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Young pediatric patients who undergo venipuncture or capillary blood sampling often experience high levels of pain and anxiety. This often results in distressed young patients and their parents, increased treatment times, and a higher workload for healthcare professionals. Social robots are a new and promising tool to mitigate children’s pain and anxiety. This study aims to purposefully design and test a social robot for mitigating stress and anxiety during blood draw of children. We first programmed a social robot based on the requirements expressed by experienced healthcare professionals during focus group sessions. Next, we designed a randomized controlled experiment in which the social robot was applied as a distraction method to measure its capacity to mitigate pain and anxiety in children during blood draw in a children’s hospital setting. Children who interacted with the robot showed significantly lower levels of anxiety before actual blood collection, compared to children who received regular medical treatment. Children in the middle classes of primary school (aged 6–9) seemed especially sensitive to the robot’s ability to mitigate pain and anxiety before blood draw. Children’s parents overall expressed strong positive attitudes toward the use and effectiveness of the social robot for mitigating pain and anxiety. The results of this study demonstrate that social robots can be considered a new and effective tool for lowering children’s anxiety prior to the distressing medical procedure of blood collection.

Social robots hold potential for supporting children’s well-being in classrooms. However, it is unclear which robot features add to a trustworthy relationship between a child and a robot and whether social robots are just as able to reduce stress as traditional interventions, such as listening to classical music. We set up two experiments wherein children interacted with a robot in a real-life school environment. Our main results show that regardless of the robotic features tested (intonation, male/female voice, and humor) most children tend to trust a robot during their first interaction. Adding humor to the robots’ dialogue seems to have a negative impact on children’s trust, especially for girls and children without prior experience with robots. In comparing a classical music session with a social robot interaction, we found no significant differences. Both interventions were able to lower the stress levels of children, however, not significantly. Our results show the potential for robots to build trustworthy interactions with children and to lower children’s stress levels. Considering these results, we believe that social robots provide a new tool for children to make their feelings explicit, thereby enabling children to share negative experiences (such as bullying) which would otherwise stay unnoticed.

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While social robots bring new opportunities for education, they also come with moral challenges. Therefore, there is a need for moral guidelines for the responsible implementation of these robots. When developing such guidelines, it is important to include different stakeholder perspectives. Existing (qualitative) studies regarding these perspectives however mainly focus on single stakeholders. In this exploratory study, we examine and compare the attitudes of multiple stakeholders on the use of social robots in primary education, using a novel questionnaire that covers various aspects of moral issues mentioned in earlier studies. Furthermore, we also group the stakeholders based on similarities in attitudes and examine which socio-demographic characteristics influence these attitude types. Based on the results, we identify five distinct attitude profiles and show that the probability of belonging to a specific profile is affected by such characteristics as stakeholder type, age, education and income. Our results also indicate that social robots have the potential to be implemented in education in a morally responsible way that takes into account the attitudes of various stakeholders, although there are multiple moral issues that need to be addressed first. Finally, we present seven (practical) implications for a responsible application of social robots in education following from our results. These implications provide valuable insights into how social robots should be implemented.

Ethics by Design concerns the methods, algorithms and tools needed to endow autonomous agents with the capability to reason about the ethical aspects of their decisions, and the methods, tools and formalisms to guarantee that an agent's behavior remains within given moral bounds. In this context some questions arise: How and to what extent can agents understand the social reality in which they operate, and the other intelligences (AI, animals and humans) with which they co-exist? What are the ethical concerns in the emerging new forms of society, and how do we ensure the human dimension is upheld in interactions and decisions by autonomous * Corresponding author.Permission to make digital or hard copies of part or all of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for third-party components of this work must be honored.

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