The concept of social dignity as a yardstick to delimit ethical use of robotic assistance in the care of older persons

Health, Well-Being, Gender, and Dignity in Nursing Care for Older Adults

This article reflects on the concepts of health, well-being, gender, and dignity when providing nursing care to older adults, focusing on their wisdom and the phenomena that can affect their health or improve their quality of life. These concepts are analyzed based on the current health conditions of older adults and their needs, on the perspectives of authors in this field of research, and on Patricia Benner's philosophy: the integration of science, clinical wisdom, and ethics in nursing practice. Furthermore, this article aims at contributing to the health, well-being, gender, and dignity of older adults, despite the discrimination that they may face, as well as to the reality of nursing practice. As such, this study stems from the observed reality, experiences as caregivers and reflection of nurses committed to the values of the profession. Therefore, the article begins with the conceptualization of health, well-being, gender, and dignity, subsequently analyzing the health-disease status of older adults from a gender perspective, addressing nursing care for older adults based on Patricia Benner's philosophy and concluding with reflections on nursing practice for a better future for older adults.

Remote Technologies and Filial Obligations at a Distance: New Opportunities and Ethical Challenges

The coupled growth of population aging and international migration warrants attention on the methods and solutions available to adult children living overseas to provide distance caregiving for their aging parents. Despite living apart from their parents, the transnational informal care literature has indicated that first-generation immigrants remain committed to carry out their filial caregiving obligations in extensive and creative ways. With functions to remotely access health information enabled by emergency, wearable, motion, and video sensors, remote monitoring technologies (RMTs) may thus also allow these international migrants to be alerted in sudden changes and remain informed of their parent's state of health. As technological solutions for caregiving, RMTs could allow independent living for older persons while any unusual deviations from normal health patterns are detected and appropriately supported. With a vignette of a distance care arrangement, we engage with concepts such as filial piety, in-absentia caregiving distress, and the social exchange theory, as well as the upholding of shifting cultural ideals to illustrate the complex dynamic of the satisfaction and quality of the informal caregiving relationship. This paper extends the traditional ethical issues in technology-aided caregiving, such as autonomy, privacy, and justice, to be considered within the context of distance care. We also posit newer ethical considerations such as consent in power imbalances, harm to caregivers, and stigma. These known and new ethical issues aim to encourage further ethically conscious design and use of RMTs to support distance care for older persons.

Mapping ethical issues in the use of smart home health technologies to care for older persons: a systematic review

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.

Social Robots Outdo the Not-So-Social Media for Self-Disclosure: Safe Machines Preferred to Unsafe Humans?

COVID-19 may not be a ‘youth disease’ but it nevertheless impacts the life of young people dramatically, loneliness and a negative mood being an unexpected additional pandemic. Many young people rely on social media for their feeling of connectedness with others. However, social media is suggested to have many negative effects on people’s anxiety. Instead of self-disclosing to others, design may develop alternatives to employ social robots for self-disclosure. In a follow-up on earlier work, we report on a lab experiment of self-disclosing negative emotions to a social media group as compared to writing a conventional diary journal or to talking to an AI-driven social robot after negative mood induction (i.e., viewing shocking earthquake footage). Participants benefitted the most from talking to a robot rather than from writing a journal page or sharing their feelings on social media. Self-disclosure on social media or writing a journal page did not differ significantly. In the design of interventions for mental well-being, human helpers thus far took center stage. Based on our results, we propose design alternatives for an empathic smart home, featuring social robots and chatbots for alleviating stress and anxiety: a social-media interference chatbot, smart watch plus speaker, and a mirror for self-reflection.