Dilemmas of a care robot in home

The care robots are coming, and that’s a fact. As the average age of the population increases, care robots can be an asset as there will be greater demand for care for the elderly. At the same time, there are also the frightening images of lonely, languishing elderly being cared for by emotionless, insensitive robots. How are we going to prevent robotization from leading to dehumanization? With technology philosopher Lambèr Royakkers we explore the ethical dilemmas surrounding care robots that must be answered. What would your preferences be?

Should we really consider using care robots for elderly care?

  • Yes

    The number of caregivers required cannot keep up with the growing need for care for the elderly. Care robots would allow elderly people to live independently at home for longer. Robots do not experience stress in the same way that a person does; they are available 24 hours a day, and they never forget to give medication.

  • No

    Robots are above all effective, efficient and impersonal. That is the opposite of care, which stands for warmth, kindness and empathy.

Lambèr Royakkers is an associate professor in the ethics of technology at Eindhoven University of Technology. His research has an interdisciplinary character and deals with the interface between ethics, law and technology, and has a particular focus on robotics and artificial intelligence.

Royakkers: “We can’t escape the fact: there is going to be a huge shortage of care personnel in the future. This is mainly due to our ‘ageing’ society. The proportion of the population that is 65 years of age or older is expected to rise to 30% by 2060. We are also getting older: our life expectancy at birth will rise from an average of 79.6 to 86.9 years in 2060.

In particular, the growth of the oldest group (over 80 years of age) will increase the pressure on care services due to their need for companionship and help with everyday tasks. Robot designers have high expectations: thanks to care robots, more care is conceivably possible, with more influence on the care itself, and therefore a lower workload for care professionals.

The question is what kind of role we let the robot play: as a companion, assistant, or caretaker. It is also important that the elderly are actively involved in the design of these robots: they know better than anyone what they need. This ensures better acceptance of robots in their homes and care facilities.”

Is our privacy at stake when we use care robots?

  • Yes

    To properly support care recipients, they need to be monitored on the one hand – using cameras or sensors, for example – and on the other hand a lot of data needs to be collected to monitor their wellbeing and health.

  • No

    Collecting data is necessary to provide good care, which is more important than privacy. Rather be filmed naked in the bath, than fall and become unconscious while nobody notices.

Royakkers: “The issue of privacy is particularly relevant to domotics, which are already being introduced. Domotics directly interface with the technology in and around the house to make it easier to meet the resident’s needs, such as automatically opening doors, and setting or monitoring alarm systems that allow doctors to monitor health remotely.

Thanks to domotics, people spend less time in hospitals and rehabilitate more often at home. Also, thanks to online monitoring, a hospital visit is less necessary, and healthcare providers do not have to come to the patient’s home.

However, this is always at the expense of privacy. Who really wants to be followed by a camera when you’re not dressed or taking a bath? It is also important to consider who collects the data. Who guarantees that the data is safely stored? These are questions that politicians and designers must answer. A balance is needed between a certain, inherent right to privacy and the importance of being able to live independently at home.”

Can robots be ‘buddies’ for the elderly?

  • Yes

    Robots can keep the elderly company and help them with their daily activities. This will allow the elderly to live independently at home for longer.

  • No

    Robots affect the autonomy of the elderly, and will never be able to form a real relationship with a human being.

TU/e is also working on the development of care robots as an aid. These are the care robots developed by the Tech United student team. They participate in worldwide robot competitions – the RoboCup – a competition that is intended to accelerate the development of robotics. From left to right: NAO (Aldebaran), Human Support Robot (HSR – Toyota), PICO (rebuilt Gostai Jazz), Pepper (Aldebaran), AMIGO and SERGIO.

Royakkers: “Where robots still take the form of rather clumsy behemoths with metallic voices, the dream of designers is to create multifunctional devices that respond to emotion and can show emotion themselves. That will take some time, by the way, as the most fundamental issues such as localization and navigation are already proving to be major technological challenges.

The question is whether a robot that you can ignore, pause, or turn off can build a meaningful relationship with you. Some ethicists even speak of a ‘simulacra’, an imitation of real social interaction. Our relationships with other people are often unpredictable, sometimes unexpected or uncomfortable. That is what makes them so valuable. It becomes very difficult for a robot to replicate such spontaneity.

Perhaps cute robot animals can help to somewhat reduce the loneliness or ensure that the elderly keep practicing social interaction.

An important point to consider with robots as an ‘assistant’ in the home is how pushy a robot can become, for example when it comes to reminding a person to take medication. What if an individual refuses to take the medication? In this way, the autonomy of the elderly can be affected and, in an extreme sense, lead to quite authoritarian robots. That is effectively the opposite of ‘care’, isn’t it?”

Do care robots provide ‘quality of care’?

  • Yes

    As long as we only use robots for routine tasks and leave the ‘care’ to real people.

  • No

    We ‘dehumanize’ our care and present our elderly as ‘objects’ that we can keep sweet with robots.

Will robots also do the shopping in the future? Photo: Bart van Overbeeke

Royakkers: “If you are going to use care robots to replace the care provider, there is a risk that the care will become ‘dehumanized’. As soon as robots take over tasks such as feeding and lifting, patients can start to feel like ‘objects’. A solution to this can be ‘mutual care’, the robot can also ask the care recipient for help from time to time to perform its tasks. In that case the user also feels important and less like an object.

Also keep in mind that there is a decrease in human contact when caregivers no longer visit people, but only keep in touch remotely. This can affect the wellbeing of care recipients, some ethicists think. This raises the question: how much right has a patient to actually have human contact? For one person, one human contact per day is very valuable, while for another, their preference lies with the presence of a robot at the bedside. The user’s choice must be central.

Central to all this is the ethical question: can robots really provide ‘care’? Care is about people’s wellbeing, about building a relationship with them, and about dealing with the problems they encounter. Fundamentally, robots are designed to be effective and efficient. I don’t think they are going to replace care providers, but their arrival will lead to a shift and redistribution of responsibilities and tasks, and therefore form new kinds of care in a general sense.”

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