Emergent Everyday Ethics in Infrastructures for Smart Care, 2021-2022

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New smart technologies offer great promise to improve care for people living with long-term conditions such as dementia and enable them to live in their own homes for longer. Engineers work with healthcare professionals, patients and carers to develop technologies to monitor wellbeing and support people. Significant ethical challenges can arise, however, as decisions are made about what features the technology should contain, who has access to data collected by monitoring devices and what actions should be taken in response. Such situation offer an opportunity to explore how the ethical qualities of artificial intelligence emerge and are managed within a broader socio-technical infrastructure. The dataset comprises transcripts of interviews with engineers, healthcare professionals, carers and patients who are involved in development of smart technologies for care settings. The interviews explored from each participants’ perspective their experience of the opportunities and challenges of smart care, including when and how they become aware of ethical challenges, how they distinguish the ethical challenges from other kinds of issue such as a technical hitch or a misunderstanding, and how they deal with the various kinds of issue to negotiate acceptable outcomes. Interviews also explored with participants their understanding of principles of ethical artificial intelligence (beneficence, non-maleficence, autonomy, justice and explainability) as applied to smart care. Each interviewee was offered two short follow up interviews. In total the dataset comprises interviews with 14 pairs of service users and carers, 12 researchers and developers and 4 healthcare professionals . Across the interviews, different ways of understanding and acting on ethical challenges were found, involving diverse forms of expertise. The research demonstrates that ethics are a collective socio-technical achievement rather than something intrinsically embedded in the technology itself. The research leads to recommendations for enhancing ethical conversations across the lifetime of a project.

New smart technologies offer great promise to improve care for people living with long-term conditions such as dementia and to enable them to live in their own homes for longer. Engineers work with healthcare professionals, patients and carers to develop technologies to monitor wellbeing and support people to live well at home. Significant ethical challenges arise, however, as decisions are made about what features the technology should contain, who has access to data collected by monitoring devices and what actions should be taken in response. Smart technologies can take decisions on our behalf, and sometimes this can be troubling. In this project, a social scientist will work with an expert in machine learning and Internet of Things who is developing smart technologies for care settings. Together they will explore how ethical challenges arise and are managed in everyday practice. The research will entail observing the work of participants and interviewing engineers, healthcare professionals, carers and patients who are involved in development of smart technologies for care settings. The aim of these interviews is to identify from each participants’ perspective when and how they become aware of ethical challenges, how they distinguish the ethical challenges from other kinds of issue such as a technical hitch or a misunderstanding, and how they deal with the various kinds of issue to negotiate acceptable outcomes. As a result we will learn more about whether ethical issues can be anticipated in advance and develop ways to build ethical decision-making into the lifespan of a project.