Designing robots for care: care centered value-sensitive design

The ethics of artificial intelligence systems in healthcare and medicine: from a local to a global perspective, and back

Artificial intelligence systems (ai-systems) (e.g. machine learning, generative artificial intelligence), in healthcare and medicine, have been received with hopes of better care quality, more efficiency, lower care costs, etc. Simultaneously, these systems have been met with reservations regarding their impacts on stakeholders' privacy, on changing power dynamics, on systemic biases, etc. Fortunately, healthcare and medicine have been guided by a multitude of ethical principles, frameworks, or approaches, which also guide the use of ai-systems in healthcare and medicine, in one form or another. Nevertheless, in this article, I argue that most of these approaches are inspired by a local isolationist view on ai-systems, here exemplified by the principlist approach. Despite positive contributions to laying out the ethical landscape of ai-systems in healthcare and medicine, such ethics approaches are too focused on a specific local healthcare and medical setting, be it a particular care relationship, a particular care organisation, or a particular society or region. By doing so, they lose sight of the global impacts ai-systems have, especially environmental impacts and related social impacts, such as increased health risks. To meet this gap, this article presents a global approach to the ethics of ai-systems in healthcare and medicine which consists of five levels of ethical impacts and analysis: individual-relational, organisational, societal, global, and historical. As such, this global approach incorporates the local isolationist view by integrating it in a wider landscape of ethical consideration so to ensure ai-systems meet the needs of everyone everywhere.

Compassionate Care with Autonomous AI Humanoid Robots in Future Healthcare Delivery: A Multisensory Simulation of Next-Generation Models

The integration of AI and robotics in healthcare raises concerns, and additional issues regarding autonomous systems are anticipated. Effective communication is crucial for robots to be seen as "caring", necessitating advanced mechatronic design and natural language processing (NLP). This paper examines the potential of humanoid robots to autonomously replicate compassionate care. The study employs computational simulations using mathematical and agent-based modeling to analyze human-robot interactions (HRIs) surpassing Tetsuya Tanioka's TRETON. It incorporates stochastic elements (through neuromorphic computing) and quantum-inspired concepts (through the lens of Martha Rogers' theory), running simulations over 100 iterations to analyze complex behaviors. Multisensory simulations (visual and audio) demonstrate the significance of "dynamic communication", (relational) "entanglement", and (healthcare system and robot's function) "superpositioning" in HRIs. Quantum and neuromorphic computing may enable humanoid robots to empathetically respond to human emotions, based on Jean Watson's ten caritas processes for creating transpersonal states. Autonomous AI humanoid robots will redefine the norms of "caring". Establishing "pluralistic agreements" through open discussions among stakeholders worldwide is necessary to align innovations with the values of compassionate care within a "posthumanist" framework, where the compassionate care provided by Level 4 robots meets human expectations. Achieving compassionate care with autonomous AI humanoid robots involves translating nursing, communication, computer science, and engineering concepts into robotic care representations while considering ethical discourses through collaborative efforts. Nurses should lead the design and implementation of AI and robots guided by "technological knowing" in Rozzano Locsin's TCCN theory.

HoLLiECares - Development of a multi-functional robot for professional care

Germany's healthcare sector suffers from a shortage of nursing staff, and robotic solutions are being explored as a means to provide quality care. While many robotic systems have already been established in various medical fields (e.g., surgical robots, logistics robots), there are only a few very specialized robotic applications in the care sector. In this work, a multi-functional robot is applied in a hospital, capable of performing activities in the areas of transport and logistics, interactive assistance, and documentation. The service robot platform HoLLiE was further developed, with a focus on implementing innovative solutions for handling non-rigid objects, motion planning for non-holonomic motions with a wheelchair, accompanying and providing haptic support to patients, optical recognition and control of movement exercises, and automated speech recognition. Furthermore, the potential of a robot platform in a nursing context was evaluated by field tests in two hospitals. The results show that a robot can take over or support certain tasks. However, it was noted that robotic tasks should be carefully selected, as robots are not able to provide empathy and affection that are often required in nursing. The remaining challenges still exist in the implementation and interaction of multi-functional capabilities, ensuring ease of use for a complex robotic system, grasping highly heterogeneous objects, and fulfilling formal and infrastructural requirements in healthcare (e.g., safety, security, and data protection).

Emotional Labor and the Problem of Exploitation in Roboticized Care Practices: Enriching the Framework of Care Centred Value Sensitive Design

Care ethics has been advanced as a suitable framework for evaluating the ethical significance of assistive robotics. One of the most prominent care ethical contributions to the ethical assessment of assistive robots comes through the work of Aimee Van Wynsberghe, who has developed the Care-Centred Value-Sensitive Design framework (CCVSD) in order to incorporate care values into the design of assistive robots. Building upon the care ethics work of Joan Tronto, CCVSD has been able to highlight a number of ways in which care practices can undergo significant ethical transformations upon the introduction of assistive robots. In this paper, we too build upon the work of Tronto in an effort to enrich the CCVSD framework. Combining insights from Tronto's work with the sociological concept of emotional labor, we argue that CCVSD remains underdeveloped with respect to the impact robots may have on the emotional labor required by paid care workers. Emotional labor consists of the managing of emotions and of emotional bonding, both of which signify a demanding yet potentially fulfilling dimension of paid care work. Because of the conditions in which care labor is performed nowadays, emotional labor is also susceptible to exploitation. While CCVSD can acknowledge some manifestations of unrecognized emotional labor in care delivery, it remains limited in capturing the structural conditions that fuel this vulnerability to exploitation. We propose that the idea of privileged irresponsibility, coined by Tronto, helps to understand how the exploitation of emotional labor can be prone to happen in roboticized care practices.

