{"id":9,"date":"2016-01-21T17:46:33","date_gmt":"2016-01-21T17:46:33","guid":{"rendered":"http:\/\/cusjc.ca\/agingtech\/?page_id=9"},"modified":"2016-04-09T20:09:06","modified_gmt":"2016-04-09T20:09:06","slug":"chapter-three","status":"publish","type":"page","link":"https:\/\/cusjc.ca\/agingtech\/chapter-three\/","title":{"rendered":"Ethical Issues"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p><script id=\"infogram_0_the_ethics_of_wearable_technology\" title=\"The Ethics of Wearable Technology\" src=\"\/\/e.infogr.am\/js\/embed.js?XVZ\" type=\"text\/javascript\"><\/script><\/p>\n<div style=\"padding: 8px 0; font-family: Arial!important; font-size: 13px!important; line-height: 15px!important; text-align: center; border-top: 1px solid #dadada; margin: 0 30px;\"><a style=\"color: #989898!important; text-decoration: none!important;\" href=\"https:\/\/infogr.am\/the_ethics_of_wearable_technology\" target=\"_blank\">The Ethics of Wearable Technology<\/a><br \/>\n<a style=\"color: #989898!important; text-decoration: none!important;\" href=\"https:\/\/infogr.am\" target=\"_blank\">Create your own infographics<\/a><\/div>\n<p>&nbsp;<\/p>\n<h1>The new normal<\/h1>\n<p class=\"p2\"><span class=\"s1\">Wearable technology is increasingly popular for senior wellness management both in hospitals and in homes. These\u00a0<\/span><span class=\"s1\"><a href=\"http:\/\/cusjc.ca\/agingtech\/chapter-two\/on-the-market\/\">technologies<\/a>,\u00a0<\/span><span class=\"s1\">such as Tractivity and Hexoskin, are being developed at a rapid pace to meet the demands of<\/span><span class=\"s1\"><a href=\"http:\/\/cusjc.ca\/agingtech\/chapter-1\/canadas-aging-population\/\">\u00a0Canada\u2019s aging population<\/a>.\u00a0<\/span><span class=\"s1\">There is a market for wearables, however, there are numerous ethical issues that present themselves, not least because of the rapid development and deployment of wearable tech. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Associate Professor <a href=\"https:\/\/carleton.ca\/english\/people\/stuart-murray\/\">Stuart Murray<\/a>,\u00a0<\/span><span style=\"line-height: 1.5;\">the Canada Research Chair of Rhetoric and Ethics, addresses some of the important ethical issues surrounding the use of wearable technology: issues such as alienating language, presumptions in language and the definition of quality of life.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Murray says\u00a0the biggest ethical \u201cred flag\u201d is the effect wearable technology has on the way we think about ourselves. \u201cIf we think about biotechnologies, what is the bio? What is the life that is presumed?\u201d Murray\u2019s view is that if the purpose of technology is to service lives, then there must be a conversation around the kind of language that is used. Then, there must be a second conversation about the kind of life a person is living, the quality of life. Quality to one person might not mean a life that is extended, it might be a \u201cshort and heroic\u201d life, Murray says. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Murray suggests putting aside for a moment the virtuous qualities that technology brings us in terms of improved wellness, extension of life, making the quality of life better and so forth. One thing that concerns him is the effect this wearable has in making individuals think of their lives in instrumental terms. What would it mean to think of your body in instrumental terms, he asks. <\/span><span class=\"s2\">\u201cIt would mean to think of my body as nothing more than spare parts that could be replaced technologically, biomedically &#8211; and when the time comes, I will need a new part.\u201d Is this really how we want to think of the relationship between ourselves and our bodies? <\/span><\/p>\n<p class=\"p3\"><span class=\"s1\">The greatest challenge, states\u00a0Murray, will be to have a more open dialogue and discussion about these ethical issues, the rhetoric, the concept of our bodies as instruments, death and quality of life.<\/span><\/p>\n<p class=\"p3\"><span class=\"s1\">\u201cThat is where we need investigative journalists,\u201d states\u00a0Murray, \u201cWe need people to investigate, research, and expose.