will be approx 35 million service robots at work by 2018. Given that individuals will interact and even cooperate with these service robots, their design and development demand ethical attention. With this in mind I suggest the use of an approach for incorporating ethics into the (...) design process of robots known as Care Centered Value Sensitive Design. Although this approach was originally and intentionally designed for the healthcare domain, the aim of this paper is to present a preliminary study of how personal and professional service robots might also be evaluated using the CCVSD approach. The normative foundations for CCVSD come from its reliance on the care ethics tradition and in particular the use of care practices for: structuring the analysis and, determining the values of ethical import. To apply CCVSD outside of healthcare one must show that the robot has been integrated into a care practice. Accordingly, the practice into which the robot is to be used must be assessed and shown to meet the conditions of a care practice. By investigating the foundations of the approach I hope to show why it may be applicable for service robots and further to give examples of current robot prototypes that can and cannot be evaluated using CCVSD. (shrink)

Current national and international guidelines for the ethical design and development of artificial intelligence (AI) and robotics emphasize ethical theory. Various governing and advisory bodies have generated sets of broad ethical principles, which institutional decisionmakers are encouraged to apply to particular practical decisions. Although much of this literature examines the ethics of designing and developing AI and robotics, medical institutions typically must make purchase and deployment decisions about technologies that have already been designed and developed. The primary problem facing medical (...) institutions is not one of ethical design but of ethical deployment. The purpose of this paper is to develop a practical model by which medical institutions may make ethical deployment decisions about ready-made advanced technologies. Our slogan is “more process, less principles.” Ethically sound decisionmaking requires that the process by which medical institutions make such decisions include participatory, deliberative, and conservative elements. We argue that our model preserves the strengths of existing frameworks, avoids their shortcomings, and delivers its own moral, practical, and epistemic advantages. (shrink)

Although some authors claim that deception requires intention, we argue that there can be deception in social robotics, whether or not it is intended. By focusing on the deceived rather than the deceiver, we propose that false beliefs can be created in the absence of intention. Supporting evidence is found in both human and animal examples. Instead of assuming that deception is wrong only when carried out to benefit the deceiver, we propose that deception in social robotics is wrong when (...) it leads to harmful impacts on individuals and society. The appearance and behaviour of a robot can lead to an overestimation of its functionality or to an illusion of sentience or cognition that can promote misplaced trust and inappropriate uses such as care and companionship of the vulnerable. We consider the allocation of responsibility for harmful deception. Finally, we make the suggestion that harmful impacts could be prevented by legislation, and by the development of an assessment framework for sensitive robot applications. (shrink)

Mark Coeckelbergh (Int J Soc Robot 1:217–221, 2009) argues that robot ethics should investigate what interaction with robots can do to humans rather than focusing on the robot’s moral status. We should ask what robots do to our sociality and whether human–robot interaction can contribute to the human good and human flourishing. This paper extends Coeckelbergh’s call and investigate what it means to live with disembodied AI-powered agents. We address the following question: Can the human–AI interaction contribute to our moral (...) development? We present an empirically informed philosophical analysis of how the AI personal assistant Siri changes its users’ way of life, based on the responses obtained from 20 semi-directive individual interviews with Siri users. We identify changes in the users’ social interaction associated with the adoption of Siri. These changes include: (1) the indirect effect of reducing opportunities of human interaction, (2) the second-order effect of diminished expectations toward each other in a community, and (3) the acquired preference to obtain hassle-free interaction with Siri over human interaction. We examine them in relation to concerns that are voiced in the current debates over the rise of AI, namely the suspicion that humans could become overly reliant on AI (Danaher 2019) and the worry that social AI could impede on moral development (Fröding and Peterson, Ethics Inf Technol 23:207–214, 2012; Li, Ethics Inf Technol 23:543–550, 2021). We analyze the ethical costs that come from these changes in light of virtue ethics and address potential objections along the way. We end by offering directions for thinking about how to live with AI personal assistant while preserving favorable conditions for moral development. (shrink)

