Why ethics matter in AgeTech for older adults
The world is changing rapidly. New technologies are integrating every part of our lives and the world we live in, and it’s no exception in the healthcare sector.
Dubbed ‘AgeTech’ these technologies include e-health information systems, surgical robotics, artificial intelligence use in data management and smarter than ever mobile devices. AgeTech can also have wide ranging consumer applications including in-home monitoring systems, health alert systems and even assistive robots. This technology has many benefits from increasing independence, making communications more effective and better connecting people in isolated regions to providing much needed health-supports.
While this is a promising narrative, there are a number of ethical concerns that come to the forefront when integrating technology into something so personal as healthcare. From questions of data privacy and the use of new terminology and generalizations to funding disparities, there’s lots to consider. The takeaway – keeping ethics top of mind when utilizing this technology is crucial.
Future directions
Enter the formation of ICE-TEA: International Consortium on Technology and Aging project, funded by AGE-WELL, Canada’s Technology and Aging Network. Simply put, ICE-TEA was established to ensure ethical thinking is factored into all aspects of AGE-WELL’s work and hopefully the whole AgeTech sector.
The project focuses on exploring the ethical considerations of AgeTech and fostering an initiative for increased knowledge and long-term research in key areas. A number of ethical issues were highlighted:
• Privacy and surveillance in the home.
• Digital divide and tech accessibility.
• Autonomy vs. safety in cognitive decline.
• Unpredictable nature of technological outcomes.
• Ageism in AI and data bias.
By hosting co-creation workshops and activities the ICE-TEA researchers were able to develop a more fulsome understanding of a variety of ethical concerns from an older adults’ perspective.
While the first takeaways are still being evaluated, main themes included:
a) A disputed general definition of the idea of ethics. While ethical practice may be well defined in established fields such as the medical or legal sector, there is a more vague approach beyond that. People have diverse perspectives which affects how they frame the idea of ethics and an ethical issue.
b) Another concern was the extensive resources and effort that would be required to regularly involve older adults in the research and development at AgeTech.
c) Following this issue, it was felt that ensuring marginalized groups are included in the conversation made this work even more resource intensive and costly.
d) Of note, many people working in the industry are motivated by personal experience and want to bring a positive impact, which is promising. However, this doesn’t mean that ageist attitudes can’t creep into development or that bias isn’t present.
Utilizing technology that has been designed for older adults can seem daunting for some people and their caregivers. Some recommendations to improve user experience that are recommended include:
• Ask questions about how the manufacturer protects user privacy and data.
• Choose user-friendly devices with customization options.
• Provide feedback to developers and researchers.
• Encourage older loved ones to express needs and fears.
Community of practice
One of ICE-TEA’s launch objectives was to develop an effective Community of Practice (CoP) – a transdisciplinary community of diverse stakeholders who will mobilize their skills and capabilities to promote ethical thinking in AgeTech research and development.
Their vision for an ICE-TEA CoP is “to embed ethical thinking across the whole AgeTech innovation cycle from design and research to development, implementation and commercialization”. This CoP would involve older adults, health practitioners, government agencies, tech companies, researchers and other relevant community partners who are passionate about ensuring ethical practices in the sector.
ICE-TEA’s approach to developing this CoP is meant to be pragmatic, with tangible action steps including building on existing mechanisms, mobilizing assets and networking with established partners. When looking at the development of a CoP their workshops showcased the importance of having a clear set of ethical issues to work to prevent, so as to provide a clear directive free of ambiguous definitions. ICE-TEA’s CoP would focus on enabling older people to participate fully, ensure research and innovation are free from ageist ideologies and build a capacity to support older people as changemakers in the AgeTech community.
Beyond the creation of a CoP, ICE-TEA provided a number of recommendations for the larger AgeTech sector. These included:
1) Emphasizing stakeholder engagement and participatory design of older adults, caregivers, and other stakeholders.
2) Fostering a cultural shift so there is reflexivity and inclusion in AgeTech development.
3) Addressing distributive justice and cultural sensitivity concerns to ensure equitable and fair access to technology.
4) Incorporate a relational and contextual ethical framework that considers the broader relational and social contexts in which these individuals reside.
ICE-TEA is a project led by Simon Fraser University’s STAR Institute and The University of Dundee with funding from AGE-WELL.
Images: iStock.