From care practices to speculative vignettes-design considerations for robots in good care

The care sector has become one of the test beds for developing robotic technologies, which have been promised to mitigate problems with aging populations and labor shortages. Despite these promises, the practical application of such technologies have been met with limited success. Apart from technical limitations, other challenges exist in the way we approach designing these technologies. Critical to the development in the care sector is understanding the complexity of the contexts, the needs and goals of diverse actors, and how these are socio-materially scaffolded. This paper presents a study conducted at the intersection of a value sensitive design and speculative design to understand these sensitivities. Based on the data collected in interviews (n = 6) and card workshops (n = 6) from care workers and residents in mobile care and care home contexts in Austria, we developed five themes capturing situated practices and understandings of good care as built on trust-developing routines, negotiations between different actors, affective and reciprocal dimension of care, care worker self-care, and material mediations. Subsequently, we created six speculative vignettes which serve as rhetorical devices to emphasize the tensions that arise with any technological intervention entering and reshaping existing care practices and relations. We argue that our approach can support robot designers to develop a rich understanding of the values and tensions in the specific context under study from the before design and development begin.

Developing digital competencies of nursing professionals in continuing education and training - a scoping review

Introduction

The German health and care system is transforming due to advancing digitalization. New technological applications in nursing, such as social and assistance robotics, artificial intelligence and legal framework conditions are increasingly focused in numerous research projects. However, the approaches to digitalization in nursing are very different. When integrating technologies such as robotics and artificial intelligence into nursing, it is particularly important to ensure that ethical and human aspects are taken into account. A structured classification of the development of digitalization in nursing care is currently hardly possible. In order to be able to adequately deal with this digital transformation, the acquisition of digital competences in nursing education programs is pivotal. These include the confident, critical and creative use of information and communication technologies in a private and professional context. This paper focuses on the question which specific training offers already exist at national and international level for nursing professions to acquire digital competences.

Methods

A scoping review according to the PRISMA scheme was conducted in the PubMed and CINAHL databases. The search period for the scoping review extended from 2017 to 2024.

Results

The selection of the studies took place by inclusion and exclusion criteria and the content-related orientation of the publications. After reviewing the titles and abstracts, eight studies were included. Of these, four were published in German-speaking countries and another four in international English-language journals.

Discussion

The topic of digitization of the nursing professions and the question of how nurses can acquire digital competences is gaining international attention. Nevertheless, the research on explicit continuing education programs for nursing professions is still undifferentiated. No specific continuing education offer for the development of digital competences of nursing professionals was identified. Many authors remained at the meta-level when developing methodological concepts for the acquisition of digital competences. The systematic integration of digitalization into higher education and continuing vocational training is mentioned in the publications. The development of theory- and research-based educational frameworks, which can be used as a basis for curricula in nursing studies and continuing education, is highly recommendable.

Promising directions for human-robot interactions defined by older adults

Introduction: Older adults are engaging more and more with voice-based agent and social robot technologies, and roboticists are increasingly designing interactions for these systems with older adults in mind. Older adults are often not included in these design processes, yet there are many opportunities for older adults to collaborate with design teams to design future robot interactions and help guide directions for robot development. Methods: Through a year-long co-design project, we collaborated with 28 older adults to understand the key focus areas that older adults see promise in for older adult-robot interaction in their everyday lives and how they would like these interactions to be designed. This paper describes and explores the robot-interaction guidelines and future directions identified by older adults, specifically investigating the change and trajectory of these guidelines through the course of the co-design process from the initial interview to the design guideline generation session to the final interview. Results were analyzed through an adapted ethnographic decision tree modeling approach to understand older adults' decision making surrounding the various focus areas and guidelines for social robots. Results: Overall, over the course of the co-design process between the beginning and end, older adults developed a better understanding of the robot that translated to them being more certain of their attitudes of how they would like a robot to engage with them in their lives. Older adults were more accepting of transactional functions such as reminders and scheduling and less open to functions that would involve sharing sensitive information and tracking and/or monitoring of them, expressing concerns around surveillance. There was some promise in robot interactions for connecting with others, body signal monitoring, and emotional wellness, though older adults brought up concerns around autonomy, privacy, and naturalness of the interaction with a robot that need to be further explored. Discussion: This work provides guidance for future interaction development for robots that are being designed to interact with older adults and highlights areas that need to be further investigated with older adults to understand how best to design for user concerns.

Sustainable integration of digitalisation in nursing education-an international scoping review

Introduction

Trainees and teachers at nursing schools as well as nursing professionals are increasingly facing new challenges as a result of the digital transformation. Opportunities for the entire care system exist in the improvement of care quality and communication between those involved. However, this change also harbours risks, such as the use of immature digital applications in the care sector, data theft and industrial espionage. In order to be able to exploit the potential of digitalisation despite these risks, it is necessary to integrate relevant aspects such as digital skills into nursing training. The aim of this study is to investigate the extent to which the sustainable integration of digitalisation in nursing education is discussed.

Methods

The methods of the systematic literature and database search were carried out in the form of a scoping review according to the PRISMA scheme. The PubMed and CINAHL databases were used for this purpose. The search period covered the years 2017-2023.

Findings

After screening the titles and abstracts using inclusion and exclusion criteria, 13 studies were included in the synthesis of findings. The international literature focuses on content areas that highlight trends in digitalisation-related training in nursing. These focal points include concept development, considering the heterogeneity of demand constellations, as well as the reflexive reorientation of existing competences, whereby the technological competence of teachers is not disregarded. Other focal points relate to the initiation of digital skills in training and maintaining the employability of older nursing staff through professional development.

Discussion

The literature research shows that there is a rudimentary discussion about digitalisation and curricular developments in nursing training in an international context, while the discourse in the German-language literature is less advanced. Among the sustainability desiderata derived from the literature is the involvement of nursing professionals in the development, testing and implementation of digital technologies. Only through active cooperation between nursing professionals and nursing sciences can the topic of digitalisation be integrated into the education and training of professional nursing in a targeted and future-oriented manner, whereby the focus should always be on the ability to deal with digital technologies and the associated change.

