ReviewThe use of care robots in aged care: A systematic review of argument-based ethics literature
Introduction
With expanding care technology, the issue of whether better technology can contribute positively to the current state of aged care is gaining more attention. Moreover, there is a rapidly increasing imbalance between the number of older adults needing care and a decreasing number of caregivers (World Health Organization, 2015). Care robots are viewed by some as a promising technological development that has the potential to mitigate this growing care recipient-caregiver disparity. These robots can be considered as embodied forms of semi-independent or independent technology. They support caregivers and/or older adults in physically assistive tasks. For example, the “My Spoon Robot” can aid someone with eating problems, and the “Sanyo Bath Robot” provides hygienic care to older adults (Bedaf, Gelderblom, & de Witte, 2015). Other care robots serve as social supports (e.g. the seal-like robot Paro or the dog-like robot AIBO) (Bemelmans, Gelderblom, Jonker, & de Witte, 2012). There are also care robots that combine both functions, being socially assistive. They give assistance through social interaction (Feil-Seifer & Matarić, 2005) (e.g. the human-like robot Robovie, and the robot, Pearl) (Kachouie, Sighadeli, Khosla, & Chu, 2014).
Many studies have examined how care robots can be used in aged-care settings (Bedaf et al., 2015; Kachouie et al., 2014; Robinson, MacDonald, & Broadbent, 2014); their effectiveness (Bemelmans et al., 2012; Mordoch, Osterreicher, Guse, Roger, & Thompson, 2013); what factors influence older adults’ acceptance or rejection of care robots (De Graaf & Allouch, 2013; Flandorfer, 2012); and older adults’ attitudes toward socially assistive robots (Vandemeulebroucke, Dierckx de Casterlé, & Gastmans, 2017). Nonetheless, as robot technology advances, care robots become increasingly independent. As the conviction of their use in aged-care practices builds, there is a growing need to ethically reflect on this use. Indeed, the field of roboethics addresses care robot use in aged-care practices (Lin, Abney, & Bekey, 2014; Tzafestas, 2016). Although these studies are valuable, we believe they do not address all arguments in the ethical debate about using care robots in aged care. Furthermore, the arguments presented in these studies have received limited analysis. To address this, we conducted a systematic review of the normative literature motivating the ethical debate on care robot use in aged-care practices.
Section snippets
Methods
Systematic reviews of normative literature are published frequently (Mertz, Kahrass, & Strech, 2016). Their goal is to promote informed decisions and judgments in all segments of healthcare, to improve research that aids these decisions and to continuously improve the standards of bioethics (McCullough, Coverdale, & Chervenak, 2007; Sofaer & Strech, 2012). The methodology developed for the present review shares these goals. Three steps were undertaken in our analyses. First, we identified the
Results
We identified twenty-eight eligible publications for inclusion. Publications dates were from 2002 to 2016, with three appearing before 2010. While doing the data extraction and synthesis, it became evident that most authors of the included publications argued from a specific ethical stance. Four ethical approaches were apparent in the included publications (Table 2): (a) a deontological approach, (b) a principlist approach, (c) an objective-list approach and, (d) a care-ethical approach. Some
Discussion
The overall aim of this review of the normative literature was to gain a better understanding of the range of views and ethical arguments on the use of care robots in aged-care practices and their grounding concepts. The diversity and wide-ranging views compiled in our analysis shows that the ethical debate is far from reaching a consensus and potentially is unreachable.
In this robotic age, we find ourselves in well-tilled ethical soil. Debates on the ethics of using robots in human activities
Funding
The authors did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors to plan or conduct this research.
Conflict of interest
The authors did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors to plan or conduct this research.
Acknowledgments
None.
References (53)
- et al.
Exploring influencing variables for the acceptance of social robots
Robotics and Autonomous Systems
(2013) - et al.
QUAGOL: A guide for qualitative data analysis
International Journal of Nursing Studies
(2012) - et al.
Use of social commitment robots in the care of elderly people with dementia: A literature review
Maturitas
(2013) - et al.
Overview and categorization of robots supporting independent living of elderly people: What activities do they support and how far have they developed
Assistive Technology
(2015) - et al.
Socially assistive robots in elderly care: A systematic review into effects and effectiveness
JAMDA
(2012) Robots and reality: A reply to Robert Sparrow
Ethics and Information Technology
(2012)- et al.
Robot caregivers: Harbingers of expanded freedom for all?
Ethics and Information Technology
(2010) Health care, capabilities, and AI assistive technology
Ethical Theory and Moral Practice
(2010)Are emotional robots deceptive?
IEEE Transactions on Affective Computing
(2012)Artificial agents, good care, and modernity
Theoretical Medicine and Bioethics
(2015)
Care robots and the future of ICT-mediated elderly care: A response to doom scenarios
AI & Society
Caregiving robots and ethical reflection: The perspective of interdisciplinary technology assessment
AI & Society
Questioning technology
Defining socially assistive robotics
Proceedings of the 2005 IEEE 9th international conference on rehabilitation robotics
Socially assistive robotics. Ethical issues related to technology
IEEE Robotics & Automation Magazine
Population ageing and socially assistive robots for elderly persons: The importance of sociodemographic factors for user acceptance
International Journal of Population Research
The machine question. Critical perspectives on AI, robots, and ethics
Social and assistive robotics in dementia care: Ethical recommendations for research and practice
International Journal of Social Robotics
Ethical Challenges in the use of social service robots for elderly people
Zeitschrift für Gerontologie und Geriartrie
Socially assistive robots in elderly care: A mixed-method systematic literature review
International Journal of Human-Computer Interaction
The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration
BMJ
Robot ethics. The ethical and social implication of robotics
Robot lies in health care: When is deception morally permissible?
Kennedy Institute of Ethics Journal
Constructing a systematic review for argument-based clinical ethics literature: The example of concealed medications
Journal of Medicine and Philosophy
Current state of ethics literature synthesis: A systematic review of reviews
BMC Medicine
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