\u201d <\/span><\/p>\n<h3>Part One: The language<\/h3>\n<p>&nbsp;<\/p>\n<h4>Lost in translation: the alienating language of wearable technology<\/h4>\n<p class=\"p1\"><span class=\"s1\">During a recent interview, Murray is\u00a0intrigued to hear about an investigative journalism piece into the sustainability for wearable technology for senior wellness management. The discussion moves\u00a0on to the technologies to be profiled, the relationship between wearable technology and health, and the views of doctors and healthcare professionals about how they implement and integrate the technology into their work. The discussion also touches\u00a0on a common hope among technology developers that these innovations will allow seniors to remain autonomous, stay in their homes longer, and improve their quality of life. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cTo begin,\u201d starts\u00a0Murray, \u201cI want to problematize some of the presumptions even within your language itself. I think this debate is already staked in the favour of certain conceptions and preconceptions.\u201d <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Murray explains that some of the language associated with wearable technology and senior care is alienating to this demographic simply because they are not familiar with these technologies. <\/span><span class=\"s1\">In addition, \u201cinnovation and healthcare\u201d and \u201cimplementation of technology\u201d are each terms that presume an instrumental relationship with ourselves and our bodies, says\u00a0Murray. \u201cThis is only one way that we relate to ourselves and our bodies. But it\u2019s not the only way.\u201d To talk about wearable technology as a means to improve quality of life is an alien way to relate to our bodies and to think about what is health, he says. <\/span><\/p>\n<h4>Presumptions of language<\/h4>\n<p class=\"p1\"><span class=\"s1\">Not only are these terms alienating to seniors, but terms like \u201cautonomy\u201d and \u201cprivacy\u201d also come with certain presumptions continues Murray. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">If individuals are autonomous subjects, then presumably we have control over our technology, technologies are simply tools that we can use or not. But in reality, part of the problem is that we are not autonomous and private subjects, says\u00a0Murray. \u201cI would turn your study on its head and say, actually autonomy and privacy are the effects of technologies.\u201d <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\"><i>Prof. Stuart Murray explains how privacy and autonomy are the effects of technology and why this is an ethical quandary: <\/i><\/span><\/p>\n<p><iframe loading=\"lazy\" width=\"700\" height=\"400\" scrolling=\"no\" frameborder=\"no\" src=\"https:\/\/w.soundcloud.com\/player\/?visual=true&#038;url=http%3A%2F%2Fapi.soundcloud.com%2Ftracks%2F256293231&#038;show_artwork=true&#038;maxwidth=700&#038;maxheight=1000\"><\/iframe><\/p>\n<p class=\"p1\"><span class=\"s1\">Murray goes on to say that &#8220;autonomy&#8221; is a predominantly Western phenomenon, but Canada is a diverse and multicultural society, therefore, there are numerous ethical issues with using this term. <\/span><\/p>\n<p><iframe loading=\"lazy\" width=\"700\" height=\"400\" scrolling=\"no\" frameborder=\"no\" src=\"https:\/\/w.soundcloud.com\/player\/?visual=true&#038;url=http%3A%2F%2Fapi.soundcloud.com%2Ftracks%2F256293137&#038;show_artwork=true&#038;maxwidth=700&#038;maxheight=1000\"><\/iframe><\/p>\n<h3>Part two: Quality of life<\/h3>\n<p>&nbsp;<\/p>\n<h4>Do you want to live forever?<\/h4>\n<p class=\"p1\"><span class=\"s1\">Murray says that in addition to the presumptions of language, there is a set of presumptions already built into the aging population. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cProlonging life is always supposedly a good,\u201d Murray says. But there is an ethical debate surrounding the length of a life versus the quality of that life. \u201cHow do you measure that? Will technologies actually measure the quality of life?