Implementing ethical aspects in the development of a robotic system for nursing care: a qualitative approach

Abstract

Background 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. Methods 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). Results 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. Conclusion 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.

Care Robotics: An Assessment of Professional Perception in the Face of the COVID-19 Pandemic

“…Similar studies have concentrated the objective of their analysis on the perception of technologies or robots in samples of health professionals and patients, both potential end users of these devices [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 37 , 38 , 39 , 40 ].…”

“…These robots can have human or animal appearance and focus on simulating behaviour (including human emotions) to enhance well-being through the feeling of companionship. However, this area of research must address cultural, social and political factors that contextualise the interaction process and personalise the meaning of verbal and nonverbal language [ 23 , 40 , 57 ].…”

“…Likewise, some research has delved into the perspective of professionals and patients in relation to the use of robotics in healthcare and, more specifically, in relation to COVID-19. [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ].…”

Moral Values in Medical AI: A Scoping Review

“…The use of AI in healthcare, and particularly robots, has the potential to infringe on the dignity of patients by making them feel "less worthy and less perceived as a human being when touched by a robot instead of by a human caregiver" [53]. Similarly, AI puts human dignity at risk if it replaces individuals whose jobs are instrumental for dignity [100].…”

“…Similarly, AI puts human dignity at risk if it replaces individuals whose jobs are instrumental for dignity [100]. The dignity of healthcare workers, moreover, may also be harmed by way of a reduced sense of the value of care that can be replaced by or assisted by robot [53].…”