Care-ethical considerations of technology-care-assemblages

Technology plays a major role in care. Against the background of demographic ageing, the use of assistive technologies to support and relieve carers in their work is becoming more and more important. One sector that is increasingly coming into focus is home care by family caregivers. Here, the use of assistive technologies takes place under specific conditions. The article proposes a care-ethical perspective to understand these conditions. It critically discusses issues of power and participation in the negotiation of care that can be associated with the use of technology and outlines a care-ethical perspective on technocare.

More Process, Less Principles: The Ethics of Deploying AI and Robotics in Medicine

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.

Views about perceived training needs of health care professionals in relation to socially assistive robots: an international online survey

BACKGROUND

As Artificial Intelligence and social robots are increasingly used in health and social care, it is imperative to explore the training needs of the workforce, factoring in their cultural background.

OBJECTIVES

Explore views on perceived training needs among professionals around the world and how these related to country cultures.

DESIGN

Cross-sectional, descriptive, mixed-methods international online survey.

METHODS

Descriptive statistical analysis explored the ranking across countries and relationships with three Hofstede cultural dimensions. Thematic analysis was conducted on the open-ended text responses.

RESULTS

A sample of N = 1284 participants from eighteen countries. Knowing the capabilities of the robots was ranked as the top training need across all participating countries and this was also reflected in the thematic analysis. Participants' culture, expressed through three Hofstede's dimensions, revealed statistically significant ranking differences.

CONCLUSIONS

Future research should further explore other factors such as the level of digital maturity of the workplace.

IMPACT STATEMENT

Training needs of health and social care staff to use robotics are fast growing and preparation should factor in patient safety and be based on the principles of person- and culture-centred care.

Care robot research and development plan for disability and aged care in Korea: A mixed-methods user participation study

The population of Korea is aging rapidly, and this has led to a care burden for caregivers. Without adequate caregivers to address the increased burden, people with significant disabilities and older adults with disabilities who have greatly reduced mobility are at risk. The aim of this study was to determine suitable types of care robots for care applications in Korea and formulate a strategy for a future care robot R&D plan through a user participation study. We categorized nine types of care robots that are suitable for the care needs in Korea. By adopting a mixed research methodology involving user participation, we conducted discussions with caregivers, care receivers, and other stakeholders under a public-private-people partnership model. We also identified five primary strategies for care robot R&D: (1) intensive investment to match the needs of people with very severe disabilities to care robot technologies, particularly for transfer, repositioning, toileting, and feeding; (2) translational research and technology development; (3) realization of smart-care through fourth industrial revolution (i.e., digital) technologies; (4) user-centered research with stakeholders; and (5) building of a care robot ecosystem. The formulated plan would be shared with other developers and clinical experts to drive development of suitable care robots.

AI-assisted ethics? considerations of AI simulation for the ethical assessment and design of assistive technologies

Current ethical debates on the use of artificial intelligence (AI) in healthcare treat AI as a product of technology in three ways. First, by assessing risks and potential benefits of currently developed AI-enabled products with ethical checklists; second, by proposing ex ante lists of ethical values seen as relevant for the design and development of assistive technology, and third, by promoting AI technology to use moral reasoning as part of the automation process. The dominance of these three perspectives in the discourse is demonstrated by a brief summary of the literature. Subsequently, we propose a fourth approach to AI, namely, as a methodological tool to assist ethical reflection. We provide a concept of an AI-simulation informed by three separate elements: 1) stochastic human behavior models based on behavioral data for simulating realistic settings, 2) qualitative empirical data on value statements regarding internal policy, and 3) visualization components that aid in understanding the impact of changes in these variables. The potential of this approach is to inform an interdisciplinary field about anticipated ethical challenges or ethical trade-offs in concrete settings and, hence, to spark a re-evaluation of design and implementation plans. This may be particularly useful for applications that deal with extremely complex values and behavior or with limitations on the communication resources of affected persons (e.g., persons with dementia care or for care of persons with cognitive impairment). Simulation does not replace ethical reflection but does allow for detailed, context-sensitive analysis during the design process and prior to implementation. Finally, we discuss the inherently quantitative methods of analysis afforded by stochastic simulations as well as the potential for ethical discussions and how simulations with AI can improve traditional forms of thought experiments and future-oriented technology assessment.

The Care-Dependent are Less Averse to Care Robots: An Empirical Comparison of Attitudes

A growing gap is emerging between the supply of and demand for professional caregivers, not least because of the ever-increasing average age of the world's population. One strategy to address this growing gap in many regions is the use of care robots. Although there have been numerous ethical debates about the use of robots in nursing and elderly care, an important question remains unexamined: how do the potential recipients of such care perceive situations with care robots compared to situations with human caregivers? Using a large-scale experimental vignette study, we investigated people's affective attitudes toward care robots. Specifically, we studied the influence of the caregiver's nature on participants' perceived comfort levels when confronted with different care scenarios in nursing homes. Our results show that the care-robot-related views of actual care recipients (i.e., people who are already affected by care dependency) differ substantially from the views of people who are not affected by care dependency. Those who do not (yet) rely on care placed care robots' value far below that of human caregivers, especially in a service-oriented care scenario. This devaluation was not found among care recipients, whose perceived level of comfort was not influenced by the caregiver's nature. These findings also proved robust when controlled for people's gender, age, and general attitudes toward robots.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12369-023-01003-2.

