Significant advancements in medicine, public health, and technology have resulted in a growing population of older adults, adding to the steady rise in the proportion of senior citizens. With the increasing aging population, the demand for and financial costs of caring for older adults are both rising, and many prefer to age in place and receive healthcare at home.
However, this may require accepting risks such as falling, which increases with frailty. Smart home health technologies (SHHTs) represent a potential solution to this problem, allowing for remote monitoring of the older resident and registering any abnormal deviations in daily habits and vital signs while sending alerts to their formal and informal caregivers when necessary. While focusing on practical advantages is important, an equally important question to ask is how ethical these technologies are when used in the care of older persons.
A new systematic review published in BMC Medical Ethics has been conducted to investigate if and how ethical considerations appear in the current research on Smart Home Health Technologies (SHHTs) in the context of caregiving for older persons. The review included both empirical and theoretical works of literature, making it more comprehensive than existing systematic reviews that have either only explored the empirical side of the research and neglected to study ethical concerns.
This review sheds fresh light on some of the most pressing ethical dilemmas in caring, such as autonomy and trust. While the findings are encouraging, they also shed light on a number of little-known ethical issues linked with the employment of technology in the healthcare context.
The key result of the review is that little to no research has been conducted on the possible ethical repercussions of SHHTs for providers. More than one-third of the pieces we read made no mention of ethical issues. This might be explained by the shortage effect. One of the many interpretations of “scarcity” that arise from aged care research is that there is a limited possibility for the application of ethical standards in the development of medical technology.
Because journals can only accommodate so much material in each issue, there isn’t much room for in-depth examinations of moral quandaries. Unfortunately, there may not be enough room in scientific articles to emphasize principles or difficulties discovered in the systematic study, such as trust, accountability, or ageism.
Caregivers may be too concerned or stressed out to “solve” the problem of insufficient resources. Scientists may be tempted to ignore the ethical implications of their research in order to gain evidence of its advantages. Finally, researchers must compete for limited funding, and technological research is frequently sponsored more than biomedical ethics, therefore, it is probable that more publications cite just empirical investigations rather than emphasizing ethical issues or combining empirical and ethical parts.
It’s not surprising that when discussing SHHTs in a clinical environment, privacy concerns are raised as the primary ethical issue. Several issues about health and/or technological surveillance have revolved around privacy concerns. The link between private privacy and cognitive decline was a fascinating discovery in this field of ethics.
While worries about autonomy and cognitive impairment are prevalent in bioethical studies, academics and practitioners have increasingly focused on privacy. According to the research, the elderly with cognitive impairments were more likely to have intrusions into their privacy justified. This is not to say that these intrusions are moral, simply that they are conceivable, if not necessary, under the circumstances.
Interestingly, the ethics of human-machine connections received more attention than autonomy. Discussions about autonomy tend to be the most impassioned when it comes to technology challenges. Yet, there is a rising concern, particularly in recent years, that automated technology will one day replace human caregivers.
This is an essential problem since caring for the elderly has been and will continue to be a people-centered endeavor. The ability of technology to eliminate this necessity is not new, but it rightly creates concerns among both the elderly and their carers. There was considerable concern that medical care would be supplanted by technology. This discovery is not surprising, given that the advent of new technology has sparked concerns about job loss in a variety of areas, including nursing.