Electronic Health and Ambient Assisted Living: On the Technisation of Ageing and Responsibility

Abstract

Mobile health systems, electronic health systems and technologies for so-called “ambient assisted living” (AAL) are schemes based on information technologies that focus on “empowering people’s capabilities by the means of digital environments that are sensitive, adaptive and responsive to human needs” (Parisa and Mihailidis 2013, 579). Tools developed under this paradigm are designed to offer supportive human–machine interaction technologies, which help users to cope with their daily environments and tasks including medical care and self-care. Senior citizens today are confronted with a range of such mobile health technologies developed for their benefit. Many of these intend to support the prevention of disease (e.g., by continuously monitoring chronic conditions such as high blood pressure or diabetes) or are designed for supporting the delivery and effectiveness of therapies or improving adherence. A major reason for older people to use these tools might be their expectation that modern, highly technical, webbased mobile solutions could increase their quality of life better than the use of conventional support methods (Ammicht Quinn et al. 2015). Simultaneously, in advertisements, public media and popular culture, ageing is propagated as a dynamic and modifiable process such that senior citizens are increasingly being represented as active and responsible for their own well-being. Thus, push and pull effects regarding the use of mobile health utilities by the elderly seem to go hand in hand. Besides their obvious advantages, however, the use of these devices is also linked to some ethical considerations. In the following, we intend to focus on ethical questions related to the use of ambient mobile and electronic health technologies by people of advanced age. Our goal is to evaluate their usage in the context of intergenerational responsibility.We consider intergenerational responsibility to be a key concept to include within an ethical evaluation against which the goals of AAL tools must be tested. The major propagated goals of health-related technologies for the aged include securing privacy, autonomy, participation and justice. In our assessment, we will focus on these values and discuss them in the broader context of moral responsibilities.