Moral psychology of nursing robots: Exploring the role of robots in dilemmas of patient autonomy

Abstract

Artificial intelligences (AIs) are widely used in tasks ranging from transportation to healthcare and military, but it is not yet known how people prefer them to act in ethically difficult situations. In five studies (an anthropological field study, n = 30, and four experiments, total n = 2150), we presented people with vignettes where a human or an advanced robot nurse is ordered by a doctor to forcefully medicate an unwilling patient. Participants were more accepting of a human nurse's than a robot nurse's forceful medication of the patient, and more accepting of (human or robot) nurses who respected patient autonomy rather than those that followed the orders to forcefully medicate (Study 2). The findings were robust against the perceived competence of the robot (Study 3), moral luck (whether the patient lived or died afterwards; Study 4), and command chain effects (Study 5; fully automated supervision or not). Thus, people prefer robots capable of disobeying orders in favour of abstract moral principles like valuing personal autonomy. Our studies fit in a new era in research, where moral psychological phenomena no longer reflect only interactions between people, but between people and autonomous AIs.

Ethics 4.0: Ethical Dilemmas in Healthcare Mediated by Social Robots

“…Our study extends previous research [9], focusing on a potential healthcare situation in which a patient refuses to take medication. We tested how different health framing messages to persuade patients to take medication in combination with distinct ethical decisions impact people's moral…”

“…Since our line of work is relatively recent, we base our hypotheses on the recent findings of Laakasuo et al [9], by anticipating the following: H1. Participants in the human agent condition will attribute higher levels of moral acceptability (H1a), moral responsibility (H1b), warmth (H1c), competence (H1d), and dilemmas applied to healthcare robots, mainly involving the ethical principles of beneficence, nonmaleficence, and respect for the patient autonomy.…”

“…Similarly, Sasson [38] also discussed ethical decisions involving an institutionalized patient with preserved mental faculties that require healthcare assistance but also resisting the treatment. However, to the best of our knowledge only Laakasuo et al [9] have empirically studied how people judge these ethical dilemmas in healthcare. In six studies (five experiments and one field study), participants were exposed to hypothetical scenarios in which an agent (human or robot) is instructed to forcefully medicate a patient who refuses medication, and then decides to either respect the patient autonomy or to forcefully medicate the patient.…”

“…Our study addresses how people judge a healthcare agent's reaction to a patient who refuses to take medication, as a function of the healthcare agent (human vs. robot), the health framing argument (gain vs. loss), and the ethical decision (respect for autonomy vs. beneficence/nonmaleficence). We adapted the scenario used in Laakasuo et al [9] study, which was also discussed previously by Anderson et al [36,37], in which the ethical principles of beneficence, nonmaleficence, and respect for patient autonomy were considered, involving a patient who does not adhere to medication. However, 77 years (M = 38.73, SD = 14.22), with a predominance of women (n = 350, 70%).…”

“…Participants were randomly assigned to one of eight different vignettes, with each vignette being shown to between 60 and 72 participants. We adapted the Laakasuo et al [9] vignettes by manipulating the healthcare agent (human vs. robot) and the ethical decision (respect for autonomy vs. beneficence/nonmaleficence) in a situation where a patient refuses medication. In addition, we manipulated the health framing (gain vs. loss).…”