Addressing Ethical Issues in the Design of Patient and Caregiver Monitoring Technology in Aged Care Settings


Authors: Joan Cahill, Niall O Neill, Sean McLoughlin, and Sean Wetherall
Page Range: 105-138
Published in: International Journal of Ethics, 17#2-3
ISSN: 1535-4776

Table of Contents


The monitoring and evaluation of patient health and wellbeing, along with the quality of care delivery is critical to patient safety. The aged care sector has faced many scandals about the quality of aged care services. New technologies are being advanced to support patient/resident and care monitoring in acute and aged care settings. The emerging ‘surveillance technology’ involves a spectrum of intelligence including passive ambient sensors, virtual monitoring, video monitoring and vision systems with different levels of artificial intelligence and machine learning capability. These technologies raise fundamental legal, ethical and societal questions in relation to the meaning of care, privacy and the role of people and technology in delivering care. This chapter presents an analysis of the ethical and societal issues to be addressed in the introduction of new patient and care/caregiver monitoring technologies. The analysis follows several phases of human factors research undertaken by the authors, including an analysis of salient literature around the ethics of monitoring, a meta-analysis of prior aged care studies relevant to the theme of ‘monitoring’, and a follow up analysis of prior research findings using a human factors and ethics canvas (HFEC). Older people, especially those living with cognitive impairment are a vulnerable group, and their dignity, rights and privacy must be safeguarded. New patient/resident monitoring technology has the potential to enable a safe, person focused, ethical, efficient and accountable care service, if implemented appropriately. Potentially, many of the ethical challenges specified in the HFEC regarding the adoption and deployment of patient/resident monitoring systems (including video and vision systems) have solutions that can be addressed in time and using an integrated human factors and ethics approach. A holistic understanding of the ethical issues surrounding monitoring technologies will help researchers design technologies that will be effective, beneficial and ethical.

Keywords: patient monitoring, care quality, safety/risk assessment, patient safety, assisted living, residential care, surveillance technology, video monitoring, vision systems, ethics, acceptability, human factors

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