Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
Faculty of Medicine, University of Basel, Basel, Switzerland.
BMC Med Ethics. 2019 Dec 19;20(1):98. doi: 10.1186/s12910-019-0437-z.
Advances in artificial intelligence (AI), robotics and wearable computing are creating novel technological opportunities for mitigating the global burden of population ageing and improving the quality of care for older adults with dementia and/or age-related disability. Intelligent assistive technology (IAT) is the umbrella term defining this ever-evolving spectrum of intelligent applications for the older and disabled population. However, the implementation of IATs has been observed to be sub-optimal due to a number of barriers in the translation of novel applications from the designing labs to the bedside. Furthermore, since these technologies are designed to be used by vulnerable individuals with age- and multi-morbidity-related frailty and cognitive disability, they are perceived to raise important ethical challenges, especially when they involve machine intelligence, collect sensitive data or operate in close proximity to the human body. Thus, the goal of this paper is to explore and assess the ethical issues that professional stakeholders perceive in the development and use of IATs in elderly and dementia care.
We conducted a multi-site study involving semi-structured qualitative interviews with researchers and health professionals. We analyzed the interview data using a descriptive thematic analysis to inductively explore relevant ethical challenges.
Our findings indicate that professional stakeholders find issues of patient autonomy and informed consent, quality of data management, distributive justice and human contact as ethical priorities. Divergences emerged in relation to how these ethical issues are interpreted, how conflicts between different ethical principles are resolved and what solutions should be implemented to overcome current challenges.
Our findings indicate a general agreement among professional stakeholders on the ethical promises and challenges raised by the use of IATs among older and disabled users. Yet, notable divergences persist regarding how these ethical challenges can be overcome and what strategies should be implemented for the safe and effective implementation of IATs. These findings provide technology developers with useful information about unmet ethical needs. Study results may guide policy makers with firsthand information from relevant stakeholders about possible solutions for ethically-aligned technology governance.
人工智能（AI）、机器人技术和可穿戴计算的进步为减轻人口老龄化的全球负担和改善痴呆症和/或与年龄相关的残疾老年人的护理质量创造了新的技术机会。智能辅助技术（IAT）是定义这一不断发展的智能应用于老年和残疾人群体的总称。然而，由于从设计实验室到床边的新型应用翻译存在许多障碍，IAT 的实施效果并不理想。此外，由于这些技术旨在为因年龄和多种疾病导致的脆弱性、认知障碍而变得脆弱的个体使用，因此它们被认为带来了重要的伦理挑战，尤其是当涉及机器智能、收集敏感数据或在靠近人体的情况下运行时。因此，本文的目的是探讨和评估专业利益相关者在老年和痴呆症护理中开发和使用 IAT 时所感知到的伦理问题。
我们进行了一项多地点研究，包括对研究人员和卫生专业人员进行半结构化定性访谈。我们使用描述性主题分析对访谈数据进行分析，以归纳性地探讨相关的伦理挑战。
我们的研究结果表明，专业利益相关者认为患者自主权和知情同意、数据管理质量、分配公正和人际接触是伦理优先事项。在如何解释这些伦理问题、如何解决不同伦理原则之间的冲突以及应该实施哪些解决方案来克服当前挑战方面存在分歧。
我们的研究结果表明，专业利益相关者普遍同意在老年和残疾用户中使用 IAT 所带来的伦理承诺和挑战。然而，在如何克服这些伦理挑战以及应该实施哪些策略来确保 IAT 的安全有效实施方面，仍然存在显著分歧。这些研究结果为技术开发者提供了有关未满足的伦理需求的有用信息。研究结果可以为政策制定者提供有关利益相关者的第一手信息，为道德一致的技术治理提供可能的解决方案。
