Abstract
Most studies on socially assistive robots (SARs) in elder care are conducted in care homes and recruit participants with some degree of cognitive impairment. The ethical dimension in these studies thus requires careful attention, suggesting that the researchers involved should be offered specific research ethics training. To meet this need in CARESSES—an international multidisciplinary project that aims to design and evaluate the first culturally competent SAR for the care of older adults—a research ethics training module for the project researchers was developed. The training module is largely based on case-based learning (CBL), a widely recognized approach to learning and instruction that is regarded as highly effective across multiple disciplines. In this paper, we argue that research ethics training should be offered to robotics investigators involved in research on SARs in elder care, and we provide an overview of the ethical issues involved in conducting research with SARs and older adults in care homes. Finally, we show how CBL can be used for research ethics training in this context.
Similar content being viewed by others
Notes
Ethical sensitivity refers to the ability to identify an ethical issue and understand the consequences of decisions made to solve or manage that issue.
The project involves researchers from Italy, the UK, France, Sweden and Japan, caressesrobot.org.
References
United Nations, Department of Economic and Social Affairs PD (2019) World Population Prospects 2019
Feil-Seifer D, Mataric MJ (2005) Defining socially assistive robotics. In: Proceedings of the 2005 IEEE 9th international conference on rehabilitation robotics Chicago, IL, USA
Lehmann H, Syrdal D, Dautenhahn K et al (2013) What should a robot do for you ? Evaluating the needs of the elderly in the UK. In: ACHI 2013—the sixth international conference on advances in computer–human interactions, pp 83–88
Abdi J, Al-Hindawi A, Ng T, Vizcaychipi MP (2018) Scoping review on the use of socially assistive robot technology in elderly care. BMJ Open. https://doi.org/10.1136/bmjopen-2017-018815
Lingler J, Jablonski R, Bourbonniere M, Kolanowski A (2009) Informed consent to research in long-term care settings. Res Gerontol Nurs 2:153–161. https://doi.org/10.3928/19404921-20090428-03
Maas ML, Kelley LS, Park M, Specht JP (2002) Issues in conducting research in nursing homes. West J Nurs Res 24:373–389. https://doi.org/10.1177/01945902024004006
Bruno B, Chong NY, Kamide H et al (2017) Paving the way for culturally competent robots : a position paper. In: 2017 26th IEEE international symposium on robot and human interactive communication (RO-MAN) Lisbon, Portugal
Bruno B, Chong NY, Kamide H et al (2019) The CARESSES EU-Japan project: making assistive robots culturally competent. Lect Not Electr Eng 540:151–169. https://doi.org/10.1007/978-3-030-04672-9_10
Pandey AK, Gelin R (2018) A mass-produced sociable humanoid robot: pepper: the first machine of its kind. IEEE Robot Autom Mag 25:40–48. https://doi.org/10.1109/MRA.2018.2833157
Papadopoulos C, Hill T, Battistuzzi L et al (2020) The CARESSES study protocol: testing and evaluating culturally competent socially assistive robots among older adults residing in long term care homes through a controlled experimental trial. Arch Public Heal. https://doi.org/10.1186/s13690-020-00409-y
Bagdasarov Z, Thiel CE, Johnson JF et al (2013) Case-based ethics instruction: the influence of contextual and individual factors in case content on ethical decision-making. Sci Eng Ethics 19:1305–1322. https://doi.org/10.1007/s11948-012-9414-3
Falkenberg L, Woiceshyn J (2008) Enhancing business ethics: using cases to reach moral reasoning. J Bus Ethics 79:213–217. https://doi.org/10.1007/s10551-007-9381-9
Kolodner JL (1997) Educational implications of analogy: a view from case-based reasoning. Am Psychol 52:57
Kalichman M (2009) Evidence-based research ethics. Am J Bioeth 9:85–87. https://doi.org/10.1080/15265160902923457
World Medical Association (2013) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Med Assoc 310:2191–4. https://doi.org/10.1001/jama.2013.281053
European Commission (2010) European textbook on ethics in research
College SN Required Education in Protecting Human Research Participants. https://www.snc.edu/irb/humansubjects.html