Interactions between humans and machines that include artificial intelligence are increasingly common in nearly all areas of life. Meanwhile, AI-products are increasingly endowed with emotional characteristics. That is, they are designed and trained to elicit emotions in humans, to recognize human emotions and, sometimes, to simulate emotions (EAI). The introduction of such systems in our lives is met with some criticism. There is a rather strong intuition that there is something wrong about getting attached to a machine, about having certain (...) emotions towards it, and about getting involved in a kind of affective relationship with it. In this paper, I want to tackle these worries by focusing on the last aspect: in what sense could it be problematic or even wrong to establish an emotional relationship with EAI-systems? I want to show that the justifications for the widespread intuition concerning the problems are not as strong as they seem at first sight. To do so, I discuss three arguments: the argument from self-deception, the argument from lack of mutuality, and the argument from moral negligence. (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)

Scenarios involving the introduction of artificially intelligent (AI) assistive technologies in health care practices raise several ethical issues. In this paper, I discuss four objections to introducing AI assistive technologies in health care practices as replacements of human care. I analyse them as demands for felt care, good care, private care, and real care. I argue that although these objections cannot stand as good reasons for a general and a priori rejection of AI assistive technologies as such or as replacements (...) of human care, they demand us to clarify what is at stake, to develop more comprehensive criteria for good care, and to rethink existing practices of care. In response to these challenges, I propose a (modified) capabilities approach to care and emphasize the inherent social dimension of care. I also discuss the demand for real care by introducing the ‘Care Experience Machine’ thought experiment. I conclude that if we set the standards of care too high when evaluating the introduction of AI assistive technologies in health care, we have to reject many of our existing, low-tech health care practices. (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)

What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It’s also highly likely to impact on the organisational and business practices (...) of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare institutions. We will suggest that two questions, in particular, are deserving of further attention from philosophers and bioethicists. What does care look like when one is dealing with data as much as people? And, what weight should we give to the advice of machines in our own deliberations about medical decisions? (shrink)

Artificial agents are progressively becoming more present in everyday-life situations and more sophisticated in their interaction affordances. In some specific cases, like Google Duplex, GPT-3 bots or Deep Mind’s AlphaGo Zero, their capabilities reach or exceed human levels. The use contexts of everyday life necessitate making such agents understandable by laypeople. At the same time, displaying human levels of social behavior has kindled the debate over the adoption of Dennett’s ‘intentional stance’. By means of a comparative analysis of the literature (...) on robots and virtual agents, we defend the thesis that approaching these artificial agents ‘as if’ they had intentions and forms of social, goal-oriented rationality is the only way to deal with their complexity on a daily base. Specifically, we claim that this is the only viable strategy for non-expert users to understand, predict and perhaps learn from artificial agents’ behavior in everyday social contexts. Furthermore, we argue that as long as agents are transparent about their design principles and functionality, attributing intentions to their actions is not only essential, but also ethical. Additionally, we propose design guidelines inspired by the debate over the adoption of the intentional stance. (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)

With robots being introduced into caregiving, particularly for older persons, various ethical concerns are raised. Among them is the fear of replacing human caregiving. While ethical concepts like well-being, autonomy, and capabilities are often used to discuss these concerns, this paper brings forth the concept of social dignity to further develop guidelines concerning the use of robots in caregiving. By social dignity, we mean that a person’s perceived dignity changes in response to certain interactions and experiences with other persons. In (...) this paper, we will first present the concept of social dignity, and then identify a niche where robots can be used in caregiving in an ethical manner. Specifically, we will argue that, because some activities of daily living are performed in solitude to maintain dignity, a care recipient will usually prefer robotic assistance instead of human assistance for these activities. Secondly, we will describe how other philosophical concepts, which have been commonly used to judge robotic assistance in caregiving for the elderly so far, such as well-being, autonomy, and capabilities, are less useful in determining whether robotic assistance in caregiving is ethically problematic or not. To conclude, we will argue that social dignity offers an advantage to the other concepts, as it allows to ask the most pressing questions in caregiving. (shrink)

