Privacy-sensitive Empowerment. Towards an integrated ethical concept for technology-assisted care for people with dementia

Welsch, Johannes; Buhr, Eike

doi:10.14220/9783737014793.185

Cited by 5 publications

(2 citation statements)

References 16 publications

(8 reference statements)

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“…Privacy invasion was another area that was prioritized differently by the Israeli and German experts. Indeed, in accordance with existing concerns [ 8 , 13 , 16 , 51 , 52 ], most of the Israeli experts (11/15) and all of the Germans experts pointed to the main risk – namely, the invasion of the privacy of people with dementia via the use of surveillance and monitoring technologies. That said, privacy was most highly prioritized by German experts whereas Israeli experts prioritized safety over privacy.…”

Section: Discussionsupporting

confidence: 55%

Cross-cultural perspectives on intelligent assistive technology in dementia care: comparing Israeli and German experts’ attitudes

AboJabel,

Welsch,

Schicktanz

2024

BMC Med Ethics

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Background Despite the great benefits of intelligent assistive technology (IAT) for dementia care – for example, the enhanced safety and increased independence of people with dementia and their caregivers – its practical adoption is still limited. The social and ethical issues pertaining to IAT in dementia care, shaped by factors such as culture, may explain these limitations. However, most studies have focused on understanding these issues within one cultural setting only. Therefore, the aim of this study was to explore and compare the attitudes of Israeli and German dementia experts toward IAT in dementia care, to contribute to a more cultural-comparative perspective. Methods Semi-structured interviews were conducted with 35 experts (15 Israelis and 20 Germans) in key roles in health and community services for people with dementia as well as in the fields of dementia and IAT (e.g., computer science, electrical/biomedical engineering, ethics, nursing, and gerontology). Thematic content analysis was used to analyze the data. Findings Israeli and German experts identified the same social accelerators in the development and implementation of IAT in dementia care (i.e., changes in family structure and social digitization) and benefits of adopting IAT (e.g., enhancing the safety of people with dementia and increasing their independence). However, there were differences in inhibitor/risk assessments between the two groups. Namely, economic considerations and the cognitive capacity of people with dementia were identified by both groups as inhibitors, while Israeli experts additionally reported stigma and ageism. Whereas both groups agreed that IAT might reduce human connection, and that the technology is not yet reliable enough, German experts highlighted concerns regarding privacy; in contrast, Israeli experts prioritized safety over privacy. Conclusions Our research findings allow for the identification of relevant similarities but also important differences between German and Israeli experts’ perspectives. As such, an important basis has been provided for a more in-depth discussion regarding where, why, and how culturally-sensitive technology development is needed.

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Section: Discussionsupporting

confidence: 55%

Cross-cultural perspectives on intelligent assistive technology in dementia care: comparing Israeli and German experts’ attitudes

AboJabel,

Welsch,

Schicktanz

2024

BMC Med Ethics

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“…In a previous expert interview study (Welsch, 2022a;Welsch, 2022b;Welsch and Schicktanz, 2022, Abojabal et al, under review) we found that the interviewed experts stressed the fact that providing clear definitions of AI or IAT is difficult. Nevertheless, many interviewees gave specific examples of IATs: reminder systems, orientation systems, smart home applications, and robots.…”

Section: Ai As a Product Of Technology And As An Object Of Ethical Re...mentioning

confidence: 88%

AI-assisted ethics? considerations of AI simulation for the ethical assessment and design of assistive technologies

et al. 2023

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Current ethical debates on the use of artificial intelligence (AI) in healthcare treat AI as a product of technology in three ways. First, by assessing risks and potential benefits of currently developed AI-enabled products with ethical checklists; second, by proposing ex ante lists of ethical values seen as relevant for the design and development of assistive technology, and third, by promoting AI technology to use moral reasoning as part of the automation process. The dominance of these three perspectives in the discourse is demonstrated by a brief summary of the literature. Subsequently, we propose a fourth approach to AI, namely, as a methodological tool to assist ethical reflection. We provide a concept of an AI-simulation informed by three separate elements: 1) stochastic human behavior models based on behavioral data for simulating realistic settings, 2) qualitative empirical data on value statements regarding internal policy, and 3) visualization components that aid in understanding the impact of changes in these variables. The potential of this approach is to inform an interdisciplinary field about anticipated ethical challenges or ethical trade-offs in concrete settings and, hence, to spark a re-evaluation of design and implementation plans. This may be particularly useful for applications that deal with extremely complex values and behavior or with limitations on the communication resources of affected persons (e.g., persons with dementia care or for care of persons with cognitive impairment). Simulation does not replace ethical reflection but does allow for detailed, context-sensitive analysis during the design process and prior to implementation. Finally, we discuss the inherently quantitative methods of analysis afforded by stochastic simulations as well as the potential for ethical discussions and how simulations with AI can improve traditional forms of thought experiments and future-oriented technology assessment.

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Value preference profiles and ethical compliance quantification: a new approach for ethics by design in technology-assisted dementia care

Buhr,

Welsch,

Shaukat

2024

AI & Soc

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Monitoring and assistive technologies (MATs) are being used more frequently in healthcare. A central ethical concern is the compatibility of these systems with the moral preferences of their users—an issue especially relevant to participatory approaches within the ethics-by-design debate. However, users’ incapacity to communicate preferences or to participate in design processes, e.g., due to dementia, presents a hurdle for participatory ethics-by-design approaches. In this paper, we explore the question of how the value preferences of users in the field of dementia care can be integrated into AI-based MATs. First, we briefly introduce different ethics-by-design approaches and explain the challenges they face in dementia care. Next, we introduce a novel approach for addressing these challenges. Through a qualitative content analysis of interviews with persons with dementia and their family caregivers (n = 27), we identified multiple ideal–typical value preference profiles. We then applied these profiles in a computer simulation, by which we also introduce the concept of ethical compliance quantification to scale the moral preferences of the interviewees for the simulation. Finally, we discuss study results, the advantages of using computer simulations, and general study limitations before drawing conclusions for further research. The study contributes to the ongoing debate on participatory ethics-by-design by defining on the basis of empirical data ideal–typical value preference frameworks that can be used to guide MAT actions and their outcomes. Going forward, MAT end-users with dementia and other communication-impaired persons could be enabled to choose a value profile that best fits their moral preferences.

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Privacy-sensitive Empowerment. Towards an integrated ethical concept for technology-assisted care for people with dementia

Cited by 5 publications

References 16 publications

Cross-cultural perspectives on intelligent assistive technology in dementia care: comparing Israeli and German experts’ attitudes

Cross-cultural perspectives on intelligent assistive technology in dementia care: comparing Israeli and German experts’ attitudes

AI-assisted ethics? considerations of AI simulation for the ethical assessment and design of assistive technologies

Value preference profiles and ethical compliance quantification: a new approach for ethics by design in technology-assisted dementia care

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