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

Service robots in caring for older adults: Uncovering the current conceptual and intellectual structures and future research agenda

Service robots have supported human activity, mainly caring for older adults, for many years. However, a new generation of service robots empowered by artificial intelligence and other novel technologies indicates an increasing use of service robots in our society. Thus, this article aims to synthesize and integrate current research on service robots in caring for older adults, identifying its conceptual and intellectual structures and future research opportunities. A total of 390 articles ranging from the year 1997 to 2022 were analyzed with text-mining and visualization methods. We found that this research is composed of six main themes: (i) acceptance and design of robots; (ii) social role and ethical values (iii) obstacles and criticism; (iv) effects, effectiveness, and impact of using robots; (v) therapeutic use of robots and (vi) perceptions of health professionals and services. We also identified future research opportunities which researchers can use to advance the topics of this research. Identifying research clusters and key works in this multidisciplinary research field can assist researchers in understanding the current status of this research and, after that, better positioning their studies and finding avenues to move forward with the use of service robots for caring for older adults.

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.

Developing a model to explain users' ethical perceptions regarding the use of care robots in home care: A cross-sectional study in Ireland, Finland, and Japan

To date, research on ethical issues regarding care robots for older adults, family caregivers, and care workers has not progressed sufficiently. This study aimed to build a model that universally explains the relationship between the use of care robots and ethical awareness, such as regarding personal information and privacy protection in home care. We examined data obtained from cross-sectional surveys conducted in Japan (n=528), Ireland (n=296), and Finland (n=180). We performed a confirmatory factor analysis by using responses to 11 items related to the ethical use of care robots. We evaluated the model based on the chi-square to degrees of freedom ratio, the comparative fit index, and the root mean square error of approximation. Subsequently, we compared the model with the Akaike's information criterion. Ten items were adopted in the final model. There were 4 factors in the model: 'acquisition of personal information', 'use of personal information for medical and long-term care', 'secondary use of personal information', and 'participation in research and development'. All factor loadings of the final model ranged between 0.63 and 0.92, which were greater than 0.6, showing that the factors had a high influence on the model. The final model was applied to each country; the fit was relatively good in Finland and poor in Ireland. Although the three countries have different geographies, cultures, demographics, and systems, this study showed that the impact of ethical issues regarding the use of care robots in home care can be universally explained by the same model.

Uncertainties about accepting care robots

In the midst of the anticipation of care robots renewing elderly care, care workers are expected to orient themselves in this future, however uncertain. To examine how uncertainty over the appropriateness of care-robot use associates with robot acceptance, different scenarios of robot assistance were presented to a sample of care professionals in two waves 2016-2020. The views of usefulness of robot assistance yielded underlying structures of plausible and implausible care-robot use. The perceived appropriateness of utilizing robots in care was stronger in the plausible robot scenarios. The uncertainty about robots having an appropriate role in care work correlated negatively with the perceived usefulness of robot assistance, but was even highlighted among the scenarios of implausible tasks. Findings further show how uncertainties about care-robot use have been reduced across four years between data collections. In robotizing care work processes, it may be more beneficial to attempt to convince the care workers who are undecided about robot acceptance than to push care-robot orientation to those who strongly oppose care-robot use.

The Ethical Governance for the Vulnerability of Care Robots: Interactive-Distance-Oriented Flexible Design

The application of caring robots is currently a widely accepted solution to the problem of aging. However, for the elderly groups who live in gregarious residences and share intelligence devices, caring robots will cause intimacy and assistance dilemmas in the relationship between humans and non-human agencies. This is an information-assisted machine setting, with resulting design ethics issues brought about by the binary values of human and machine, body and mind. The “vulnerability” in risk ethics demonstrates that the ethical problems of human institutions stem from the increase of dependence and the obstruction of intimacy, which are essentially caused by the increased degree of ethical risk exposure and the restriction of agency. Based on value-sensitive design, caring ethics and machine ethics, this paper proposes a flexible design with the interaction-distance-oriented concept, and reprograms the ethical design of caring robots with intentional distance, representational distance and interpretive distance as indicators. The main purpose is to advocate a new type of human-machine interaction relationship emphasizing diversity and physical interaction.

Technological risks and ethical implications of using robots in long-term care

Introduction

The pandemic provides a unique opportunity to examine new directions in innovative technological approaches in long-term care (LTC) homes. While robotics could enhance staff capacity to provide care, there are potential technology risks and ethical concerns involved in technology use among older people residing in communal aged care homes. This qualitative descriptive study explores the technological risks and ethical issues associated with the adoption of robots in the specific context of LTC homes.

Methods

The research team including patient and family partners employed purposive and snowballing methods to recruit 30 LTC participants: frontline interdisciplinary staff, operational leaders, residents and family members, and ethics experts in dementia care. Semi-structured interviews were conducted. Thematic analysis was performed to identify themes that capture empirical experiences and perspectives of a diverse group of LTC stakeholders about robotic use.

Results

Technological risks include safety, increased workload, privacy, cost and social justice, and human connection. The findings offer practical insights based on the LTC perspective to contribute to the robot ethics literature. We propose a list of pragmatic recommendations, focusing on six principles (ETHICS): Engagement of stakeholders, Technology benefit and risk assessment, Harm mitigation, Individual autonomy, Cultural safety and justice, Support of privacy.

Conclusions

There is both a growing interest as well as fear in using robotics in LTC. Practice leaders need to reflect on ethical considerations and engage relevant stakeholders in making technology decisions for everyday care.