When is it ethically acceptable to use artificial agents in health care? This article articulates some criteria for good care and then discusses whether machines as artificial agents that take over care tasks meet these criteria. Particular attention is paid to intuitions about the meaning of ‘care’, ‘agency’, and ‘taking over’, but also to the care process as a labour process in a modern organizational and financial-economic context. It is argued that while there is in principle no objection to using (...) machines in medicine and health care, the idea of them functioning and appearing as ‘artificial agents’ is problematic and attends us to problems in human care which were already present before visions of machine care entered the stage. It is recommended that the discussion about care machines be connected to a broader discussion about the impact of technology on human relations in the context of modernity. (shrink)

The discussion about robots in elderly care is populated by doom scenarios about a totally dehumanized care system in which elderly people are taken care of by machines. Such scenarios are helpful as they attend us to what we think is important with regard to the quality elderly care. However, this article argues that they are misleading in so far as they (1) assume that deception in care is always morally unacceptable, (2) suggest that robots and other information technologies necessarily (...) deceive elderly people by creating a “virtual” world as opposed to a “real” world, (3) assume that elderly people of the future have similar ICT skills and interests as the elderly people of today, and (4) assume a simplistic view of technologies. The article suggests an approach to evaluating care robots and ICT in health care which acknowledges and addresses a number of ethical problems raised by robotic care—for instance disengagement problems—while taking into account that some elderly people may need care that does not treat them as (empirically) autonomous, that many the elderly of the future are likely to be digital natives, and that the task of evaluating technologies in care is more complicated than the discussion of deception suggests. (shrink)

Nancy Jecker is right when she says that older persons ought not to be ashamed if they wish to remain sexually active in advanced old age. She offers a useful account of the role that sexuality plays in supporting key human capabilities. However, Jecker assumes an exaggerated account of what sex robots are likely to be able to offer for the foreseeable future when she suggests that we are obligated to make them available to older persons with disabilities. Moreover, whether (...) older persons should be ashamed to desire sex robots—or, more importantly, whether we should be ashamed at the thought that we should respond to the sexual needs of older persons by providing them with sex robots—turns on a range of arguments that Jecker fails to adequately consider. (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)

Recent developments in AI, especially the spectacular success of Large Language models, have instigated renewed questioning of what remains distinctively human. As AI stands poised to take over more and more human tasks, what is left that distinguishes humans? One way we might identify a humanlike intelligence would be when we detect it telling lies. Yet AIs lack both the intention and the motivation to truly tell lies, instead producing merely bullshit. With neither emotions, embodiment, nor the social awareness that (...) leads to a theory of mind, AIs lack the internal referents on which to judge truth or falsity. When we are deceived by our computers, we need to look for the hidden agent who benefits from the deception. (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)

Background Gerontechnologies are increasingly used in the care for older people. Many studies on their acceptability and ethical implications are conducted, but mainly from the perspective of principlism. This narrows our ethical gaze on the implications the use of these technologies have. Research question How do participants speak about the impact that gerontechnologies have on the different phases of care, and care as a process? What are the moral implications from an ethic of care perspective? Research design Secondary analysis of (...) semi-structure interviews, whose segments on specific technologies were analysed through reflexive thematic analysis. Participants and research context Sixty-seven Swiss stakeholders involved in the use of gerontechnologies, including professional caregivers, informal caregivers, and older persons themselves. Ethical considerations The research study was evaluated by the Ethics Commission of Northwest and Central Switzerland (EKNZ). All participants received an information document before the interview date detailing the purpose, procedure, and anonymization measures. After explaining the study during the agreed upon interview time and upon receiving their written informed consent, the interview process began. Findings/results Four themes are identified: Identifying care needs, Taking responsibility, Hands-on work, Responding to care. As part of these themes, many codes highlighting the ambivalent impact of gerontechnologies are created, ranging from ‘Expanded capacity for…identifying care needs’ to ‘Create new & (un)necessary…hands-on work’. The moral implications of these results from the care ethics perspective are discussed, through the ethical elements of: attentiveness, responsibility, competence, and responsiveness. Conclusions The moral implications of gerontechnologies on care phases from the care ethics perspective open up several questions on whether they actually help give care a central role in social life and provide more competent care. (shrink)

