Ethics at the Intersection of Intelligent Assistive Technology, Ageing, and the Home Environment: A Scoping Review.

Abstract

Intelligent assistive technology (IAT) is being developed to enable safe and autonomous ageing at home and is associated with supporting quality of life. These anticipated benefits must be balanced against potential unintended negative effects. This scoping review aims to identify and summarize the key ethical dimensions and frameworks discussed in the relevant scholarly literature. Furthermore, we examine whether the ethical dimensions identified can be derived from the four principles of bioethics, suggesting that, when properly specified, principlism could serve as a systematic framework for evaluating IAT. Thus, our review has two aims: identifying the ethical dimensions and frameworks currently discussed and investigating whether these frameworks can be structured according to the four principles or if additional principles are necessary. A systematic search across the databases PubMed, Web of Science, EMBASE, Belit, and PhilPapers, plus a manual search identified 535 publications, from which twenty-three studies were included. The results show twenty-one heterogeneous ethical dimensions, with similar matters considered across different categories. The review shows that key expectations and promises of developing and using IAT in this context mostly relate to the possibility of safely ageing at home and reducing healthcare costs. While assigning these ethical dimensions to the four principles of bioethics, it became clear that although all aspects discussed could be subcategorized, some ethical concerns might lose visibility or be inadequately addressed. We, therefore, conclude that the four principles generally provide a sufficient basis for evaluating these technologies.