Reflections on Putting AI Ethics into Practice: How Three AI Ethics Approaches Conceptualize Theory and Practice

Critics currently argue that applied ethics approaches to artificial intelligence (AI) are too principles-oriented and entail a theory-practice gap. Several applied ethical approaches try to prevent such a gap by conceptually translating ethical theory into practice. In this article, we explore how the currently most prominent approaches of AI ethics translate ethics into practice. Therefore, we examine three approaches to applied AI ethics: the embedded ethics approach, the ethically aligned approach, and the Value Sensitive Design (VSD) approach. We analyze each of these three approaches by asking how they understand and conceptualize theory and practice. We outline the conceptual strengths as well as their shortcomings: an embedded ethics approach is context-oriented but risks being biased by it; ethically aligned approaches are principles-oriented but lack justification theories to deal with trade-offs between competing principles; and the interdisciplinary Value Sensitive Design approach is based on stakeholder values but needs linkage to political, legal, or social governance aspects. Against this background, we develop a meta-framework for applied AI ethics conceptions with three dimensions. Based on critical theory, we suggest these dimensions as starting points to critically reflect on the conceptualization of theory and practice. We claim, first, that the inclusion of the dimension of affects and emotions in the ethical decision-making process stimulates reflections on vulnerabilities, experiences of disregard, and marginalization already within the AI development process. Second, we derive from our analysis that considering the dimension of justifying normative background theories provides both standards and criteria as well as guidance for prioritizing or evaluating competing principles in cases of conflict. Third, we argue that reflecting the governance dimension in ethical decision-making is an important factor to reveal power structures as well as to realize ethical AI and its application because this dimension seeks to combine social, legal, technical, and political concerns. This meta-framework can thus serve as a reflective tool for understanding, mapping, and assessing the theory-practice conceptualizations within AI ethics approaches to address and overcome their blind spots.

Designing for Care

This article introduces Designing for Care (D4C), a distinctive approach to project management and technological design informed by Care Ethics. We propose to conceptualize "care" as both the foundational value of D4C and as its guiding mid-level principle. As a value, care provides moral grounding. As a principle, it equips D4C with moral guidance to enact a caring process. The latter is made of a set of concrete, and often recursive, caring practices. One of the key assumption of D4C is a relational ontology of individual and group identities, which fosters the actualization of caring practices as essentially relational and (often) reciprocal. Moreover, D4C adopts the "ecological turn" in CE and stresses the ecological situatedness and impact of concrete projects, envisioning an extension of caring from intra-species to inter-species relations. We argue that care and caring can influence directly some of the phases and practices within the management of (energy) projects and the design of sociotechnical (energy) artefacts and systems. When issues related to "value change" emerge as problematic (e.g., values trade-offs, conflicts), the mid-level guiding principle of care helps evaluate and prioritize different values at stake within specific projects. Although there may be several actors and stakeholders involved in project management and technological design, here we will focus on the professionals in charge of imagining, designing, and carrying out these processes (i.e., project managers, designers, engineers). We suggest that adopting D4C would improve their ability to capture and assess stakeholders' values, critically reflect on and evaluate their own values, and judge which values prioritize. Although D4C may be adaptable to different fields and design contexts, we recommend its use especially within small and medium-scale (energy) projects. To show the benefits of adopting it, we envisage the application of D4C within the project management and the technological design of a community battery. The adoption of D4C can have multiple positive effects: transforming the mentality and practice of managing a project and designing technologies; enhancing caring relationships between managers, designers, and users as well as among users; achieving better communication, more inclusive participation, and more just decision-making. This is an initial attempt to articulate the structure and the procedural character of D4C. The application of D4C in a concrete project is needed to assess its actual impact, benefits, and limitations.

The participatory value-sensitive design (VSD) of a mHealth app targeting citizens with dementia in a Danish municipality

The Sammen Om Demens (together for dementia), a citizen science project developing and implementing an AI-based smartphone app targeting citizens with dementia, is presented as an illustrative case of ethical, applied AI entailing interdisciplinary collaborations and inclusive and participative scientific practices engaging citizens, end users, and potential recipients of technological-digital innovation. Accordingly, the participatory Value-Sensitive Design of the smartphone app (a tracking device) is explored and explained across all of its phases (conceptual, empirical, and technical). Namely, from value construction and value elicitation to the delivery, after various iterations engaging both expert and non-expert stakeholders, of an embodied prototype built on and tailored to their values. The emphasis is on how moral dilemmas and value conflicts, often resulting from diverse people's needs or vested interests, have been resolved in practice to deliver a unique digital artifact with moral imagination that fulfills vital ethical-social desiderata without undermining technical efficiency. The result is an AI-based tool for the management and care of dementia that can be considered more ethical and democratic, since it meaningfully reflects diverse citizens' values and expectations on the app. In the conclusion, we suggest that the co-design methodology outlined in this study is suitable to generate more explainable and trustworthy AI, and also, it helps to advance towards technical-digital innovation holding a human face.

Care Ethics and the Future of Work: a Different Voice

The discourse on the future of work should learn from a turn in philosophy that occurred in the 1980s, one that recognizes the good life towards which ethics strives can only be reached on a foundation of caring relationships (Gillian, 1982; Noddings, 1984). Care ethics recognizes that human well-being is a group project, one that involves strong relationships, and concern for bodies and emotions. Too often, these features are left out of research exploring robotics in the workplace. This paper outlines the main tenets of care ethics, then applies the moral framework to the context of industrial and retail settings using robots. This approach sees these contexts through a relational lens, helping to identify, evaluate, and improve relationships critical to ensuring workers' well-being. Second, care ethics considers taking care of people's bodies beyond mere safety, examining how working with robots can exacerbate societal or economic pressures. Lastly, care ethics takes emotions as an important source of knowledge in building and supporting care. Additionally, this paper contributes to the care ethics literature by applying the framework to the context of robotized industrial workplaces, which has yet to be done.

[Artificial intelligence and ethics in healthcare-balancing act or symbiosis?]