The use of robots in therapy for children with autism spectrum disorder raises issues concerning the ethical and social acceptability of this technology and, more generally, about human–robot interaction. However, usually philosophical papers on the ethics of human–robot-interaction do not take into account stakeholders’ views; yet it is important to involve stakeholders in order to render the research responsive to concerns within the autism and autism therapy community. To support responsible research and innovation in this field, this paper identifies a (...) range of ethical, social and therapeutic concerns, and presents and discusses the results of an exploratory survey that investigated these issues and explored stakeholders’ expectations about this kind of therapy. We conclude that although in general stakeholders approve of using robots in therapy for children with ASD, it is wise to avoid replacing therapists by robots and to develop and use robots that have what we call supervised autonomy. This is likely to create more trust among stakeholders and improve the quality of the therapy. Moreover, our research suggests that issues concerning the appearance of the robot need to be adequately dealt with by the researchers and therapists. For instance, our survey suggests that zoomorphic robots may be less problematic than robots that look too much like humans. (shrink)

There is an urge to introduce high technology and robotics in care settings. Assisted living (AL) is the fastest growing form of older adults’ long-term care. Resident autonomy has become the watchword for good care. This article sheds light on the potential effects of care robotics on the sense of autonomy of older people in AL. Three aspects of the residents’ sense of autonomy are of particular interest: (a) interaction-based sense of autonomy, (b) coping-based sense of autonomy, and (c) potential-based (...) sense of autonomy. Ethnographical data on resident autonomy in an AL facility and existing literature on care robots are utilized in studying what kind of assurances different types of robots would provide to maintain the sense of autonomy in AL. Robots could strengthen the different types of sense of autonomy in multiple ways. Different types of robots could widen the residents’ space of daily movements, sustain their capacities, and help them maintain and even create future expectations. Robots may strengthen the sense of autonomy of older persons in AL; however, they may simultaneously pose a threat. Multi-professional discussions are needed on whether robots are welcomed in care, and if they are, how, for whom, and in what areas. (shrink)

This paper treats the political and ethical issues associated with the new caretaking technologies. Given the number of feminists who have raised serious concerns about the future of care work in the United States, and who have been critical of the degree to which society “free rides” on women's caretaking labor, I consider whether technology may provide a solution to this problem. Certainly, if we can create machines and robots to take on particular tasks, we may lighten the care burden (...) that women currently face, much of which is heavy and repetitious, and which results in injury and care “burnout” for many female caretakers. Yet, in some contexts, I argue that high-tech robotic care may undermine social relationships, cutting individuals off from the possibility of social connectedness with others. (shrink)

According to a widespread view, people often anthropomorphize machines such as certain robots and computer and AI systems by erroneously attributing mental states to them. On this view, people almost irresistibly believe, even if only subconsciously, that machines with certain human-like features really have phenomenal or subjective experiences like sadness, happiness, desire, pain, joy, and distress, even though they lack such feelings. This paper questions this view by critiquing common arguments used to support it and by suggesting an alternative explanation. (...) Even if people’s behavior and language regarding human-like machines suggests they believe those machines really have mental states, it is possible that they do not believe that at all. The paper also briefly discusses potential implications of regarding such anthropomorphism as a popular myth. The exercise illuminates the difficult concept of anthropomorphism, helping to clarify possible human relations with or toward machines that increasingly resemble humans and animals. (shrink)

