Perspectives of older adults on the ethics of active assisted living technologies: A Scoping review and conceptual...

Active Assisted Living (AAL) technologies have emerged as a multidisciplinary endeavor driven by the imperative to enhance the lives of older adults. However, users' perspectives on the ethics of AAL technology use are often secondary considerations.

The objective of this scoping review was to synthesize the literature on users' perspectives on the ethics of AAL technologies to bridge the gap in both academic and non-academic contexts.

This scoping review was conducted comprehensively using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Reviews (PRISMA-ScR) in Covidence, focusing on peer-reviewed publications from 2000 to 2023. Our search strategies integrated concepts of AAL technologies, ethics, and user perspectives. Inclusion criteria encompassed qualitative and mixed methods that obtained users' perspectives on AAL technologies in smart home communities. A gray literature review was also conducted to retrieve documents for analysis that incorporated guidelines, standardization, and/ or recommendations.

Five relevant articles utilized qualitative methods (n = 3) and mixed methods (n = 2). Privacy and data protection were highlighted, with users expressing concerns about data tracking (n = 4). Respect for autonomy was emphasized in decision-making regarding technology use (n = 3). Accessibility issues pertained to missing accommodations for some physical abilities (n = 2). Diversity and social inclusion were important for social engagement and mental health support (n = 2). Perceived beneficence was also cited as a factor in improving health outcomes (n = 3). Transparency and accountability by the AAL technologies implementers were deemed essential for building trust (n = 1). The gray literature review yielded six relevant documents that included discussions on ethics and the use of AAL-related technologies for older adults.

Older adults are willing to include wearables and Internet of Things devices in their AAL technologies ecosystem, especially when they co-design the technology, but it is contingent on the implementation of ethical principles such as safety, security, and privacy to counter intrusive monitoring systems. This scoping review has the potential to offer valuable insights to various stakeholders, including tech developers and designers, providers, health policymakers, providers, and regulatory agencies.