Ethical AI in the re-ablement of older people: Opportunities and challenges
Marinka Lanne DSc*, Jaana Leikas PhD
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AbstractBackground: Artificial intelligence (AI) has enormous potential that can be harnessed to promote the health, well-being, safety, and quality of life of older people as well as the work of rehabilitators. Discussion on its utilisation in rehabilitation and therapy work has gradually begun. Our study looks at homecare and re-ablement of older people, where many new technologies are already actively used, but the debate over the use of AI is still limited.
Objective: Both the nature of AI and the application of its use, especially in situations involving vulnerable people, raise ethical issues in the debate. We discuss opportunities and challenges that arise when applying AI to rehabilitation processes and particularly to occupational therapy. The aim is to shed light on how AI can be implemented in an ethically sustainable way. As re-ablement services usually employ occupational therapists as members of the rehabilitation team for older people, we chose the Occupational Therapy Intervention Process Model as an example of a customer-oriented process model for the rehabilitation implementation.
Method: Based on the content analysis of nine interviews and 22 scientific articles, perceptions of opportunities and challenges related to AI utilisation were studied and the results were linked to the occupational therapy intervention process.
Results: Opportunities enabled by AI for rehabilitation were identified, and they include clinical decision support, workload optimisation, intervention planning, remote monitoring of home rehabilitation, and the use of AI-based rehabilitation. Most of the AI challenges related to social trust and the experience of autonomy, power structures, privacy concerns, data security, transparency, and biases leading to unfair treatment of individuals and patient groups.
Conclusion: Creating new competence, building and maintaining the trust, and leading the cultural change were considered key issues in AI utilisation. Ethics guidelines for trustworthy AI set out the key ethical principles, but leave much room for interpretation for the implementation of ethical AI in rehabilitation. Deliberation of the ethical impacts of AI requires discussion of values and attitudes, broad citizen involvement, motivation, training for both professionals and citizens, knowledge building through trusted networks, and multi-professional collaboration.Keywords: artificial intelligence, ethics, older people, re-ablement, occupational therapy
Marinka Lanne DSc*, Jaana Leikas PhD (2021). Ethical AI in the re-ablement of older people: Opportunities and challenges. Gerontechnology, 20(2), 1-13
https://doi.org/10.4017/gt.2021.20.2.26-473.11