Technological approaches are increasingly discussed as a solution for the provision of support in activities of daily living as well as in medical and nursing care for older people. The development and implementation of such assistive technologies for eldercare raise manifold ethical, legal, and social questions. The discussion of these questions is influenced by theoretical perspectives and approaches from medical and nursing ethics, especially the principlist framework of autonomy, non-maleficence, beneficence, and justice. Tying in with previous criticism, the present contribution (...) is taking these principles as a starting point and as a frame of reference to be critically re-examined. It thus aims to outline how existing ethical frameworks need to be extended or reconsidered to capture the ethical issues posed by technological developments regarding care for older people. In a first step, we provide a brief overview of assistive technologies in eldercare according to their purposes and functions. In the next step, we discuss how the questions and problems raised by new technologies in eldercare call for an expansion, re-interpretation, and revision of the principlist framework. We underline that the inclusion of ethical perspectives from engineering and computer science as well as a closer consideration of socio-political dimensions and fundamental anthropological and praxeological questions are needed. (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)

If people are inclined to attribute race to humanoid robots, as recent research suggests, then designers of social robots confront a difficult choice. Most existing social robots have white surfaces and are therefore, I suggest, likely to be perceived as White, exposing their designers to accusations of racism. However, manufacturing robots that would be perceived as Black, Brown, or Asian risks representing people of these races as slaves, especially given the historical associations between robots and slaves at the very origins (...) of the project of robotics. The only way engineers might avoid this ethical and political dilemma is to design and manufacture robots to which people will struggle to attribute race. Doing so, however, would require rethinking the relationship between robots and “the social,” which sits at the heart of the project of social robotics. Discussion of the race politics of robots is also worthwhile because of the potential it has to generate insights about the politics of artifacts, the relationship between culture and technology, and the responsibilities of engineers. (shrink)

The implementation of care robotics in care settings is identified by some authors as a disruptive innovation, in the sense that it will upend the praxis of care. It is an open ethical question whether this alleged disruption will also have a transformative impact on established ethical concepts and principles. One prevalent worry is that the implementation of care robots will turn deception into a routine component of elderly care, at least to the extent that these robots will function as (...) simulacra for something that they are not (i.e. human caregivers). At face value, this may indeed seem to indicate a concern for how this technology may upend existing practices and relationships within a care setting. Yet, on closer inspection, this reaction may rather point to a rediscovery and a revaluation of a particularly well-entrenched value or virtue, i.e. veracity. The virtue of veracity is one of the values that is mobilized to argue against a substitution of human caregivers (while a combination of care robots and human caregivers is much more accepted). The subject of this paper is to explore how the moral panic surrounding care robots should not so much be interpreted as an anticipated and probable disruptor in a care setting, but rather as a sensitizing – in a way conservationist – argument that identifies veracity as an established value that is supposed to be protected and advanced in present day and future care settings. (shrink)

Contemporary ICTs such as speaking machines and computer games tend to create illusions. Is this ethically problematic? Is it deception? And what kind of “reality” do we presuppose when we talk about illusion in this context? Inspired by work on similarities between ICT design and the art of magic and illusion, responding to literature on deception in robot ethics and related fields, and briefly considering the issue in the context of the history of machines, this paper discusses these questions through (...) the lens of stage magic and illusionism, with the aim of reframing the very question of deception. It investigates if we can take a more positive or at least morally neutral view of magic, illusion, and performance, while still being able to understand and criticize the relevant phenomena, and if we can describe and evaluate these phenomena without recourse to the term “deception” at all. This leads the paper into a discussion about metaphysics and into taking a relational and narrative turn. Replying to Tognazzini, the paper identifies and analyses two metaphysical positions: a narrative and performative non-dualist position is articulated in response to what is taken to be a dualist, in particular Platonic, approach to “deception” phenomena. The latter is critically discussed and replaced by a performative and relational approach which avoids a distant “view from nowhere” metaphysics and brings us back to the phenomena and experience in the performance relation. The paper also reflects on the ethical and political implications of the two positions: for the responsibility of ICT designers and users, which are seen as co-responsible magicians or co-performers, and for the responsibility of those who influence the social structures that shape who has power to deceive or to let others perform. (shrink)

