The future of ICT for health and ageing: Unveiling ethical and social issues through horizon scanning foresight
Graphical Abstract
Introduction
ICT for health and ageing has been a multibillion-dollar industry for years (Wolf, 2014). The ageing population is increasingly technology savvy and connected. At the same time, older people are demanding better services and all the conveniences of the information age (Hussain et al., 2015). Relatives are turning to technology to help keep in touch with and care for their family members as they juggle the modern responsibilities of work and family life. Public health services are looking to cut costs and increase coverage of care through technologically enabled products and services. This creates a huge potential for business.
Technological advances allow the multitude of systems and devices to monitor and collect data from users and the environment in order to diagnose health issues, prevent accidents, make suggestions and more. Such advancements pose important ethical questions and touch upon issues of trust and privacy, but also issues that relate to the pertinence of the technology, and the designers’ responsibility towards the end user, to only name a few. However, it is not always clear, how or if ICT designers and developers approach the implications of their technological products and services for the individual. Older people can be particularly vulnerable, have multiple health problems, and technology can sometimes be used in ways that exacerbate existing care gaps and leave some seniors at risk of harm. In addition, health ICTs are often treated as a means for “fixing a health condition”, instead of “[sustaining] everyday life as a whole” (Ballegaard et al., 2008, p. 1807).
In this paper, we explore the future of ICT for health and ageing in Europe by applying foresight analysis, more specifically horizon scanning. The question we want to answer is which technical developments in the field of ICT for health and ageing can be expected and which ethical and social issues this is likely to raise. Answering this question is of high practical importance, as it provides the basis for technology developers and companies to position their products and services accordingly. Due to the potentially large practical impact of these technologies, an awareness of future technologies and their ethical and social consequences is of large societal importance and critical for policy making.
For this study we use foresight analysis by way of horizon scanning. Foresight analyses, and horizon scanning specifically, have recently been attracting the interest of researchers and policy makers alike, because they support learning and allow for improved policy-making (Rhisiart et al., 2017). Our empirical material consists of interviews, case studies, existing foresight studies, and European policy documents, which we analyse for background primary signals. We also employ a qualitative analysis of social media, news articles, discussion fora and venture capital funders to capture the cutting edge of opinion on the future of the sector. These components are then analysed to determine the ethical and social issues that are likely to arise in the development of future ICTs for health and ageing.
The paper makes an important contribution to the foresight and in particular horizon scanning literature. It showcases strong and weak signals by describing possible futures under the headings of future technologies, future ICT companies, future older generations and future environments. These possible socio-technical futures are then analysed to identify ethical and social issues. The most important concerns are stereotyping older people, the human face of ICT, privacy and informed consent, autonomy and anxieties around ICT. This analysis shows that there are clear and recognisable ethical issues that arise from currently envisaged futures that can be considered and proactively addressed now. The paper outlines general implications and their consequences for innovators, companies and policymakers.
The paper is structured as follows. First, we present the method of horizon scanning in detail and discuss both our data and the data analysis approach. Then we present our findings and answer our research question with regards to the potential opportunities and challenges, as well as the ethical and social issues that need to be addressed when dealing with ICTs for health and ageing. We then offer our recommendations for avoiding ethical and social pitfalls in the sector, based on our findings. The paper concludes with implications for future research, as well as product and service design.
Section snippets
Horizon scanning for foresight analysis
Foresight analysis helps businesses and organisations to identify and anticipate the outcomes of their decisions, and ultimately integrate foresight into their strategy (Booth, Durance and Monti, 2019). To date, foresight analysis has been used in many different contexts, such as strategy formulation for multinational corporations, business innovation, and policy making (Betz et al., 2019), to name only a few. Earlier research also indicates that companies use such tools also in the context of
Results
This discussion combines the primary and weak signal analysis under the broad topics of “future technologies”, “future companies”, “future older people”, and “future environments” to discuss what is likely to be the future of ICT for health and ageing. These are summaries of the complete findings. The results are transferred into scenarios and general possible futures, with some specifically referenced examples. These broad topics have resulted directly from the analysis of weak, primary and
Ethical and social issues in ICT for health and ageing
The aim of this Horizon Scanning approach was to identify technological advances in the field of ICT for health and ageing that show an increased potential to trigger social and ethical issues. Through the investigation of weak, primary and secondary signals, we identified a series of potential ICTs, which we classified under four different categories, namely: future technologies, companies, environments, and older people.
The integration of current technologies is similar to previous
Implications and conclusion
Many people believe that technologies will solve many problems that are associated with ageing. It appears likely that citizens of industrialised countries will be living longer and healthier lives in the future, even though it is important to realise that this is not an immutable law and there are indications of a reversal of the trend towards longer lives (Pike, 2019).
There is, furthermore an expectation that current technologies will continue being large parts of the future landscape of ICT
Acknowledgments
This research received funding from the European Union’s Horizon 2020 Framework Programme for Research and Innovation under the Framework Partnership Agreement No. 609817 (Responsible-Industry).
Dr. Catherine Flick; is Reader in Computing & Social Responsibility at De Montfort University, Leicester, UK. Her areas of research have involved ethics and video games, responsible research and innovation in technology, anonymous technologies, trusted computing, and informed consent in IT
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Dr. Catherine Flick; is Reader in Computing & Social Responsibility at De Montfort University, Leicester, UK. Her areas of research have involved ethics and video games, responsible research and innovation in technology, anonymous technologies, trusted computing, and informed consent in IT
Dr. Efpraxia D. Zamani; is a Senior Lecturer of Information Systems at the Information School, The University of Sheffield University of Sheffield, UK. Her interests are found at the intersection of organizational and social aspects of information systems, with an emphasis on post-adoption user behaviour, enterprise information systems and blockchain applications
Bernd Carsten Stahl; is Professor of Critical Research in Technology and Director of the Centre for Computing and Social Responsibility at De Montfort University, Leicester, UK. His interests cover philosophical issues arising from the intersections of business, technology, and information. This includes ethical questions of current and emerging of ICTs, critical approaches to information systems and issues related to responsible research and innovation
Alexander Brem; is Chaired Professor of Technology Management at the Friedrich-Alexander-University Erlangen-Nürnberg (FAU). In addition, he is Honorary Professor at the University of Southern Denmark (SDU). His research activities are focused on the Management of Research & Development in technology-orientated companies. This includes research fields like Idea Management, Constraint-based Innovation, User Innovation as well as Technology Entrepreneurship