A Review of Contemporary Work on the Ethics of Ambient Assisted Living Technologies for People with Dementia

Abstract

Ambient assisted living (AAL) technologies can provide assistance and support to persons with dementia. They might allow them the possibility of living at home for longer whilst maintaining their comfort and security as well as offering a way towards reducing the huge economic and personal costs forecast as the incidence of dementia increases worldwide over coming decades. However, the development, introduction and use of AAL technologies also trigger serious ethical issues. This paper is a systematic literature review of the on-going scholarly debate about these issues. More specifically, we look at the ethical issues involved in research and development (R&D), clinical experimentation, and clinical application of AAL technologies for people with dementia and related stakeholders. In the discussion we focus on: 1) the value of the goals of AAL technologies, 2) the special vulnerability of persons with dementia in their private homes, 3) the complex question of informed consent for the usage of AAL technologies.

User in the Loop: Adaptive Smart Homes Exploiting User Feedback—State of the Art and Future Directions

“…Several robotic projects are discussed in this review including robots to assist the elderly, the disabled, and children: navigation chair systems, cooperating arms, Nursebots, rehabilitation assistants, and entertainment robots. In [10], the authors present a review of the current works that are related to the use of these assistant robots for elderly people that have to cope with dementia.…”

Technology and dementia

“…Though many of these technologies intuitively seem to make sense, the research into their development and divers applications is not without ethical challenges. These involve the ratio of risks and potential benefits, informed consent, discrimination, stigmatization, privacy and data protection, amongst others (Felzmann et al 2015;Novitzky et al 2015). Apart from the specific ethical challenges that any individual technology currently being developed for people with dementia might trigger, there are two concerns deserving our attention that they all have in common.…”

Privacy challenges in Ambient Intelligence systems

“…The pervasiveness of AAL technologies poses certain challenges to user privacy, due to the sometimes intrusive nature of the devices [64]. In this section, we discuss the privacy challenges which are emerging in AAL and illustrate them throughout with examples from our scenario.…”

“…However, the use of assistive technology or leakage of disease data may cause embarrassment or even stigmatization [64]. Some AAL technologies evoked resistance in certain persons because of their "handicapped-look" design.…”

“…Moreover, an explicit feedback of information of a delicate nature coming from a device in front of other people or in public can be embarrassing for its user. Stigmatization can have major effects on the isolation of the user [64].…”