Artificial intelligence (AI) is becoming increasingly important in healthcare. This development triggers serious concerns that can be summarized by six major "worst-case scenarios". From AI spreading disinformation and propaganda, to a potential new arms race between major powers, to a possible rule of algorithms ("algocracy") based on biased gatekeeper intelligence, the real dangers of an uncontrolled development of AI are by no means to be underestimated, especially in the health sector. However, fear of AI could cause humanity to miss the opportunity to positively shape the development of our society together with an AI that is friendly to us.Use cases in healthcare play a primary role in this discussion, as both the risks and the opportunities of new AI-based systems become particularly clear here. For example, would older people with dementia (PWD) be allowed to entrust aspects of their autonomy to AI-based assistance systems so that they may continue to independently manage other aspects of their daily lives? In this paper, we argue that the classic balancing act between the dangers and opportunities of AI in healthcare can be at least partially overcome by taking a long-term ethical approach toward a symbiotic relationship between humans and AI. We exemplify this approach by showcasing our I‑CARE system, an AI-based recommendation system for tertiary prevention of dementia. This system has been in development since 2015 as the I‑CARE Project at the University of Bremen, where it is still being researched today.

Justice, Equity, Diversity, and Inclusion Curriculum Within an Introductory Bioengineering Course

Curriculum initiatives that provide the societal context of engineering practice can contribute to justice, equity, diversity, and inclusion (JEDI) within the profession, as well as within the communities served by engineers. JEDI curriculum can foster diversity and inclusion by acknowledging and addressing social justice issues, providing a safe and inclusive space for students' voices to be heard, and advancing a productive dialogue within their institution of higher learning. Furthermore, such curriculum initiatives can empower students with the theoretical frameworks, analytical tools, and knowledge base to recognize and address ethical challenges and opportunities related to justice, equity, diversity, and inclusion in their field. This Teaching Tips paper offers a description of a pilot program to incorporate JEDI material within a core bioengineering course modeled on evidence-based curriculum programs to embed ethics within technical courses. The author and collaborators sought to achieve two aims with the JEDI-focused material: (1) for students to learn how justice, equity, diversity, and inclusion intersect with bioengineering practice through an interdisciplinary lens of history, philosophy, sociology and anthropology which provide strong scholarly frameworks and theoretical foundations and (2) for students to participate in and foster an inclusive environment within their own educational institution through effectively communicating about these topics with each other. At the conclusion of the semester, a student survey indicated an overwhelmingly positive reception of the material. This paper will discuss the interdisciplinary curriculum development initiative, how the learning objectives were addressed by the specific lesson plans, and challenges to be addressed to create a sustainable educational model for the program.

Maximizing team synergy in AI-related interdisciplinary groups: an interdisciplinary-by-design iterative methodology

In this paper, we propose a methodology to maximize the benefits of interdisciplinary cooperation in AI research groups. Firstly, we build the case for the importance of interdisciplinarity in research groups as the best means to tackle the social implications brought about by AI systems, against the backdrop of the EU Commission proposal for an Artificial Intelligence Act. As we are an interdisciplinary group, we address the multi-faceted implications of the mass-scale diffusion of AI-driven technologies. The result of our exercise lead us to postulate the necessity of a behavioural theory that standardizes the interaction process of interdisciplinary groups. In light of this, we conduct a review of the existing approaches to interdisciplinary research on AI appliances, leading to the development of methodologies like ethics-by-design and value-sensitive design, evaluating their strengths and weaknesses. We then put forth an iterative process theory hinging on a narrative approach consisting of four phases: (i) definition of the hypothesis space, (ii) building-up of a common lexicon, (iii) scenario-building, (iv) interdisciplinary self-assessment. Finally, we identify the most relevant fields of application for such a methodology and discuss possible case studies.

Which Framework to Use? A Systematic Review of Ethical Frameworks for the Screening or Evaluation of Health Technology Innovations

Innovations permeate healthcare settings on an ever-increasing scale. Health technology innovations (HTIs) impact our perceptions and experiences of health, care, disease, etc. Because of the fast pace these HTIs are being introduced in different healthcare settings, there is a growing societal consensus that these HTIs need to be governed by ethical reflection. This paper reports a systematic review of argument-based literature which focused on articles reporting on ethical frameworks to screen or evaluate HTIs. To do this a four step methodology was followed: (1) Literature search conducted in five electronic literature databases; (2) Identification of relevant articles; (3) Development of data-extraction tool to analyze the included articles; (4) Analysis, synthesis of data and reporting of results. Fifty-seven articles were included, each reporting on a specific ethical framework. These ethical frameworks existed out of characteristics which were grouped into five common ones: (1) Motivations for development and use of frameworks; (2) Objectives of using frameworks; (3) Specific characteristics of frameworks (background context, scope, and focus); (4) Ethical approaches and concepts used in the frameworks; (5) Methods to use the frameworks. Although this multiplicity of ethical frameworks shows an increasing importance of ethically analyzing HTIs, it remains unclear what the specific role is of these analyses. An ethics of caution, on which ethical frameworks rely, guides HTIs in their design, development, implementation, without questioning their technological paradigm. An ethics of desirability questions this paradigm, without guiding HTIs. In the end, a place needs to be found in-between, to critically assess HTIs.

Characteristics of interactive communication between Pepper robot, patients with schizophrenia, and healthy persons

Background

Expressing enjoyment when conversing with healthcare robots is an opportunity to enhance the value of human robots with interactive capabilities. In clinical practice, it is common to find verbal dysfunctions in patients with schizophrenia. Thus, interactive communication characteristics may vary between Pepper robot, persons with schizophrenia, and healthy persons.

Objective

Two case studies aimed to describe the characteristics of interactive communications, 1) between Pepper as a healthcare robot and two patients with schizophrenia, and 2) between Pepper as a healthcare robot and two healthy persons.

Case Report

The "Intentional Observational Clinical Research Design" was used to collect data. Using audio-video technology, the conversational interactions between the four participants with the Pepper healthcare robot were recorded. Their interactions were observed, with significant events noted. After their interactions, the four participants were interviewed regarding their experience and impressions of interacting with the Pepper healthcare robot. Audio-video recordings were analyzed following the analysis and interpretation protocol, and the interview data were transcribed, analyzed, and interpreted.

