Background The worldwide increase in older persons demands technological solutions to combat the shortage of caregiving and to enable aging in place. Smart home health technologies (SHHTs) are promoted and implemented as a possible solution from an economic and practical perspective. However, ethical considerations are equally important and need to be investigated. Methods We conducted a systematic review according to the PRISMA guidelines to investigate if and how ethical questions are discussed in the field of SHHTs in caregiving for older (...) persons. Results 156 peer-reviewed articles published in English, German and French were retrieved and analyzed across 10 electronic databases. Using narrative analysis, 7 ethical categories were mapped: privacy, autonomy, responsibility, human vs. artificial interactions, trust, ageism and stigma, and other concerns. Conclusion The findings of our systematic review show the (lack of) ethical consideration when it comes to the development and implementation of SHHTs for older persons. Our analysis is useful to promote careful ethical consideration when carrying out technology development, research and deployment to care for older persons. Registration We registered our systematic review in the PROSPERO network under CRD42021248543. (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)

A type of transcendental argument for libertarian free will maintains that if acting freely requires the availability of alternative possibilities, and determinism holds, then one is not justified in asserting that there is no free will. More precisely: if an agent A is to be justified in asserting a proposition P (e.g. "there is no free will"), then A must also be able to assert not-P. Thus, if A is unable to assert not-P, due to determinism, then A is not (...) justified in asserting P. While such arguments often appeal to principles with wide appeal, such as the principle that ‘ought’ implies ‘can’, they also require a commitment to principles that seem far less compelling, e.g. the principle that ‘ought’ implies ‘able not to’ or the principle that having an obligation entails being responsible. It is argued here that these further principles are dubious, and that it will be difficult to construct a valid transcendental argument without them. (shrink)

While philosophers have worried about mental causation for centuries, worries about the causal relevance of conscious phenomena are also increasingly featuring in neuroscientific literature. Neuroscientists have regarded the threat of epiphenomenalism as interesting primarily because they have supposed that it entails free will scepticism. However, the steps that get us from a premise about the causal irrelevance of conscious phenomena to a conclusion about free will are not entirely clear. In fact, if we examine popular philosophical accounts of free will, (...) we find, for the most part, nothing to suggest that free will is inconsistent with the presence of unconscious neural precursors to choices. It is only if we adopt highly non-naturalistic assumptions about the mind (e.g. if we embrace Cartesian dualism and locate free choice in the non-physical realm) that it seems plausible to suppose that the neuroscientific data generates a threat to free will. (shrink)

While philosophers have worried about mental causation for centuries, worries about the causal relevance of conscious phenomena are also increasingly featuring in neuroscientific literature. Neuroscientists have regarded the threat of epiphenomenalism as interesting primarily because they have supposed that it entails free will scepticism. However, the steps that get us from a premise about the causal irrelevance of conscious phenomena to a conclusion about free will are not entirely clear. In fact, if we examine popular philosophical accounts of free will, (...) we find, for the most part, nothing to suggest that free will is inconsistent with the presence of unconscious neural precursors to choices. It is only if we adopt highly non-naturalistic assumptions about the mind that it seems plausible to suppose that the neuroscientific data generates a threat to free will. (shrink)

Haji argues that determinism threatens deontic morality, not via a threat to moral responsibility, but directly, because of the principle that ‘ought’ implies ‘can’. Haji’s argument requires not only that we embrace an ‘ought’ implies ‘can’ principle, but also that we adopt the principle that ‘ought’ implies ‘able not to’. I argue that we have little reason to adopt the latter principle, and examine whether deontic morality might be destroyed on the basis of the more commonly embraced ‘ought’ implies ‘can’ (...) principle alone. I argue that despite what look like initially compelling reasons why we might suppose that this weaker conclusion is similarly destructive to deontic morality, we actually have good reason to doubt that it has any practical relevance for moral deliberation at all. (shrink)