Robots as social companions in close proximity to humans have a strong potential of becoming more and more prevalent in the coming years, especially in the realms of elder day care, child rearing, and education. As human beings, we have the fascinating ability to emotionally bond with various counterparts, not exclusively with other human beings, but also with animals, plants, and sometimes even objects. Therefore, we need to answer the fundamental ethical questions that concern human-robot-interactions per se, and we need (...) to address how we conceive of »good lives«, as more and more of the aspects of our daily lives will be interwoven with social robots. (shrink)

Social isolation and loneliness are growing concerns around the globe that put people at increased risk of disease and early death. One much‐touted approach to addressing them is deploying artificially intelligent agents to serve as companions for socially isolated and lonely people. Focusing on digital humans, we consider evidence and ethical arguments for and against this approach. We set forth and defend public health policies that respond to concerns about replacing humans, establishing inferior relationships, algorithmic bias, distributive justice, and data (...) privacy. (shrink)

There are two dominant trends in the humanitarian care of 2019: the ‘technologizing of care’ and the centrality of the humanitarian principles. The concern, however, is that these two trends may conflict with one another. Faced with the growing use of drones in the humanitarian space there is need for ethical reflection to understand if this technology undermines humanitarian care. In the humanitarian space, few agree over the value of drone deployment; one school of thought believes drones can provide a (...) utility serving those in need while another believes the large scale deployment of drones will exacerbate the already prevalent issues facing humanitarian aid providers. We suggest in this paper that the strength of the humanitarian principles approach to answer questions of aid provision can be complimented by a technology-facing approach, namely that of robot ethics. We have shown that for humanitarian actors we ought to be concerned with the risks of a loss of contextualization and de-skilling. For the beneficiary, we raise three concerns associated with the threat to the principle of humanity for this group: a loss of dignity by reducing human-to-human interactions; a threat to dignity through a lack of informational transparency; and, a threat to dignity by failing to account for the physiological and behavioral impacts of the drone on human actors. Although we acknowledge the obstacles associated with understanding the physiological and behavioral impacts we insist that the moral acceptability and desirability of drones in humanitarian contexts is dependent on the findings from such studies and that tailored ethical guidelines for drone deployment in humanitarian action be created to reflect the results of such studies. (shrink)

An elderly patient in a care home only wants human nurses to provide her care – not robots. If she selected her carers based on skin colour, it would be seen as racist and morally objectionable, but is choosing a human nurse instead of a robot also morally objectionable and speciesist? A plausible response is that it is not, because humans provide a better standard of care than robots do, making such a choice justifiable. In this paper, I show why (...) this response is incorrect, because robots can theoretically care as well as human nurses can. I differentiate between practical caring and emotional caring, and I argue that robots can match the standard of practical care given by human nurses, and they can simulate emotional care. There is growing evidence that people respond positively to robotic creatures and carebots, and AI software is apt to emotionally support patients in spite of the machine’s own lack of emotions. I make the case that the appearance of emotional care is sufficient, and need not be linked to emotional states within the robot. After all, human nurses undoubtedly ‘fake’ emotional care and compassion sometimes, yet their patients still feel adequately cared for. I show that it is a mistake to claim that ‘the human touch’ is in itself a contributor to a higher standard of care; ‘the robotic touch’ will suffice. Nevertheless, it is not speciesist to favour human nurses over carebots, because carebots do not suffer as the result of such a choice. (shrink)

Nurses have traditionally been regarded as clinicians that deliver compassionate, safe, and empathetic health care (Nurses again outpace other professions for honesty & ethics, 2018). Caring is a fundamental characteristic, expectation, and moral obligation of the nursing and caregiving professions (Nursing: Scope and standards of practice, American Nurses Association, Silver Spring, MD, 2015). Along with caring, nurses are expected to undertake ever‐expanding duties and complex tasks. In part because of the growing physical, intellectual and emotional demandingness, of nursing as well (...) as technological advances, artificial intelligence (AI) and AI care robots are rapidly changing the healthcare landscape. As technology becomes more advanced, efficient, and economical, opportunities and pressure to introduce AI into nursing care will only increase. In the first part of the article, we review recent and existing applications of AI in nursing and speculate on future use. Second, situate our project within the recent literature on the ethics of nursing and AI. Third, we explore three dominant theories of caring and the two paradigmatic expressions of caring (touch and presence) and conclude that AI—at least for the foreseeable future—is incapable of caring in the sense central to nursing and caregiving ethics. We conclude that for AI to be implemented ethically, it cannot transgress the core values of nursing, usurp aspects of caring that can only meaningfully be carried out by human beings, and it must support, open, or improve opportunities for nurses to provide the uniquely human aspects of care. (shrink)

