Nielsen Svenja, Langensiepen Sina, Madi Murielle, Elissen Maurice, Stephan Astrid, Meyer Gabriele
Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany.
Department of Nursing Science, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
BMC Nurs. 2022 Jul 8;21(1):180. doi: 10.1186/s12912-022-00959-2.
As robotics in nursing care is still in an early explorative research phase, it is not clear which changes robotic systems will ultimately bring about in the long term. According to the approach of "Responsible Research and Innovation", the research project "PfleKoRo" aims to anticipate and mitigate ethical risks that might be expected when starting to develop a robot. The robot under investigation is intended to be a hands-on support in nursing care in due course. Therefore, the question is which ethical risks and requirements must be considered when developing the robot.
Guided by the British Standard for the design of robotic systems, ethical risks related to the robot's use were identified at the outset (Step 1). This was followed by the definition of the requirements needed to mitigate ethical risks (Step 2). Professional nurses, patients and relatives were involved in focus groups and interviews in Step 1. The transcribed interviews and focus groups were then analysed using content analysis. The available literature and expert guidance were taken into account in both steps. Finally, validation and verification methods were defined (Step 3).
Sixteen professional nurses participated in three focus groups. Individual interviews were held with a total of eight patients and relatives. Ethical risks and requirements could be defined in the context of dignity, autonomy, privacy, human relationships and safety in the project. Professional nurses feared most issues relating to safety and that the robot would lead to more workload instead of relief, whereas patients and relatives frequently raised the issue of the staffing ratio. Despite the focus on possible negative consequences, participants also made uncritical or optimistic comments regarding the robot's use in the future.
Focus groups, individual interviews and existing literature revealed to some extent different ethical issues. Along with identified risks, the results suggest a general open-mindedness of nurses, patients and relatives towards the introduced robot. When investigating the ethical implications of robots for nursing care, one should include multiple perspectives and, in particular, potentially affected individuals.
由于护理机器人仍处于早期探索性研究阶段，目前尚不清楚机器人系统最终将在长期内带来哪些变化。根据“负责任的研究与创新”方法，“PfleKoRo”研究项目旨在预测并减轻在开始研发机器人时可能出现的伦理风险。正在研究的这款机器人旨在最终为护理工作提供实际支持。因此，问题在于在研发机器人时必须考虑哪些伦理风险和要求。
以英国机器人系统设计标准为指导，在一开始就识别出与机器人使用相关的伦理风险（步骤1）。随后定义减轻伦理风险所需的要求（步骤2）。在步骤1中，专业护士、患者及亲属参与了焦点小组和访谈。然后使用内容分析法对转录的访谈和焦点小组进行分析。在这两个步骤中均考虑了现有文献和专家指导。最后定义了验证和核查方法（步骤3）。
16名专业护士参与了3个焦点小组。共对8名患者及亲属进行了个人访谈。在尊严、自主性、隐私、人际关系和安全等方面能够确定该项目中的伦理风险和要求。专业护士最担心与安全相关的大多数问题，以及机器人会导致工作量增加而非减轻，而患者及亲属则经常提出人员配备比例的问题。尽管关注可能的负面后果，但参与者对机器人未来的使用也发表了不加批判或乐观的评论。
焦点小组、个人访谈和现有文献在一定程度上揭示了不同的伦理问题。除了已识别的风险外，结果表明护士、患者及亲属对引入的机器人总体持开放态度。在研究机器人对护理的伦理影响时，应纳入多个视角，尤其是潜在受影响的个体。
