Ethical Challenges with Welfare Technology: A Review of the Literature

Abstract

Demographical changes in high income counties will increase the need of health care services but reduce the number of people to provide them. Welfare technology is launched as an important measure to meet this challenge. As with all types of technologies we must explore its ethical challenges. A literature review reveals that welfare technology is a generic term for a heterogeneous group of technologies and there are few studies documenting their efficacy, effectiveness and efficiency. Many kinds of welfare technology break with the traditional organization of health care. It introduces technology in new areas, such as in private homes, and it provides new functions, e.g. offering social stimuli and entertainment. At the same time welfare technology is developed for groups that traditionally have not been extensive technology users. This raises a series of ethical questions with regard to the development and use of welfare technologies, which are presented in this review. The main challenges identified are: (1) Alienation when advanced technology is used at home, (2) conflicting goals, as welfare technologies have many stakeholders with several ends, (3) respecting confidentiality and privacy when third-party actors are involved, (4) guaranteeing equal access and just distribution, and (5) handling conflicts between instrumental rationality and care in terms of respecting dignity and vulnerability. Addressing these issues is important for developing and implementing welfare technologies in a morally acceptable manner.

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

“…These are presented here from the point of view of the stakeholders involved: the PwD, formal and informal care-givers (nurses, family proxies), researchers and clinicians, (software/hardware) engineers, designers, and technicians. These stakeholders involved in our ethical analysis had been previously defined by various authors (Allen et al, 2008;Duquenoy and Whitehouse, 2006;Duquenoy, 2004;Hofmann, 2012;R. Sparrow and L. Sparrow, 2006;Sponselee et al, 2008;van Hoof et al, 2011).…”

“…(Cook et al, 2009, p. (Darwish and Hassanien, 2011). According to Hofmann (2012), its aim is to provide better and more specific care and to reduce risks and therefore increase safety, making it possible for the vulnerable to increase their ability to cope and thus improve their capacity for self-determination, as well as enabling them to stay at home for longer before being institutionalised. Ubiquitous computing in the context of (elderly) care is also referred to as health telematics (Friedewald and Raabe, 2011).…”

“…This dependence on the (hi-tech) pseudo-intelligence provided by AAL technologies means that, while they empower very specific faculties, they can reduce people's autonomy. Consequently, they could also dramatically infringe the validity of informed consent given by PwD at the more advanced stages of their AAL usage (Hofmann, 2012). Also, the ambient functioning of the AAL technology in the private homes of PwDs would mean that additional informed consent would be needed from co-habitants (Hofmann, 2012).…”

“…Consequently, they could also dramatically infringe the validity of informed consent given by PwD at the more advanced stages of their AAL usage (Hofmann, 2012). Also, the ambient functioning of the AAL technology in the private homes of PwDs would mean that additional informed consent would be needed from co-habitants (Hofmann, 2012). Moreover, Kosta, Pitkänen, et al (2010) criticise the opt-out policy, which weakens personal autonomy and thereby the decision-making of the user.…”

“…accidental falls) (Hofmann, 2012;Sponselee et al, 2008). This can have the positive benefit of reducing anxiety (Hofmann, 2012).…”