Kalichman M (2014) Rescuing responsible conduct of research (RCR) education. Acc Res 21:68–83. https://doi.org/10.1080/08989621.2013.822271
Sedenberg E, Chuang J, Mulligan D (2016) Designing commercial therapeutic robots for privacy preserving systems and ethical research practices within the home. Int J Soc Robot 8:575–587. https://doi.org/10.1007/s12369-016-0362-y
Lam HR, Chow S, Taylor K et al (2018) Challenges of conducting research in long-term care facilities: a systematic review. BMC Geriatr 18:242. https://doi.org/10.1186/s12877-018-0934-9
Ramos L, van den Hoven E (2015) Balancing ethics in research with older adults and persons with dementia. Paper presented at the OzCHI 2015 workshop on ethical encounters: HCI research in sensitive and complex settings, pp 1–3
Mody L, Miller DK, McGloin JM et al (2008) Recruitment and retention of older adults in aging research. J Am Geriatr Soc 56:2340–2348. https://doi.org/10.1111/j.1532-5415.2008.02015.x.Recruitment
Begun AL, Otto-Salaj LL, Berger L (2018) Participant recruitment and retention in intervention and evaluation research. Oxford University Press, New York
Glesne C (1989) Rapport and friendship in ethnographic research. Int J Qual Stud Educ 2:45–54. https://doi.org/10.1080/0951839890020105
Berkman BE, Chandros Hull S, Eckstein L (2014) The unintended implications of blurring the line between research and clinical care in a genomic age. Person Med 11:285–295
McGuire J (2009) Ethical considerations when working with older adults in psychology. Int J Aviat Psychol 19:112–128. https://doi.org/10.1080/10508420902772702
Bonnie RJ, Wallace RB (2003) Elder mistreatment abuse, neglect and exploitation in an aging America. The National Academies Press, Washington
Resnik DB, Randall D (2018) Reporting suspected abuse or neglect in research involving children. J Med Ethics. https://doi.org/10.1136/medethics-2017-104452
Ragan A, Bowen A (2001) Improving attitudes regarding the elderly population: the effects of information and reinforcement for change. Gerontologist 41:511–515
van Wynsberghe A (2013) Designing robots for care: care centered value-sensitive design. Sci Eng Ethics 19:407–433. https://doi.org/10.1007/s11948-011-9343-6
van Wynsberghe A (2016) Healthcare robots: ethics, design and implementation, 1st edn. Routledge, London
Fosch-Villaronga E (2019) Robots, healthcare, and the law: regulating automation in personal care, 1st edn. Routledge, London
Sharkey A, Sharkey N (2012) Granny and the robots: ethical issues in robot care for the elderly. Ethics Inf Technol 14:27–40. https://doi.org/10.1007/s10676-010-9234-6
Sharkey AJ (2015) Robots and human dignity: a consideration of the effects of robot care on the dignity of older people. Ethics Inf Technol 14:27–40. https://doi.org/10.1007/s10676-014-9338-5
Vallor S (2011) Carebots and caregivers: sustaining the ethical ideal of care in the twenty-first century. Philos Technol 24:251–268. https://doi.org/10.1007/s13347-011-0015-x
Battistuzzi L, Sgorbissa A, Papadopoulos C et al (2018) Embedding ethics in the design of culturally competent socially assistive robots. In: IEEE international conference on intelligent robots and systems
Alzheimer Europe (2010) The ethical issues linked to the use of assistive technology in dementia care—ethical issues in practice—ethics—Alzheimer Europe. In: Alzheimer Eur. http://www.alzheimer-europe.org/Ethics/Ethical-issues-in-practice/2010-The-ethical-issues-linked-to-the-use-of-assistive-technology-in-dementia-care. Accessed 19 Feb 2019
Turkle S (2007) Authenticity in the age of digital companions. Interact Stud 8:501–517
Annas GJ (2003) HIPAA regulations—a new era of medical-record privacy? N Engl J Med. https://doi.org/10.1056/nejmlim035027
EU General Data Protection Regulation (GDPR) Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data
Alvseike H, Brønnick K (2012) Feasibility of the iPad as a hub for smart house technology in the elderly; effects of cognition, self-efficacy, and technology experience. J Multidiscip Healthc 5:299–306. https://doi.org/10.2147/JMDH.S35344
Draucker CB, Martsolf DS, Poole C (2009) Developing distress protocols for research on sensitive topics. Arch Psychiatr Nurs 23:343–350
