Socially Assistive Devices in Healthcare–a Systematic Review of Empirical Evidence from an Ethical Perspective

Abstract

Socially assistive devices such as care robots or companions have been advocated as a promising tool in elderly care in Western healthcare systems. Ethical debates indicate various challenges. An important part of the ethical evaluation is to understand how users interact with these devices and how interaction influences users’ perceptions and their ability to express themselves. In this review, we report and critically appraise findings of non-comparative empirical studies with regard to these effects from an ethical perspective.Electronic databases and other sources were queried using a comprehensive search strategy generating 9851 records. Studies were screened independently by two authors. Methodological quality of studies was assessed. For 22 reports on 21 datasets using a non-comparative design a narrative synthesis was performed.Data shows positive findings in regard to attitudes and emotional reactions of users. Varying perception of a social relation and social presence are the most commonly observed traits of interaction. Users struggle with understanding technical complexities while functionality of the devices is limited. This leads to a behavioral alignment of users towards the requirements of the devices to be able to make use of them.This evidence adds to three important ethical debates on the use of socially assistive devices in healthcare in regard to (1) reliability of existing empirical evidence to inform normative judgements, (2) ethical significance of the social presence of devices and (3) user autonomy in regard to behavioral alignment.

Increasing efficiency and well-being? a systematic review of the empirical claims of the double-benefit argument in socially assistive devices

“…To answer this question, we used the subset of comparative studies from a comprehensive review of empirical evidence on human-machine interaction with SATs in healthcare. The results from the arm of non-comparative studies were reported elsewhere [ 5 ]. The review protocol was designed and agreed upon by the authors.…”

“…These technologies, which include care robots, smart screen assistants, virtual avatars, and companion devices can be characterized by entailing at least three essential features. Firstly, they integrate into the everyday lifeworld of their users [ 4 , 5 ]. Secondly, they offer support by taking over control, routine, or steering tasks or by acting with or on behalf of their users [ 1 , 4 , 5 ].…”

“…Firstly, they integrate into the everyday lifeworld of their users [ 4 , 5 ]. Secondly, they offer support by taking over control, routine, or steering tasks or by acting with or on behalf of their users [ 1 , 4 , 5 ]. Finally and most importantly, SATs provide their services through a special interface that resembles interacting with an animate being [ 6 – 9 ].…”

Aging with robots: A brief review on eldercare automation

“…Conducted through focus group interviews with 97 individuals, averaging 75 years old, a study revealed that elderly users frequently express a strong inclination toward determining the information monitored and stored by robots, advocating for a selective approach to maintain control and safeguard privacy in the realm of robotic assistance 12 . Furthermore, there is often a lack of awareness among both the elderly and their caregivers regarding constant behavioral monitoring and the potential sharing of these records with third parties 83 .…”