The global scale of contemporary human life and activity places us in a generic conflict between our identity as individuals and our awareness of the individual's global responsibilities. We face a conflict between the reassuring condition of living according to tradition and the unsettling condition of living in the "new continent" where human self-constitution has global implications. The cohesive set of shared traditional values and ideals is effectively overwritten by the possibility and necessity of innovation in response to global demands. (...) Many paths between the ideal of universahsm and the individual's instantiation in tradition have been contemplated by philosophers and social activists. Given the current dynamics of change, most of these projects, while of good intendon, are nevertheless profoundly naïve in their fundamental assumptions. We are at a crossroads in which we experience a condition of instability that precedes any fundamental bifurcation. But in contrast to the dominant view that instability is by definition negative, we are witnessing an extraordinary explosion of creativity. (shrink)

The notion of computation has changed the world more than any previous expressions of knowledge. However, as know-how in its particular algorithmic embodiment, computation is closed to meaning. Therefore, computer-based data processing can only mimic life’s creative aspects, without being creative itself. AI’s current record of accomplishments shows that it automates tasks associated with intelligence, without being intelligent itself. Mistaking the abstract for the concrete has led to the religion of “everything is an output of computation”—even the humankind that conceived (...) the computer. The hypostatized role of computers explains the increased dependence on them. The convergence machine called deep learning is only the most recent form through which the deterministic theology of the machine claims more than what it actually is: extremely effective data processing. A proper understanding of complexity, as well as the need to distinguish between the reactive nature of the artificial and the anticipatory nature of the living are suggested as practical responses to the challenges posed by machine theology. (shrink)

Since our moral and legal judgments are focused on our decisions and actions, one would expect information about the neural underpinnings of human decision-making and action-production to have a significant bearing on those judgments. However, despite the wealth of empirical data, and the public attention it has attracted in the past few decades, the results of neuroscientific research have had relatively little influence on legal practice. It is here argued that this is due, at least partly, to the discussion on (...) the relationship of the neurosciences and law mixing up a number of separate issues that have different relevance on our moral and legal judgments. The approach here is hierarchical; more and less feasible ways in which neuroscientific data could inform such judgments are separated from each other. The neurosciences and other physical views on human behavior and decision-making do have the potential to have an impact on our legal reasoning. However, this happens in various different ways, and too often appeal to any neural data is assumed to be automatically relevant to shaping our moral and legal judgments. Our physicalist intuitions easily favor neural-level explanations to mental-level ones. But even if you were to subscribe to some reductionist variant of physicalism, it would not follow that all neural data should be automatically relevant to our moral and legal reasoning. However, the neurosciences can give us indirect evidence for reductive physicalism, which can then lead us to challenge the very idea of free will. Such a development can, ultimately, also have repercussions on law and legal practice. (shrink)

If complexity is a necessary but not sufficient premise for the existence and expression of the living, anticipation is the distinguishing characteristic of what is alive. Anticipation is at work even at levels of existence where we cannot refer to intelligence. The prospect of artificially generating aesthetic artifacts and ethical constructs of relevance to a world in which the natural and the artificial are coexistent cannot be subsumed as yet another product of scientific and technological advancement. Beyond the artificial, the (...) synthetic conjures the understanding of aesthetics and ethics no longer from the perspective of the How? type of question, but rather the Why? Given the current infatuation with synthetic biology (i.e., making life from non-life), there is a practical consequence to such considerations. Synthetic life, as any other form of life, implies the possibility of evolution. Anticipation, which is the underlying factor of evolution, is thus expected. At the level of human existence, anticipation is expressed, for instance (but not exclusively), in aesthetic forms and ethical values. This translates, in turn, into an argument for the role aesthetics and ethics play in the process. Consequently, to qualify as life, the synthesis of the physical and the living will have to efficiently handle ambiguity. Current computational facilities, regardless of their nature or performance, operate exclusively in the semiotic domain of the well defined non-ambiguous. (shrink)

Justified by spectacular achievements facilitated through applied deep learning methodology, the “Everything is possible” view dominates this new hour in the “boom and bust” curve of AI performance. The optimistic view collides head on with the “It is not possible”—ascertainments often originating in a skewed understanding of both AI and medicine. The meaning of the conflicting views can be assessed only by addressing the nature of medicine. Specifically: Which part of medicine, if any, can and should be entrusted to AI—now (...) or at some moment in the future? AI or not, medicine should incorporate the anticipation perspective in providing care. (shrink)