Research into and the development of robotic applications for both home care and care institutions has been supported by substantial public funding for several years now. Politicians justify this by referring to the urgent infrastructural, personnel and financial problems raised by the shortage of qualified nursing staff vis-à-vis the growing number of people in need of care and assistance. The German Ethics Council acknowledges the potential benefits of robotics for the entire care sector, but sees these benefits less in eliminating staff shortages or avoiding a nursing crisis than in the potential to promote good care. For those in need of care, this potential consists not only in maintaining independence and physical and cognitive abilities, but also in the possible recovery of these assets through rehabilitative measures.
Assistance robots, which support caregivers and care recipients in everyday activities, facilitate strenuous physical tasks for nursing staff or postpone the necessity of inpatient care for people with an increasing need of care. Similarly, robotic monitoring techniques are supposed to support self-determined life in the home environment by enabling remote monitoring of bodily functions or ensuring rapid help in an emergency. So-called companion robots, some of which are offered in the guise of different animals, primarily fulfil communicative and emotional needs by assisting in social interactions or by serving as interaction partners.
From an ethical point of view, however, it would be extremely questionable if in the future, people in need of care were to satisfy their social and emotional needs predominantly by using companion robots, which merely simulate emotions. Likewise, in the case of other types of robots, an independent life in familiar surroundings could well turn out to be a life in social isolation. On the part of the nursing staff, fears of being overburdened by the challenging handling of complicated robot technology should be taken seriously. Another worry is that instead of creating space for relationship-oriented care, the support by robotics might result in an even higher density of work. With regard to the health care system, there is concern that the high costs of introducing robotic assistance systems could lead to budget cuts for staff or in other important domains of care.
The German Ethics Council investigates these and other concerns and acknowledges their validity but remains confident that robotic technologies can be of great value to the care sector. Realising this value requires a responsible approach to both the development and implementation of applications. In support of such an approach, the Council offers a number of recommendations which address not only the individual and institutional, but also the systemic and political levels. For example, there is a call for the appropriate participation of both (professional) caregivers and people in need of assistance or care in the development of robotic systems. Safety standards and liability regulations should be reviewed and, if necessary, amended to prevent an erosion of responsibility in dealing with robotic technologies. The well-being of care recipients in their individuality should always be the focus of care, even if the use of technology requires the standardisation and schematisation of processes. The Council further recommends that nursing staff receive systematic training in the use of robot technologies, both in their education and in advanced vocational training, with due consideration of ethical aspects.
Further information on the present opinion and on the German Ethics Council’s annual meeting in 2019, which prepared its enquiry into the topic, can be found at www.ethikrat.org.