This paper explores the ways in which health care professionals, family carers, and older persons expressed attitudes and opinions on using Paro, a social robot designed to stimulate patients with dementia. Thereafter, we critically evaluate existing prejudicial views toward Paro users to provide recommendations for its future use. Using an exploratory qualitative interview method, we recruited a total of 67 participants in Switzerland. They included 23 care professionals, 17 family carers, and 27 older persons. Data obtained were analyzed thematically. Study (...) findings present general agreement that Paro is an appealing and beneficial social robot, but it is not a tool that everyone feels comfortable with. Because it is perceived as “child play,” it would be demeaning for competent adults to play with such things. Consequently, Paro is appropriate only for persons with dementia. These findings brought forth ethical concerns about deception, infantilization, and respecting older persons' dignity. The idea of who is an appropriate Paro user led to our discussions on predicting future Paro users. The meaning of using social robotics in nursing homes can be conditioned by a rigid interpretation of adulthood and playful behavior. To protect future selves when one is living with dementia from prejudices, it may be useful for older persons and their loved ones to plan their future care situations to ensure that they are treated in accordance with their delineated decisions. (shrink)

Creating android and humanoid robots to furnish companionship in the nursing care of older people continues to attract substantial development capital and research. Some people object, though, that machines of this kind furnish human–robot interaction characterized by inauthentic relationships. In particular, robotic and artificial intelligence (AI) technologies have been charged with substituting mindless mimicry of human behaviour for the real presence of conscious caring offered by human nurses. When thus viewed as deceptive, the robots also have prompted corresponding concerns regarding (...) their potential psychological, moral, and spiritual implications for people who will be interacting socially with these machines. The foregoing objections and concerns can be assessed quite differently, depending upon ambient religious beliefs or metaphysical presuppositions. The complaints may be set aside as unnecessary, for example, within religious traditions for which even current robots can be viewed as presenting spiritual aspects. Elsewhere, technological cultures may reject the complaints as expression of outdated superstition, holding that the machines eventually will enjoy a consciousness described entirely in materialist and behaviourist terms. While recognizing such assessments, the authors of this essay propose that the heart of the foregoing objections and concerns may be evaluated, in part, scientifically – albeit with a conclusion recommending fundamental revisions in AI modelling of human mental life. Specifically, considerations now favour introduction of AI models using interactive classical and quantum computation. Without this change, the answer to the essay's title question arguably is ‘no’ – with it, the answer plausibly becomes ‘maybe’. Either outcome holds very interesting implications for nurses. (shrink)

To integrate social robots in real-life contexts, it is crucial that they are accepted by the users. Acceptance is not only related to the functionality of the robot but also strongly depends on how the user experiences the interaction. Established design principles from usability and user experience research can be applied to the realm of human–robot interaction, to design robot behavior for the comfort and well-being of the user. Focusing the design on these aspects alone, however, comes with certain ethical (...) challenges, especially regarding the user’s privacy and autonomy. Based on an example scenario of human–robot interaction in elder care, this paper discusses how established design principles can be used in social robotic design. It then juxtaposes these with ethical considerations such as privacy and user autonomy. Combining user experience and ethical perspectives, we propose adjustments to the original design principles and canvass our own design recommendations for a positive and ethically acceptable social human–robot interaction design. In doing so, we show that positive user experience and ethical design may be sometimes at odds, but can be reconciled in many cases, if designers are willing to adjust and amend time-tested design principles. (shrink)