Summary
We decided to analyze the ethical dilemma presented by having robots provide elder-care. The provided article[1], written by Business Insider, was an overview of the growing market in Japan for elder-care robots. According to the article, 20% of Japan’s population is 65 or older. For comparison, the 2010 Census found that just 13% of US citizens are over the age of 65. Japan has a growing shortage of elder-care workers available, and in order to combat this, Japan has dedicated a substantial portion of its budget to developing automated elder-care, called Carebots. These carebots are designed to replace or assist human nurses in their everyday duties. Their use remains controversial[6], and we will discuss the main ethical issues raised by the use of carebots.
Stakeholders:
Elders, their children, relatives, the robot manufacturers, nursing homes or organizations hosting elderly care.
Utility Test:
https://www.ethicsops.com/best-outcomes-test
- Identify the alternative actions that are possible and the persons and groups (the stakeholders) who will be affected by these actions.
Alternative 1: Do not use robots to take care of elderly, use existing forms of cars, nurses, and family
Persons affected: More responsibility on nurses and family members to provide care. Elderly may not be provided with adequate care if shortage of nurses or staff.
Alternative 2: Implement automation for practical tasks that are not designed to replace human emotional interaction, but facilitate consistent human interaction on a daily basis.
Persons affected: Reduces need for nurses, guarantees more wholesome care of elderly by fulfilling demand while not jeopardizing care
-
For each of the most promising alternatives, determine the benefits and costs to each person or group affected. These calculations:
-
Require predicting probable outcomes based on facts and experience
-
Should include both short-term and long-term consequences
-
Should consider the relative value or “marginal utility” of an outcome to different individuals and groups
Alternative 1:
Benefits:
-
-
All ethical concerns associated with robotic care are eliminated
-
Guaranteed human interaction, which leads to better mental well being of elderly
-
More job opportunities
Costs:
-
Shortage of nurses can lead to lack of care to elderly
-
Humans, unlike robots, can act irresponsibly or be abusive
-
Overworked nurses are more likely to make mistakes or provide lower quality care
Alternative 2:
Benefits:
-
Human interaction portion of care still remains
-
Automated tasks reduces possibility of errors
-
In the case of a widespread robotics failure, the presence of humans reduces the impact
-
Nurses keep their jobs, but are not overworked
Costs:
-
Organizations will be paying for robotic maintenance and nurse salaries
-
Potential resentment from nurses due to fear of being replaced by robots
-
Select the action in the current situation that produces the greatest benefits over costs for all affected. If costs outweigh benefits, select the action with the least costs relative to benefits. This step shows the alternative that has the greatest net good for this one situation.
Alternative 2 has more benefits than costs and is therefore the best action for the current situation
-
Ask what would happen if the action were a policy for all similar situations. Since what is done in one situation often becomes an example or even a policy for future actions, this step shows which alternative maximizes good for this and future situations.
Our alternative action focuses on the continued presence of humans in the elderly care industry, ensuring that the industry is not completely dominated by robots. In the future, this policy could inspire other industries and prevent them from being completely dominated by robots. Having a balance of humans and robots allows there to be a system of checks and balance between the two while ultimately improving the industry due to the inherent advantaged capabilities of robots over humans
-
** Draw a conclusion**
-
If the same action is selected in Steps 3 & 4, then this is the ethical action.
-
If different actions are selected, then decide whether the individual action or the policy will produce the greatest good and the least harm, for all affected, over the long term
-
Alternative two is the ethical action because it serves the most good in both the present and future situations. The action implemented as a policy would also provide future benefits to other industries considering converting to full automation.
Justice Test
https://www.ethicsops.com/justice-test
-
**What is the distribution? **These are factual questions. Once you know the distribution you can decide if it is fair or not.
-
Who is getting the benefits and burdens in the situation?
-
Do those who get benefits also share burdens?
-
Do those with benefits share some of the burdens?
-
Considering the action under analysis is replacing the current system for taking care of elderly with “Carebots”, the distribution of benefits and burdens is as follows.
Benefits:
-
Elderly will receive sufficient care because shortage of caregivers will no longer exist
-
Elderly will be provided with more consistent care, free of human error or forgetfulness
-
In the long run care-giving organizations may save on cost, by not having to pay nurses
Burdens:
-
Elderly may suffer from lack of human engagement
-
Potential loss of privacy for elders
-
Elderly may feel objectified due to interactions with machines or a loss of control
-
Elderly may feel loss of personal freedom
-
Elderly may feel misunderstood due to robots inability to interpret human emotion
-
**Is the distribution fair? **You have to defend the distribution and the criterion or reason for the distribution.
-
Which criterion for distribution would be most fair in this situation?
-
Why would it be most fair in this situation?
-
This distribution shows there are more burdens for the elderly than benefits when automating caregiving with the use of robots. This solution is not fair because although its intended purpose is to provide care for the elderly, it burdens them more than it benefits them.
- If disagreement persists over which outcome is fair or over which criterion for inequality is best in the situation, then select a fair process to decide what is fair, for example, an election, dispassionate judge, pick winners out of a hat, chance decided by a coin, or paper-rock-scissors.
A more fair solution is to consider the specific needs and feelings of the elderly with regards to their ideal caregiving situation. Elderly people desire company, require assistance and attention, and must be monitored for the health and safety. While robots are ideal for some of these things, such as health monitoring or assistance getting out of a chair or walking up stairs, there are some things, such as showing empathy, having emotional or passionate conversations, or providing personalized care, that robots are bad at due to their lack of emotional intelligence. A fair solution, therefore, which accommodates all of elderly’s needs involves a combination of both human and robot caregiving. Humans should be involved in any aspect of caregiving that requires emotional intelligence, while robot should be responsible for all other aspects.
