PDF(Pubmed)
Abstract：
BACKGROUND: Technological advances in robotics, artificial intelligence, cognitive algorithms, and internet-based coaches have contributed to the development of devices capable of responding to some of the challenges resulting from demographic aging. Numerous studies have explored the use of robotic coaching solutions (RCSs) for supporting healthy behaviors in older adults and have shown their benefits regarding the quality of life and functional independence of older adults at home. However, the use of RCSs by individuals who are potentially vulnerable raises many ethical questions. Establishing an ethical framework to guide the development, use, and evaluation practices regarding RCSs for older adults seems highly pertinent.
OBJECTIVE: The objective of this paper was to highlight the ethical issues related to the use of RCSs for health care purposes among older adults and draft recommendations for researchers and health care professionals interested in using RCSs for older adults.
METHODS: We conducted a narrative review of the literature to identify publications including an analysis of the ethical dimension and recommendations regarding the use of RCSs for older adults. We used a qualitative analysis methodology inspired by a Health Technology Assessment model. We included all article types such as theoretical papers, research studies, and reviews dealing with ethical issues or recommendations for the implementation of these RCSs in a general population, particularly among older adults, in the health care sector and published after 2011 in either English or French. The review was performed between August and December 2021 using the PubMed, CINAHL, Embase, Scopus, Web of Science, IEEE Explore, SpringerLink, and PsycINFO databases. Selected publications were analyzed using the European Network of Health Technology Assessment Core Model (version 3.0) around 5 ethical topics: benefit-harm balance, autonomy, privacy, justice and equity, and legislation.
RESULTS: In the 25 publications analyzed, the most cited ethical concerns were the risk of accidents, lack of reliability, loss of control, risk of deception, risk of social isolation, data confidentiality, and liability in case of safety problems. Recommendations included collecting the opinion of target users, collecting their consent, and training professionals in the use of RCSs. Proper data management, anonymization, and encryption appeared to be essential to protect RCS users\' personal data.
CONCLUSIONS: Our analysis supports the interest in using RCSs for older adults because of their potential contribution to individuals\' quality of life and well-being. This analysis highlights many ethical issues linked to the use of RCSs for health-related goals. Future studies should consider the organizational consequences of the implementation of RCSs and the influence of cultural and socioeconomic specificities of the context of experimentation. We suggest implementing a scalable ethical and regulatory framework to accompany the development and implementation of RCSs for various aspects related to the technology, individual, or legal aspects.
OBJECTIVE: The objective of this paper was to highlight the ethical issues related to the use of RCSs for health care purposes among older adults and draft recommendations for researchers and health care professionals interested in using RCSs for older adults.
METHODS: We conducted a narrative review of the literature to identify publications including an analysis of the ethical dimension and recommendations regarding the use of RCSs for older adults. We used a qualitative analysis methodology inspired by a Health Technology Assessment model. We included all article types such as theoretical papers, research studies, and reviews dealing with ethical issues or recommendations for the implementation of these RCSs in a general population, particularly among older adults, in the health care sector and published after 2011 in either English or French. The review was performed between August and December 2021 using the PubMed, CINAHL, Embase, Scopus, Web of Science, IEEE Explore, SpringerLink, and PsycINFO databases. Selected publications were analyzed using the European Network of Health Technology Assessment Core Model (version 3.0) around 5 ethical topics: benefit-harm balance, autonomy, privacy, justice and equity, and legislation.
RESULTS: In the 25 publications analyzed, the most cited ethical concerns were the risk of accidents, lack of reliability, loss of control, risk of deception, risk of social isolation, data confidentiality, and liability in case of safety problems. Recommendations included collecting the opinion of target users, collecting their consent, and training professionals in the use of RCSs. Proper data management, anonymization, and encryption appeared to be essential to protect RCS users\' personal data.
CONCLUSIONS: Our analysis supports the interest in using RCSs for older adults because of their potential contribution to individuals\' quality of life and well-being. This analysis highlights many ethical issues linked to the use of RCSs for health-related goals. Future studies should consider the organizational consequences of the implementation of RCSs and the influence of cultural and socioeconomic specificities of the context of experimentation. We suggest implementing a scalable ethical and regulatory framework to accompany the development and implementation of RCSs for various aspects related to the technology, individual, or legal aspects.