Fraser SA, Kenyon V, Lagacé M et al (2016) Stereotypes associated with age-related conditions and assistive device use in Canadian media. Gerontologist 56:1023–1032. https://doi.org/10.1093/geront/gnv094
Werhane PH (2002) Moral imagination and systems thinking. J Bus Ethics 38:33–42
Kolodner JL (2014) Case-based reasoning. Morgan Kaufmann, Burlington
Kolodner J, Owensby J, Guzdial M (2004) Case-based learning aids. In: Jonassen D (ed) Handbook of research for educational communications and technology, 2nd edn. Lawrence Erlbaum Associates, Mahwah, pp 829–861
Kim S, Phillips WR, Pinsky L et al (2006) A conceptual framework for developing teaching cases: a review and synthesis of the literature across disciplines. Med Educ 40:867–876. https://doi.org/10.1111/j.1365-2929.2006.02544.x
Johnson JF, Bagdasarov Z, Connelly S et al (2012) Case-based ethics education: the impact of cause complexity and outcome favorability on ethicality. J Empir Res Hum Res Ethics 7:63–77. https://doi.org/10.1525/jer.2012.7.3.63
Menzel DC (2009) Teaching and learning ethical reasoning with cases. Public Integr 11:239–250. https://doi.org/10.2753/pin1099-9922110303
Harkrider LN, MacDougall AE, Bagdasarov Z et al (2013) Structuring case-based ethics training: how comparing cases and structured prompts influence training effectiveness. Ethics Behav 23:179–198. https://doi.org/10.1080/10508422.2012.728470
Plinio AJ, Young JM, McCormick Lavery L (2010) The state of ethics in our society: a clear call for action. Int J Discl Gov 7:172–197
Atkinson TN (2008) Using creative writing techniques to enhance the case study method in research integrity and ethics courses. J Acad Ethics 6:33–50
Currie G (2008) Moving towards reflexive use of teaching cases. Int J Manag Educ 7:41–50. https://doi.org/10.3794/ijme.71.205
Herreid CF (1998) Sorting potatoes for Miss Bonner. J Coll Sci Teach 27:236–239
Watts LL, Medeiros KE, Mulhearn TJ et al (2017) Are ethics training programs improving? A meta-analytic review of past and present ethics instruction in the sciences. Ethics Behav 27:351–384. https://doi.org/10.1080/10508422.2016.1182025
Antes A, Murphy S, Waples E et al (2009) meta-analysis of ethics instruction effectiveness in the sciences. Ethics Behav 19:379–402
Velasquez M, Moberg D, Meyer MJ, Shanks T, McLean MR, DeCosse D, André C, Hanson KO (2009) A framework for thinking ethically. Markkula Center for Applied Ethics at Santa Clara University. http://www.scu.edu/ethics/practicing/decision/framework.html
Nimon K (2014) Explaining differences between retrospective and traditional pretest self-assessments: competing theories and empirical evidence. Int J Res Method Educ 37:256–269
Geldhof GJ, Warner DA, Finders JK et al (2018) Revisiting the utility of retrospective pre-post designs: the need for mixed-method pilot data. Eval Program Plann 70:83–89
Schiekirka S, Anders S, Raupach T (2014) Assessment of two different types of bias affecting the results of outcome-based evaluation in undergraduate medical education. BMC Med Educ 14:149
Carsten B, Coeckelbergh M (2016) Ethics of healthcare robotics: towards responsible research and innovation ethics of healthcare robotics: towards responsible research and innovation. Rob Auton Syst 86:152–161. https://doi.org/10.1016/j.robot.2016.08.018
Acknowledgements
This work was supported by the European Commission Horizon2020 Research and Innovation Program under Grant Agreement n. 737858 (CARESSES).
Funding
This work was supported by the European Commission Horizon2020 Research and Innovation Program under Grant Agreement n. 737858 (CARESSES).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Ethical Standards
All procedures performed in the study were in accordance with the ethical standards of the institutional research committee of the Department of Informatics, Bioengineering, Robotics and Systems Engineering at the University of Genoa, Italy, and with the 1964 Helsinki declaration and its later amendments.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Battistuzzi, L., Papadopoulos, C., Hill, T. et al. Socially Assistive Robots, Older Adults and Research Ethics: The Case for Case-Based Ethics Training. Int J of Soc Robotics 13, 647–659 (2021). https://doi.org/10.1007/s12369-020-00652-x
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12369-020-00652-x