\u201d Quality of life may mean different things for different individuals and seniors. Wearable technology has a \u201climited scope of application\u201d and it probably won\u2019t do a very good job about capturing the quality of someone\u2019s life, Murray contends. As the Canadian government responds to the Supreme Court decision to decriminalize assisted dying, there will be many conversations about death and the right time to die. Murray argues that there is something about the \u201ccapitalist\u201d thrust to biotechnology to improve and extend life that negates a discourse about death. \u201cThis is the kind of conversation that we need to have,\u201d Murray says.<\/span><\/p>\n<blockquote>\n<p class=\"p1\" style=\"text-align: center;\"><span class=\"s1\"><b>\u201cHave we considered the risks?\u201d\u00a0<\/b><\/span><\/p>\n<\/blockquote>\n<p class=\"p3\"><span class=\"s1\"><a href=\"http:\/\/agewell-nce.ca\/\">AGE-WELL<\/a>\u00a0<\/span><span style=\"line-height: 1.5;\">is a research program that is part of the Networks of Centres of Excellence. It is funded by the federal government and was inaugurated in 2015. Some 25 universities are represented within AGE-WELL. Each partner, researcher, and scientist affiliated with AGE-WELL, works on a project that is relevant to the development, commercialization, use and adoption of technologies among the elderly.<\/span><\/p>\n<p class=\"p4\"><span class=\"s2\"><a href=\"https:\/\/uniweb.uottawa.ca\/#!uottawa\/members\/787\">Virginie Cobigo <\/a>and <\/span><span class=\"s1\"><a href=\"http:\/\/uottawa.academia.edu\/HajerChalghoumi\">Hajer Chalghoumi<\/a> are AGE-WELL researchers. They are also both professors at the University of Ottawa.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Cobigo and Chalghoumi\u2019s project looks at the ethics of technology development use and adoption amongst the elderly.<span class=\"Apple-converted-space\">\u00a0<\/span>For the purpose of their research, Cobigo and Chalghoumi study those who are aging with cognitive impairment, those who have cognitive impairment after a stroke or brain injury, or those who have intellectual and developmental disabilities such as Down syndrome and autism. \u201cWhat we are looking at is those who have cognitive impairment and how they can ethically use and adopt technologies to support their daily living,\u201d Cobigo explains. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Cobigo and Chalghoumi are in the preliminary phase of their study. They have spent the past year performing literature reviews to make sure that they are up to date with what has been published already. They assume that their study will take three to five years. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">The greatest misconception they have encountered to date is the assumption that seniors with cognitive impairments cannot use technology. \u201cThere is no reason that they are excluded,\u201d said Cobigo.\u00a0<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">For their study, Cobigo and Chalghoumi are looking at many technologies. The first category of technology they are looking at is supportive communication programs. For example a communication device that instead of sending texts with words, sends pictures and photographs. They also intend to look at the use of devices that are used to help with travel and community, for example GPS applications on a smartphone. \u201cThat might be very useful for someone with a cognitive impairment who has trouble finding their way around.\u201d The third application of technology they are examining are devices and apps which have the function to set reminders and list routines and steps for different activities. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Cobigo and Chalghoumi highlight a number of ethical risks they have discovered with their preliminary research:<\/span><\/p>\n<h4>Rhetoric<\/h4>\n<p class=\"p1\"><span class=\"s1\">Much of the technology that is developed for seniors with cognitive impairments is developed specifically for them. Therefore, the user of that technology or device is labeled as a person with a disability. But a lot of people with cognitive impairment use iPads. Although iPads have applications tailored for individuals with disabilities, not every user of an iPad has a disability. The researchers contend that the labelling that occurs as a result of the association between technologies and individuals with cognitive impairments raises