- **Draw a conclusion. **Will this action produce a fair distribution, and why?
The above proposed solution has a fair distribution because it resolves all of the burdens involved with fully automated caregiving, while enabling nurses to keep their jobs and fulfilling the shortage of caregivers.
Virtue Test
https://www.ethicsops.com/blank-3
-
**Ask if the action will help to make you the kind of person you want to be. **
-
Consider whether the action fits your self-image or the story you would like to tell about your life. The most excellent or virtuous people are usually thought of as those who consistently act with honesty, courage, compassion, generosity, fidelity, integrity, fairness, self-control, prudence and so on.
-
One way to see if the action fits with who you would like to be, is to ask whether the action is something that the person you most respect in your company would do.
-
Business people often call this question the Mirror Test, “If you do this action, will you be able to look at yourself in the mirror every morning?”
-
Leaving elderly at the hands of robots is not something that help make us the kind of people we want to be. We should want elder community members to stay socially active. We want them to communicate with real people and beloved by real people. A virtuous person would not leave his parents or grandparents completely to robots because this action would make the person feel he is neglecting them. A person I respect would also not do this and I would not be able to look at myself in the mirror every morning if I did. However, knowing that the machines are just for certain tasks, and the elderlies can still maintain a healthy amount of communication with real people would make virtuous people feel right.
- **Ask whether the action will fit the company’s reputation or vision of what it would like to be. **An individual’s actions represent and affect not only him/her but also the firm or organization he/she works in. The image of what the company wants to be will be found in the mission and vision statements, the core values, and the ethics code, as well as in the stories that are told about the heroes and the villains in the firm’s history.
A good nursing home’s mission statement and core value should not be all about efficiency and convenience. We often see in dystopian films or literatures children being taken care by highly automated machines and end up with no individual character, becoming part of a highly conforming society. Same rule applies to elderlies. A ethical company should not leave people to programmed machines just for its efficiency. It should also provide elderlies care and love from people.
-
Ask whether the action maintains the right balance between excellence and success for the firm?
-
Excellence refers to how well the activities of the organization are being done. Each activity, such as producing a product or service, marketing it to customers, financing the organization, accounting and maintaining controls, and so on can be done in the best possible way. Striving for too much perfection in any one of these areas, however, can have an affect on the ability of the firm to do the other activities and generate profits necessary to keep it in operation over the long term. If the product or service is too perfect for the customer to afford it, then the firm will fail.
-
Overemphasizing success, measured as profitability, can affect the excellence of the firm’s activities, and thereby cause the firm to fail.
-
Actions that maintain the right balance between excellence and success are therefore the right ones.
-
Our Alternative solution should maintain the right balance between excellence and success for the firm. A technology advances, robots are getting cheaper and more efficient than human labor. Utilizing new technology should be able to help firms generate profits. Meanwhile, better technologies should also improve customers’ standard of living. This seems to be a win win situation for both the firm and the customers. However, some customers may also need supports that machines are not capable of providing, thus creating the need for human employees.
- **Draw a conclusion. **Actions that fit your idea of what kind of person you want to be, and with the firm’s idea of what it wants to be are good actions.
Our conclusion is that in order to be the kind of people we want to be and our firm to be a virtuous firm, we need both robot and human to take care of elderlies. This is the best solution that both provide profits to the firm, especially in the long term, and cause very little ethical concerns.
-
What are the economic, social, and political constraints that play into this scenario?
The economic factor is a variation of the current system since it deals with the inclusion of robots in **certain **aspects of elderly care. By keeping the same amount of nurses -or maybe a few less- to control the human interactivity aspect, the introduction of complex machinery such as a bed that turns into a wheelchair can cost a lot of money and maybe some families cannot afford it. On the other hand, if the prices of these robots is made affordable for all families -or at least the vast majority- then the pioneer companies can expect losses because of this price reduction. It is a very sensible idea that needs to be taken into consideration before introducing these robots into the market for commercial use. The biggest impact of this case is in the social aspect, since the human-robot interaction is a topic of infinite discussion between the revolutionaries -younger generations that are more affiliated with technology- and the conservatives -older generations that have always prefered human interaction since robots cannot sympathize like humans do-. The elderly need special attention due to their physical conditions and state of mind. Although a robot can provide very effective performance to take care of them, they are obviously not going to be able to satisfy their psychological needs like having a friend to talk to, or a HUMAN that is able to understand how they are feeling. Finally, there are not much political constraints that play a significant role in this scenario, other than the fact that a politician can use this topic to influence a specific set of people with a given opinion about this topic. Concluding, we have determined that this case would have a great impact in our society in many ways. We believe it will be more beneficial to achieve a balance in human-robot interaction than to just replace dedicated nurses with machines.
Solutions
A possible solution to using robots for elderly healthcare would be using robots only for certain practical tasks while leaving other, more personal, tasks to humans. Robots would be used for tasks like cleaning or dispensing medicine or be robots like the bed to wheelchair robot that would simply facilitate care, which would not greatly impact the social interaction of the elderly. These robots would preferably not be humanoid robots in order to minimize any psychological effects from having robots replace human tasks. This arrangement would still require some amount of human involvement to take care or non-automated tasks, hopefully reducing feelings of isolation or unwantedness from the elderly while reducing the workload of family and/or nurses.
Links
[1] http://www.businessinsider.com/japan-developing-carebots-for-elderly-care-2015-11
[2] https://www.iso.org/standard/53820.html
[4] https://link.springer.com/article/10.1007/s10676-010-9234-6
[5] http://www.sciencedirect.com/science/article/pii/S0921889016305292