Good practice examples addressing ethical issues
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The ENABLE Project’s Approach to Ethics:
The Enabling Technologies for People with Dementia (ENABLE) project investigated whether it is possible to facilitate independent living of people with dementia and to promote their wellbeing through access to enabling technologies. The project gave a deep attention to ethical issues in conducting and reporting on the research, and both the process and outcomes are useful for others to learn from.
Ethics of ICT & Ageing: Consulting the Public:
Efforts to consult the public on the ethics of ICTs & Ageing have been undertaken in Norway, including a consensus conference in 2000 and also within a new programme of scenario-workshops that commenced in 2008. Results provide guidance for Norwegian policy and practice in this area, and the approaches present useful models for application elsewhere.
Perspectives, Principles, Paradigms:
The ASTRID guide to using technology within dementia care has provided an important point of reference for ethical practice in this field since its publication in 2000. Using an approach underpinned by the ‘3 Ps’ – perspectives, principles and paradigms – the guide discusses the ethics of technology in dementia care and works through the issues in some illustrative cases.
The MINAmI Project’s Approach to Ethics:
Primarily technology-oriented projects can also take initiative to actively address and reflect on ethical issues that relate to their particular area of expertise. This way, interesting new questions may surface and new approaches to dealing with ethical issues in R&D projects and recommendations for discussion even on societal level are possible.
In-home Monitoring of Persons with Dementia:
Ethical guidelines often fall short of being sufficiently concrete to provide practical guidance for the research and development setting. An example of a guideline designed for gerontechnology research and development to support persons with Alzheimer’s disease and their caregivers shows that the translation of abstract principles to hands-on guidance is possible.
The American Telemedicine Association’s Guidelines:
In an effort to help advance science and to assure the uniform quality of services to patients, the American Telemedicine Association (ATA) has embarked on an effort to establish practice guidelines and technical standards for the field of telemedicine and telehealth. The document “Core Standards for Telemedicine Operations” addresses administrative, clinical and technical standards, whereby ethical issue such as data privacy and informed consent are addressed as far as they concern existing regulative/legal requirements.
The Mental Welfare Commission of Scotland’s “Safer to Wander?” Document:
“Safer to wander?” is a document produced by the Mental Welfare Commission of Scotland on ethical principles and guidance on good practice when considering the use of wandering technologies in support of individuals with dementia who are residents in care homes or hospitals. The technologies in focus include “tagging” and tracking devices that can be used to alert when a person leaves a given area and help locate a person who has gotten lost.
The Friendly Rest Room Project’s Approach to Ethics:
The Friendly Rest Room project was a user-centered research and development project in which prototypes of self-adapting toilets for older users and disabled users were developed. Because toileting and personal hygiene are deemed sensitive areas of research and the intended user group to be involved was likely to include potentially vulnerable persons, the project gave a deep attention to ethical issues with continual ethical review being conducted throughout the project.
North Lanarkshire Council’s Best Practice Policy:
The best practice guidance document and its appendices drafted by the North Lanarshire Council set out the principles which underpin the Council’s policy and guidance on the use of assisted living technology, describe the range of equipment available and provide advice on its use and an assessors’ checklist for use of prior to taking up a new device. From the ethical point of view, particularly valuable is the guidance provided for social workers who face technology and care-related decision-making situations with persons from whom it is difficult or practically impossible to obtain an informed consent.
The UK Department of Health’s Best Practice Guide on ‘Risk’:
The Department of Health in the UK recently prepared a best practice guide on dealing with ‘risk’ in health and social care, intended for use by everyone who is involved in supporting adults using health and social care within any setting or sector. Although not focusing only on technology-related issues, the guide is nevertheless useful for those considering using ICT-based technologies to reduce perceived ‘risk’ to vulnerable clients. The purpose of the document is to guide those involved in helping individuals to retain greater control of their lives and to avoid patronising or paternalistic approaches that focus too narrowly on risk reduction.