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)

Developing technology that accounts for values has been achieved in many areas, including security, gaming, finance, engineering, and many more. The main methodological approach has been that of value sensitive design. But most of the work to date has been on the first of its three stages. The focus of this article is on advances related to its second stage, empirical investigation, and in particular the impact of contextual understanding in that stage. Although lessons can be learnt from other domains, (...) the specific context of dementia means that there are nuances to understanding values, including justice and autonomy, that differ from other areas. The integration of value considerations in the development of assistive technology in dementia is explored in two broad categories: the traditional and ongoing need for fixed decision support, and adaptable decision support technologies. For fixed decision support the A&D Benchmark is particularly useful in design. But for adaptable technologies, that benchmark requires further development, including consideration of the values of additional stakeholders, such as the general public. (shrink)

The use of Intelligent Assistive Technology in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations in the (...) design of current IATs. Our screening shows that a significant portion of current IATs is designed in the absence of explicit ethical considerations. These results suggest that the lack of ethical consideration might be a codeterminant of current structural limitations in the translation of IATs from designing labs to bedside. Based on these data, we call for a coordinated effort to proactively incorporate ethical considerations early in the design and development of new products. (shrink)

The purpose of this study was to measure professional and personal values among nurses, and to identify the factors affecting these values. The participants were 323 Israeli nurses, who were asked about 36 personal values and 20 professional values. The three fundamental professional nursing values of human dignity, equality among patients, and prevention of suffering, were rated first. The top 10 rated values all concerned nurses' responsibility towards patients. Altruism and confidentiality were not highly rated, and health promotion and nursing (...) research were rated among the last three professional values. For personal (instrumental) values, honesty, responsibility and intelligence were rated first, while ambition and imagination were rated 14th and 16th respectively out of 18. Significant differences (P < 0.05) were found among some personal and professional values rated as functions of culture, education, professional seniority, position and field of expertise. The results may assist in understanding the motives of nurses with different characteristics and help to promote their work according to professional ethical values. (shrink)

PurposeThe purpose of this paper is to add one further value to the previously articulated “universal values” and to describe the constituent components of three universal values.Design/methodology/approachThis interpretive/constructivist study of Australia's largest online community of seniors involved a 30‐month ethnographic investigation. After an initial period of 11 months of observing social interaction on the entire site, in‐depth, semi‐structured interviews were conducted with 30 participants, selected according to criterion sampling, a form of purposive sampling.FindingsFour key moral values were identified: equality, freedom, (...) respect and trust. All of them had been found in other studies, with equality and respect (as human dignity) identified as universal values. The findings from this study suggest that freedom is another universal value.Originality/valueThis study extends the understanding of universal values to include freedom. Further, it demonstrates the constituent components for freedom, and those of two other universal values previously identified in the literature, equality and human dignity, as well as revealing linkages between these three values. (shrink)

In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and (...) nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care. (shrink)