Discussion

There were similarities and differences in the interactive communication characteristics between the Pepper robot and the two participants with schizophrenia and between Pepper and the two healthy participants. The similarities were experiences of human enjoyment while interacting with the Pepper robot. This enjoyment was enhanced with the expectancy of the Pepper robot as able to entertain, and possessing interactive capabilities, indicating two-way conversational abilities. However, different communicating characteristics were found between the healthy participants' impressions of the Pepper robot and the participants with schizophrenia. Healthy participants understood Pepper to be an automaton, with responses to questions often constrained and, on many occasions, displaying inaccurate gaze.

Conclusion

Pepper robot showed capabilities for effective communication pertaining to expressing enjoyment. The accuracy and appropriateness of gaze remained a critical characteristic regardless of the situation or occasion with interactions between persons with schizophrenia, and between healthy persons. It is important to consider that in the future, for effective use of healthcare robots with multiple users, improvements in the areas of the appropriateness of gaze, response time during the conversation, and entertaining functions are critically observed.

Parity and the Resolution of Value Conflicts in Design

Recent developments in theories for responsible innovation have focused on the importance of actively accounting for values in our technological designs. Leading among these theories is that of Value Sensitive Design (VSD) which attempts to guide the design process on the basis of evaluative analysis. However, values often come into conflict and VSD has been criticized for not providing a proper method to resolve such inevitable conflicts. This paper examines three such methods and argues that although each has its merits, they all fail to account for a common source of value conflicts known as value incommensurability. Drawing on literature from the field of axiology, this paper argues that by incorporating the evaluative relation of 'parity' each of these three methods, and the VSD framework in general, will be able to properly understand the relation which holds between conflicting design options stemming from the incommensurable of values and be able to guide designers in making rational decision in the face of such conflicts.

From an Ethics of Carefulness to an Ethics of Desirability: Going Beyond Current Ethics Approaches to Sustainable AI

‘Sustainable AI’ sets itself apart from other AI ethics frameworks by its inherent regard for the ecological costs of AI, a concern that has so far been woefully overlooked in the policy space. Recently, two German-based research and advocacy institutions have published a joint report on Sustainability Criteria for Artificial Intelligence. This is, to our knowledge, the first AI ethics document in the policy space that puts sustainability at the center of its considerations. We take this as an opportunity to highlight the foundational problems we see in current debates about AI ethics guidelines. Although we do believe the concept of sustainability has the potential to introduce a paradigm shift, we question whether the suggestions and conceptual grounding found in this report have the strength to usher it in. We show this by presenting this new report as an example of current approaches to AI ethics and identify the problems of this approach, which we will describe as ‘checklist ethics’ and ‘ethics of carefulness’. We argue to opt for an ‘ethics of desirability’ approach. This can be completed, we suggest, by reconceptualizing sustainability as a property of complex systems. Finally, we offer a set of indications for further research.

Harnessing robot experimentation to optimize the regulatory framing of emerging robot technologies

From exoskeletons to lightweight robotic suits, wearable robots are changing dynamically and rapidly, challenging the timeliness of laws and regulatory standards that were not prepared for robots that would help wheelchair users walk again. In this context, equipping regulators with technical knowledge on technologies could solve information asymmetries among developers and policymakers and avoid the problem of regulatory disconnection. This article introduces pushing robot development for lawmaking (PROPELLING), an financial support to third parties from the Horizon 2020 EUROBENCH project that explores how robot testing facilities could generate policy-relevant knowledge and support optimized regulations for robot technologies. With ISO 13482:2014 as a case study, PROPELLING investigates how robot testbeds could be used as data generators to improve the regulation for lower-limb exoskeletons. Specifically, the article discusses how robot testbeds could help regulators tackle hazards like fear of falling, instability in collisions, or define the safe scenarios for avoiding any adverse consequences generated by abrupt protective stops. The article’s central point is that testbeds offer a promising setting to bring policymakers closer to research and development to make policies more attuned to societal needs. In this way, these approximations can be harnessed to unravel an optimal regulatory framework for emerging technologies, such as robots and artificial intelligence, based on science and evidence.

Robots and the Possibility of Humanistic Care

Care robots are likely to perform increasingly sophisticated caring activities that some will consider comforting and valuable. They will get increasingly humanlike and lifelike. This paper addresses the conceptual question: Even if robots can assist and ease people's suffering, can such machines provide humanistic care? Arguably, humanistic care is the most humanly distinctive and deepest form of care there is. As such, it may be thought to show most starkly the gulf between human and robot caregiving. The paper argues that humanistic caregiving is indeed a distinctive form of 'affective' care dependent on certain uniquely human characteristics or aspects of our humanity which can provide a profound kind of comfort to suffering people. It then argues that there is an important conceptual sense in which robots cannot provide humanistic care. Nonetheless, the paper subsequently suggests that we may recognize a useful sense in which robots, of a suitably anthropomorphic type, can provide humanistic care. Robots might 'express' to people with physical, social, or emotional needs the kind of humanistic care that only human beings can provide but that sufferers can nonetheless receive comfort from precisely because of what is expressed to them. Although this sense of humanistic robot care is derivative from uniquely human care, and although it is wide open to social and ethical criticism, it is nonetheless an idea worth clarifying for anyone interested in the possibilities and limits of robot care.

Caring in the in-between: a proposal to introduce responsible AI and robotics to healthcare

In the scenario of growing polarization of promises and dangers that surround artificial intelligence (AI), how to introduce responsible AI and robotics in healthcare? In this paper, we develop an ethical–political approach to introduce democratic mechanisms to technological development, what we call “Caring in the In-Between”. Focusing on the multiple possibilities for action that emerge in the realm of uncertainty, we propose an ethical and responsible framework focused on care actions in between fears and hopes. Using the theoretical perspective of Science and Technology Studies and empirical research, “Caring in the In-Between” is based on three movements: the first is a change of focus from the world of promises and dangers to the world of uncertainties; the second is a conceptual shift from assuming a relationship with robotics based on a Human–Robot Interaction to another focused on the network in which the robot is embedded (the “Robot Embedded in a Network”); and the last is an ethical shift from a general normative framework to a discussion on the context of use. Based on these suggestions, “Caring in the In-Between” implies institutional challenges, as well as new practices in healthcare systems. It is articulated around three simultaneous processes, each of them related to practical actions in the “in-between” dimensions considered: monitoring relations and caring processes, through public engagement and institutional changes; including concerns and priorities of stakeholders, with the organization of participatory processes and alternative forms of representation; and making fears and hopes commensurable, through the choice of progressive and reversible actions.