摘要：
背景：机器人技术的进步，人工智能,认知算法，和基于互联网的教练为能够应对人口老龄化带来的一些挑战的设备的开发做出了贡献。许多研究已经探索了使用机器人教练解决方案（RCS）来支持老年人的健康行为，并显示了它们对老年人在家中的生活质量和功能独立性的好处。然而,潜在弱势人群使用RCS引发了许多伦理问题.建立一个伦理框架来指导发展，使用,关于老年人RCS的评估实践似乎非常相关。
目的：本文的目的是强调与老年人在医疗保健中使用RCS相关的伦理问题，并为有兴趣在老年人中使用RCS的研究人员和医疗保健专业人员起草建议。
方法：我们对文献进行了叙述性回顾，以确定出版物，包括对伦理维度的分析和关于老年人使用RCS的建议。我们使用了受卫生技术评估模型启发的定性分析方法。我们包括所有文章类型，如理论论文，研究,和审查处理道德问题或在一般人群中实施这些RCS的建议，尤其是在老年人中，在医疗保健部门，2011年后以英文或法文出版。审查是在2021年8月至12月之间使用PubMed进行的，CINAHL,Embase,Scopus,WebofScience,IEEE探索,SpringerLink,和PsycINFO数据库。使用欧洲卫生技术评估核心模型网络（3.0版）对选定的出版物进行了分析，涉及5个道德主题：利害平衡，自主性,隐私,正义与公平，和立法。
结果：在分析的25种出版物中，引用最多的道德问题是事故的风险，缺乏可靠性，失去控制,欺骗的风险,社会孤立的风险，数据机密性，以及安全问题的责任。建议包括收集目标用户的意见，收集他们的同意，并培训使用RCS的专业人员。正确的数据管理，匿名化,和加密似乎对保护RCS用户的个人数据至关重要。
结论：我们的分析支持对老年人使用RCS的兴趣，因为它们对个体的生活质量和幸福感有潜在的贡献。此分析突出了许多与使用RCS实现健康相关目标相关的道德问题。未来的研究应考虑实施RCS的组织后果以及实验背景下文化和社会经济特性的影响。我们建议实施可扩展的道德和监管框架，以配合与技术相关的各个方面的RCS的开发和实施，个人,或法律方面。
目的：本文的目的是强调与老年人在医疗保健中使用RCS相关的伦理问题，并为有兴趣在老年人中使用RCS的研究人员和医疗保健专业人员起草建议。
方法：我们对文献进行了叙述性回顾，以确定出版物，包括对伦理维度的分析和关于老年人使用RCS的建议。我们使用了受卫生技术评估模型启发的定性分析方法。我们包括所有文章类型，如理论论文，研究,和审查处理道德问题或在一般人群中实施这些RCS的建议，尤其是在老年人中，在医疗保健部门，2011年后以英文或法文出版。审查是在2021年8月至12月之间使用PubMed进行的，CINAHL,Embase,Scopus,WebofScience,IEEE探索,SpringerLink,和PsycINFO数据库。使用欧洲卫生技术评估核心模型网络（3.0版）对选定的出版物进行了分析，涉及5个道德主题：利害平衡，自主性,隐私,正义与公平，和立法。
结果：在分析的25种出版物中，引用最多的道德问题是事故的风险，缺乏可靠性，失去控制,欺骗的风险,社会孤立的风险，数据机密性，以及安全问题的责任。建议包括收集目标用户的意见，收集他们的同意，并培训使用RCS的专业人员。正确的数据管理，匿名化,和加密似乎对保护RCS用户的个人数据至关重要。
结论：我们的分析支持对老年人使用RCS的兴趣，因为它们对个体的生活质量和幸福感有潜在的贡献。此分析突出了许多与使用RCS实现健康相关目标相关的道德问题。未来的研究应考虑实施RCS的组织后果以及实验背景下文化和社会经济特性的影响。我们建议实施可扩展的道德和监管框架，以配合与技术相关的各个方面的RCS的开发和实施，个人,或法律方面。
