Tensions and Antagonistic Interactions of Risks and Ethics of Using Robotics and Autonomous Systems in Long-Term Care

The dwindling informal care support structure for the older population and the shortage of skilled nursing care staff propelled the rise of robotics and autonomous systems as potential solutions to meet the rising demands in long-term care. However, the nascent development in the governance of their applications could predispose older people to the negative ramifications of technological risks and ethical issues. This systematic review maps out four technological risks and five ethical issues in the deployment of robotics and autonomous systems in long-term care. Safety, privacy, liability, and adverse employment consequences to the existing nursing care workers were identified as major technological risks; while loss of autonomy, loss of human interaction and social connectedness, objectification and infantilisation, deception and social justice were identified as five major ethical issues related to the deployment of robotics and autonomous systems in long-term care. This review also identified antagonistic interactions between some of the technological risks and ethical issues that could offset each other. Findings from the review have implications for advancing knowledge on the governance of robotics in long-term care. Policy formulations and implementations would need to account for intricate issues that could arise from technological risks, ethical issues and their paradoxical interactions