The Ethical Assessment of Autonomous Systems in Practice

This paper presents the findings of a study that used applied ethics to evaluate autonomous robotic systems practically. Using a theoretical tool developed by a team of researchers in 2017, which one of the authors contributed to, we conducted a study of four existing autonomous robotic systems in July 2020. The methods used to carry out the study and the results are highlighted by examining the specific example of ANYmal, an autonomous robotic system that is one component of the CERBERUS team that won first place in DARPA’s Subterranean Challenge Systems Competition in September 2021.

Valuation in health and ageing innovation practices

In the development and deployment of health and ageing innovations, underlying values such as privacy or quality of life are often seen as a relatively stable starting point, if considered at all. However, values are neither stable nor singular. This paper introduces a valuation framework to explore the co-constitution of values and technological innovations. A careful and ongoing reflection on values and valuation, in particular in innovation practices targeted at older people, is crucial when aiming to increase sustainable innovations. Therefore, we include a Social Sciences and Humanities (SSH) perspective to technological development and innovation, to understand better the construction and co-constitution of ageing-in-place technologies. This framework is developed following a review of literature on values and valuation in the broad field of SSH. The proposed valuation framework consists of three core elements: (a) value multiplicity, (b) value dynamism, and (c) valuation implications. To demonstrate potential applicability of the framework, we conducted a thought experiment on values and valuation practices related to the development and potential further deployment of a COVID-19 health app in the Netherlands. This experiment pays special attention to multiple values at stake and implications for older adults who age in place. We argue this valuation framework provokes reflection on dynamic and multiple values underlying technology use and non-use, and contributes to responsible health and ageing innovations.

The Moral Consideration of Artificial Entities: A Literature Review

Ethicists, policy-makers, and the general public have questioned whether artificial entities such as robots warrant rights or other forms of moral consideration. There is little synthesis of the research on this topic so far. We identify 294 relevant research or discussion items in our literature review of this topic. There is widespread agreement among scholars that some artificial entities could warrant moral consideration in the future, if not also the present. The reasoning varies, such as concern for the effects on artificial entities and concern for the effects on human society. Beyond the conventional consequentialist, deontological, and virtue ethicist ethical frameworks, some scholars encourage "information ethics" and "social-relational" approaches, though there are opportunities for more in-depth ethical research on the nuances of moral consideration of artificial entities. There is limited relevant empirical data collection, primarily in a few psychological studies on current moral and social attitudes of humans towards robots and other artificial entities. This suggests an important gap for psychological, sociological, economic, and organizational research on how artificial entities will be integrated into society and the factors that will determine how the interests of artificial entities are considered.

Aging 4.0? Rethinking the ethical framing of technology-assisted eldercare

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.

Robot Care Ethics Between Autonomy and Vulnerability: Coupling Principles and Practices in Autonomous Systems for Care

Technological developments involving robotics and artificial intelligence devices are being employed evermore in elderly care and the healthcare sector more generally, raising ethical issues and practical questions warranting closer considerations of what we mean by “care” and, subsequently, how to design such software coherently with the chosen definition. This paper starts by critically examining the existing approaches to the ethical design of care robots provided by Aimee van Wynsberghe, who relies on the work on the ethics of care by Joan Tronto. In doing so, it suggests an alternative to their non-principled approach, an alternative suited to tackling some of the issues raised by Tronto and van Wynsberghe, while allowing for the inclusion of two orientative principles. Our proposal centres on the principles of autonomy and vulnerability, whose joint adoption we deem able to constitute an original revision of a bottom-up approach in care ethics. Conclusively, the ethical framework introduced here integrates more traditional approaches in care ethics in view of enhancing the debate regarding the ethical design of care robots under a new lens.

Value Sensitive Design to Achieve the UN SDGs with AI: A Case of Elderly Care Robots

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 (VSD) 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 (SDGs). 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.

How to feel about emotionalized artificial intelligence? When robot pets, holograms, and chatbots become affective partners

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.

Designing AI for Explainability and Verifiability: A Value Sensitive Design Approach to Avoid Artificial Stupidity in Autonomous Vehicles

One of the primary, if not most critical, difficulties in the design and implementation of autonomous systems is the black-boxed nature of the decision-making structures and logical pathways. How human values are embodied and actualised in situ may ultimately prove to be harmful if not outright recalcitrant. For this reason, the values of stakeholders become of particular significance given the risks posed by opaque structures of intelligent agents. This paper explores how decision matrix algorithms, via the belief-desire-intention model for autonomous vehicles, can be designed to minimize the risks of opaque architectures. Primarily through an explicit orientation towards designing for the values of explainability and verifiability. In doing so, this research adopts the Value Sensitive Design (VSD) approach as a principled framework for the incorporation of such values within design. VSD is recognized as a potential starting point that offers a systematic way for engineering teams to formally incorporate existing technical solutions within ethical design, while simultaneously remaining pliable to emerging issues and needs. It is concluded that the VSD methodology offers at least a strong enough foundation from which designers can begin to anticipate design needs and formulate salient design flows that can be adapted to the changing ethical landscapes required for utilisation in autonomous vehicles.

