Hanjahanja-Phiri Thokozani, Modebelu Ifunanya, Morgan Gillian, Abhari Shahabeddin, Noon Gaya Bin, Chumachenko Dmytro, Morita Plinio Pelegrini
School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.
School of Health and Life Sciences, Conestoga College - Doon Campus, Kitchener, ON, Canada.
Digit Health. 2025 Jul 10;11:20552076251336004. doi: 10.1177/20552076251336004. eCollection 2025 Jan-Dec.
Active Assisted Living (AAL) technologies have emerged as a multidisciplinary endeavor driven by the imperative to enhance the lives of older adults. However, users' perspectives on the ethics of AAL technology use are often secondary considerations.
The objective of this scoping review was to synthesize the literature on users' perspectives on the ethics of AAL technologies to bridge the gap in both academic and non-academic contexts.
This scoping review was conducted comprehensively using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Reviews (PRISMA-ScR) in Covidence, focusing on peer-reviewed publications from 2000 to 2023. Our search strategies integrated concepts of AAL technologies, ethics, and user perspectives. Inclusion criteria encompassed qualitative and mixed methods that obtained users' perspectives on AAL technologies in smart home communities. A gray literature review was also conducted to retrieve documents for analysis that incorporated guidelines, standardization, and/ or recommendations.
Five relevant articles utilized qualitative methods (3) and mixed methods (2). Privacy and data protection were highlighted, with users expressing concerns about data tracking (4). Respect for autonomy was emphasized in decision-making regarding technology use (3). Accessibility issues pertained to missing accommodations for some physical abilities (2). Diversity and social inclusion were important for social engagement and mental health support (2). Perceived beneficence was also cited as a factor in improving health outcomes (3). Transparency and accountability by the AAL technologies implementers were deemed essential for building trust (1). The gray literature review yielded six relevant documents that included discussions on ethics and the use of AAL-related technologies for older adults.
Older adults are willing to include wearables and Internet of Things devices in their AAL technologies ecosystem, especially when they co-design the technology, but it is contingent on the implementation of ethical principles such as safety, security, and privacy to counter intrusive monitoring systems. This scoping review has the potential to offer valuable insights to various stakeholders, including tech developers and designers, providers, health policymakers, providers, and regulatory agencies.
主动式辅助生活（AAL）技术已成为一项多学科的事业，其驱动力是改善老年人生活的迫切需求。然而，用户对AAL技术使用伦理的看法往往是次要考虑因素。
本范围综述的目的是综合关于用户对AAL技术伦理看法的文献，以弥合学术和非学术背景下的差距。
本范围综述在Covidence中全面采用系统评价和Meta分析的首选报告项目——范围综述（PRISMA-ScR）进行，重点关注2000年至2023年的同行评审出版物。我们的检索策略整合了AAL技术、伦理和用户视角的概念。纳入标准包括获得智能家居社区中用户对AAL技术看法的定性和混合方法。还进行了灰色文献综述，以检索纳入指南、标准化和/或建议的分析文件。
五篇相关文章采用了定性方法（3篇）和混合方法（2篇）。隐私和数据保护受到关注，用户对数据跟踪表示担忧（4篇）。在技术使用决策中强调了对自主权的尊重（3篇）。可及性问题涉及某些身体能力缺乏相应便利设施（2篇）。多样性和社会包容对社交参与和心理健康支持很重要（2篇）。感知到的行善也被认为是改善健康结果的一个因素（3篇）。AAL技术实施者应具备透明度和问责制，这被视为建立信任的关键（1篇）。灰色文献综述产生了六份相关文件，其中包括关于伦理以及老年人使用AAL相关技术的讨论。
老年人愿意在其AAL技术生态系统中纳入可穿戴设备和物联网设备，特别是当他们共同设计技术时，但这取决于安全、安保和隐私等伦理原则的实施，以对抗侵入性监测系统。本范围综述有可能为包括技术开发者和设计师、供应商、卫生政策制定者、供应商和监管机构在内的各利益相关者提供有价值的见解。
