Robots in elder care

It is predicted that by 2050 there will be 1.5 billion people in the world over the age of 65 years. In countries such as Japan, there is an acute awareness that the number of those in need of care will far outstrip the number of available caregivers. Japan is a pioneer of technological developments, and news headlines highlight how the problem and the technology are coming together: ‘Japan is running out of people to take care of the elderly, so it’s making robots instead’; ‘Japan’s NTT to put home care robots in the homes of the elderly’; and ‘Japanese ‘‘robot with a heart’’ will care for the elderly and children’. The robots in question take various forms and have different functions. Robots specially designed for care have become known as ‘carebots’: Paro, for example, is described as a ‘furry, seal-like bot programmed to bond with its owner and show emotions such as happiness and surprise’. Robobear is a ‘humanoid robot’ that can lift people and move them, for example, from bed to wheelchair. There are also robots that can assist with feeding, bathing, monitoring health status and giving reminders about medication. It has been claimed that a robot called ‘Pepper’ is ‘capable of understanding human emotions using an ‘‘emotional engine’’ and a cloud-based AI’. Pepper allegedly learns from interactions with humans, and the learning is shared with other ‘units’. There is scepticism, however, about Pepper’s ability to listen and to engage meaningfully. Such developments invite us to consider the ethical implications of robots as caregivers and to ask critical questions about the motivation for, and consequences of, caregiving by robots: Why might a care provider organisation invest in ‘carebots’? Is the aspiration to replace or complement human caregivers? What information and choice would care recipients be given about carebots? Isn’t it better, as we’ve heard said, to have a caring robot than an uncaring human? And why would we object to carebots when we already have other non-human caregivers such as service dogs? Robots are not new in other sectors. Service robots have been used in factories and laboratories for some time and are ‘good at dull, dangerous and dirty work’ such as cleaning sewers, doing domestic work, harvesting fruit, assisting surgeons and in bomb disposal activities. Caregiving is not, however, like factory or laboratory work. It is a complex and privileged process requiring a high level of knowledge and skill. It requires also a high level of ethical sensitivity and a commitment to maintain the dignity of care recipients in every care context. Older people are particularly vulnerable to dignity loss if they become dependent and lose some capacity for decision making. They are reliant on caregivers to respond to their individuality, to have the ability to pick up on subtle cues regarding capabilities and to communicate in an emotionally engaged and meaningful way. This involves being present to the person receiving care, making them comfortable and enabling them to feel that they are valuable persons regardless of any incapacity.