Social robots and the risks to reciprocity

A growing body of research can be found in which roboticists are designing for reciprocity as a key construct for successful human–robot interaction (HRI). Given the centrality of reciprocity as a component for our moral lives (for moral development and maintaining the just society), this paper confronts the possibility of what things would look like if the benchmark to achieve perceived reciprocity were accomplished. Through an analysis of the value of reciprocity from the care ethics tradition the richness of reciprocity as an inherent value is revealed: on the micro-level, as mutual care for immediate care givers, and on the macro-level, as foundational for a just society. Taking this understanding of reciprocity into consideration, it becomes clear that HRI cannot achieve this bidirectional value of reciprocity; a robot must deceive users into believing it is capable of reciprocating to humans or is deserving of reciprocation from humans. Moreover, on the macro-level, designing social robots for reciprocity threatens the ability and willingness to reciprocate to human care workers across society. Because of these concerns, I suggest re-thinking the goals of reciprocity in social robotics. Designing for reciprocity in social robotics should be dedicated to the design of robots to enhance the ability to mutually care for those that provide us with care, as opposed to designing for reciprocity between human and robot.

Service robots for affective labor: a sociology of labor perspective

Profit-oriented service sectors such as tourism, hospitality, and entertainment are increasingly looking at how professional service robots can be integrated into the workplace to perform socio-cognitive tasks that were previously reserved for humans. This is a work in which social and labor sciences recognize the principle role of emotions. However, the models and narratives of emotions that drive research, design, and deployment of service robots in human-robot interaction differ considerably from how emotions are framed in the sociology of labor and feminist studies of service work. In this paper, we explore these tensions through the concepts of affective and emotional labor, and outline key insights these concepts offer for the design and evaluation of professional service robots. Taken together, an emphasis on interactionist approaches to emotions and on the demands of affective labor, leads us to argue that service employees are under-represented in existing studies in human-robot interaction. To address this, we outline how participatory design and value-sensitive design approaches can be applied as complimentary methodological frameworks that include service employees as vital stakeholders.

Perspectives on technologies and care relations, illustrated by a narrative on food care1

We present a model and a narrative on food care to support reflection and dialogue, i.e. the exchange of ideas or opinions between patients, informal caregivers and care professionals, as a way to specifically explore values and perspectives on the use of technologies within care triads. To this end, we used an explorative literature study and an analysis of a care practice. We propose that care professionals have the responsibility to be sensitive to and act on potential dilemmas with the use of technologies in (food) care practice. This requires explicit thinking about one’s own personal perspectives on health and food, care and technologies, and the possible perspectives of others, in achieving a fair balance in care. The ‘Dilemma Model of Technology and Care Relations’ is presented to facilitate dialogue between patients, informal caregivers and professionals, in healthcare as well as in (food) technology. The model can be used both in the workplace and in educational settings. In conclusion, contrasting values and perspectives show that an open dialogue is needed to decide what is good (food) care in each individual care practice.

Socially Assistive Robots in Aged Care: Ethical Orientations Beyond the Care-Romantic and Technology-Deterministic Gaze

Socially Assistive Robots (SARs) 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.

Artificial intelligence for good health: a scoping review of the ethics literature

BACKGROUND

Artificial intelligence (AI) 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?

METHODS

Eight 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.

RESULTS

Upon 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 (LMICs).

CONCLUSIONS

The 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.

A Survey of Robots in Healthcare

In recent years, with the current advancements in Robotics and Artificial Intelligence (AI), robots have the potential to support the field of healthcare. Robotic systems are often introduced in the care of the elderly, children, and persons with disabilities, in hospitals, in rehabilitation and walking assistance, and other healthcare situations. In this survey paper, the recent advances in robotic technology applied in the healthcare domain are discussed. The paper provides detailed information about state-of-the-art research in care, hospital, assistive, rehabilitation, and walking assisting robots. The paper also discusses the open challenges healthcare robots face to be integrated into our society.

Integrating Value Considerations in the Decision Making for the Design of Biorefineries

Biobased production has been promoted as a sustainable alternative to fossil resources. However, controversies over its impact on sustainability highlight societal concerns, value tensions and uncertainties that have not been taken into account during its development. In this work, the consideration of stakeholders' values in a biorefinery design project is investigated. Value sensitive design (VSD) is a promising approach to the design of technologies with consideration of stakeholders' values, however, it is not directly applicable for complex systems like biorefineries. Therefore, some elements of VSD, such as the identification of relevant values and their connection to a technology's features, are brought into biorefinery design practice. Midstream modulation (MM), an approach to promoting the consideration of societal aspects during research and development activities, is applied to promote reflection and value considerations during the design decision making. As result, it is shown that MM interventions during the design process led to new design alternatives in support of stakeholders' values, and allowed to recognize and respond to emerging value tensions within the scope of the project. In this way, the present work shows a novel approach for the technical investigation of VSD, especially for biorefineries. Also, based on this work it is argued that not only reflection, but also flexibility and openness are important for the application of VSD in the context of biorefinery design.

Towards Transparency by Design for Artificial Intelligence

In this article, we develop the concept of Transparency by Design that serves as practical guidance in helping promote the beneficial functions of transparency while mitigating its challenges in automated-decision making (ADM) environments. With the rise of artificial intelligence (AI) and the ability of AI systems to make automated and self-learned decisions, a call for transparency of how such systems reach decisions has echoed within academic and policy circles. The term transparency, however, relates to multiple concepts, fulfills many functions, and holds different promises that struggle to be realized in concrete applications. Indeed, the complexity of transparency for ADM shows tension between transparency as a normative ideal and its translation to practical application. To address this tension, we first conduct a review of transparency, analyzing its challenges and limitations concerning automated decision-making practices. We then look at the lessons learned from the development of Privacy by Design, as a basis for developing the Transparency by Design principles. Finally, we propose a set of nine principles to cover relevant contextual, technical, informational, and stakeholder-sensitive considerations. Transparency by Design is a model that helps organizations design transparent AI systems, by integrating these principles in a step-by-step manner and as an ex-ante value, not as an afterthought.