an ethical issue. <\/span><\/p>\n<h4>Privacy<\/h4>\n<p class=\"p1\"><span class=\"s1\">There are many devices, as exemplified in the section on \u2018<a href=\"http:\/\/cusjc.ca\/agingtech\/chapter-two\/on-the-market\/\">Wearable Technology<\/a>\u2019 , which track a user. There are also some devices which help a user to navigate a city. Many would agree that it\u2019s a positive thing for caregivers to be able to track patients in case someone gets lost. \u201cBut the negative outcome or consequence is that individuals using that device will have their privacy denied because someone can know where they are all the time,\u201d states\u00a0<\/span><span class=\"s2\">Cobigo. \u201cSo are we really balancing the pros and cons of using such a device that would locate the individual at any time?\u201d <\/span><\/p>\n<h4>Consent<\/h4>\n<p class=\"p1\"><span class=\"s1\">A very big ethical dilemma is consent. \u201cIf you think about persons with cognitive impairment, consent is more challenging for them,\u201d explaines\u00a0<\/span><span class=\"s2\">Chalghoumi. Getting informed consent from some individuals is difficult. Everyone is different. One person may be open to wearing GPS shoes, another however may not, they may find the device too intrusive. <\/span><\/p>\n<p class=\"p1\"><span class=\"s2\">Cobigo and Chalghoumi say that the object of their research is education development. They are hoping to educate both individuals and developers about the ethical issues that surround wearable technology. Cobigo and Chalghoumi explain that both the individual and the developer should have defined roles when it comes to the use of wearable technology. <\/span><\/p>\n<p class=\"p3\"><span class=\"s1\"><b><i>The individual &#8211; \u00a0<\/i><\/b><\/span><span class=\"s1\">\u201cYou should be informed of the pros and the cons of using the technology, and make the decision that you feel comfortable with,\u201d states\u00a0Chalghoumi. This includes having informed consent of the user. <\/span><\/p>\n<p class=\"p3\"><span class=\"s1\"><b><i>The producer &#8211;\u00a0<\/i><\/b><\/span><span class=\"s1\">At present, Cobigo and Chalghoumi say they have not yet been able to determine what the ethical responsibility of the developer of technology should be. It\u2019s one of the objectives of their research. \u201cWe are working with technology developers and trying to understand their perspective and the struggle they have in developing ethical technologies,\u201d says\u00a0Cobigo. \u201cIt\u2019s not that easy.\u201d Technology developers generally become aware of ethical issues after development, or too late in the process of technology development. \u201cBeing smart from the start is compulsory,\u201d says\u00a0Chalghoumi. Both Cobigo and Chalghoumi say that it is important for developers to involve and include more persons with cognitive impairment in the development process. \u201cThis is one of the strengths of our project. It tries to put in comments and make collaboration an efficient collaborative network between the elderly with cognitive impairment, the technology developers and researchers,\u201d states\u00a0Chalghoumi.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Adrian Chan is a professor in the Department of Computer Systems and Engineering at Carleton University. He has been researching biomedical monitoring and the quality of the data wearable technology\u00a0produces. He explains the issue of consent in the setting of the hospital: <\/span><\/p>\n<p style=\"text-align: center;\"><div class=\"su-youtube su-u-responsive-media-no\"><iframe loading=\"lazy\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/uP37xV299IA?autohide=1&amp;autoplay=0&amp;mute=0&amp;controls=0&amp;fs=0&amp;loop=0&amp;modestbranding=1&amp;rel=0&amp;showinfo=0&amp;theme=light&amp;wmode=&amp;playsinline=0\" frameborder=\"0\" allowfullscreen allow=\"autoplay; encrypted-media; picture-in-picture\" title=\"\"><\/iframe><\/div>\n<h4>Cost<\/h4>\n<p class=\"p1\"><span class=\"s1\">Ontario is currently changing its policy regarding what technologies are covered as assistive technology under the Ontario Health Insurance Plan (OHIP). The Ministry of Health and Long-Term care currently covers 8,000 pieces of equipment and technology under the <\/span><span class=\"s1\"><a href=\"http:\/\/www.health.gov.on.ca\/en\/public\/programs\/adp\/\">Assistive Devices Program<\/a>. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Through the changes in Ontario law, devices like smartphones and tablets will soon be considered to be an assisted device, Cobigo predicts. Currently, individuals with disabilities have to use technologies that are labelled as \u201ctechnology for the disabled\u201d because other things are not covered, states Cobigo. \u201cThe research is very clear, persons with disabilities want to use technology that looks like the technology that everyone is using,\u201d says\u00a0Cobigo. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">The cost of these devices can also present an ethical dilemma. If the device, or wearable technology, is not covered by OHIP, then it can be quite expensive. If the technology is so useful, absolutely wonderful, might change lives, or improve quality of life for an individual, but it is so expensive that nobody can afford it &#8211; then it is not an ethical use of technology, says\u00a0Cobigo. \u201cThat\u2019s another thing that technology developers should have in mind or should be aware of,\u201d says\u00a0Cobigo. Persons with disabilities are amongst the poorest of our society, and they are generally the ones most often excluded from the use these technologies, even though in many cases, they would benefit from them most, states\u00a0Cobigo. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Through his studies, Chan has witnessed rapid development and widespread use of wearable technology<span class=\"Apple-converted-space\">\u00a0 <\/span>and says that soon individuals will have to accept a new normal. <\/span><\/p>\n<p style=\"text-align: center;\"><div class=\"su-youtube su-u-responsive-media-no\"><iframe loading=\"lazy\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/AfdXCW4FzfA?autohide=1&amp;autoplay=0&amp;mute=0&amp;controls=0&amp;fs=0&amp;loop=0&amp;modestbranding=1&amp;rel=0&amp;showinfo=0&amp;theme=light&amp;wmode=&amp;playsinline=0\" frameborder=\"0\" allowfullscreen allow=\"autoplay; encrypted-media; picture-in-picture\" title=\"\"><\/iframe><\/div>\n<p style=\"text-align: left;\"><em><a href=\"http:\/\/cusjc.ca\/agingtech\/chapter-two\/characteristics-the-benefits-of-wearable-tech\/\">PREVIOUS: The benefits and disadvantages of wearable tech.\u00a0<\/a><\/em><\/p>\n<p style=\"text-align: left;\"><em><a href=\"http:\/\/cusjc.ca\/agingtech\/chapter-four\/\">NEXT:\u00a0<\/a><a href=\"http:\/\/cusjc.ca\/agingtech\/chapter-four\/\">Ethical issues are closely intertwined with privacy. Head to the next chapter to read about privacy issues.\u00a0<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; The Ethics of Wearable Technology Create your own infographics &nbsp; The new normal Wearable technology is increasingly popular for senior wellness management both in hospitals and in homes. These\u00a0technologies,\u00a0such as Tractivity and Hexoskin, are being developed at a rapid pace to meet the demands of\u00a0Canada\u2019s aging population.\u00a0There is a market for wearables, however, there [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":338,"parent":0,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-9","page","type-page","status-publish","has-post-thumbnail","hentry","post-thumb"],"acf":[],"_links":{"self":[{"href":"https:\/\/cusjc.ca\/agingtech\/wp-json\/wp\/v2\/pages\/9","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cusjc.ca\/agingtech\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cusjc.ca\/agingtech\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cusjc.ca\/agingtech\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cusjc.ca\/agingtech\/wp-json\/wp\/v2\/comments?post=9"}],"version-history":[{"count":27,"href":"https:\/\/cusjc.ca\/agingtech\/wp-json\/wp\/v2\/pages\/9\/revisions"}],"predecessor-version":[{"id":477,"href":"https:\/\/cusjc.ca\/agingtech\/wp-json\/wp\/v2\/pages\/9\/revisions\/477"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cusjc.ca\/agingtech\/wp-json\/wp\/v2\/media\/338"}],"wp:attachment":[{"href":"https:\/\/cusjc.ca\/agingtech\/wp-json\/wp\/v2\/media?parent=9"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}