Discussion – Key Debates, Viewpoints & Interviews
Covid life-courses – Robots Versus Human Care Workers in Elderly Care: Un-/empathic and Un-/Infected
Marcus Persson, Associate professor, Department of Behavioural Sciences and Learning, Linköping University, Sweden.
The spread of the Coronavirus Covid-19 has severely affected the elderly population worldwide. Sweden is no exception. When the outbreak first hit the country, the situation at the elderly care facilities changed dramatically within a couple of weeks. On the 4th of March, Swedish Television reports that even if the elderly are identified as a risk group, there are no restrictions regarding visits from family or others. Only two weeks later, on the 18th of March, Stockholm city (which is the epicentre of the virus in the country) imposes an immediate stop to visits. All elderly care facilities in the city are now in quarantine. Two weeks after that, on the 1st of April, Corona-infected patients can be confirmed in more than a third of all elderly care facilities in Stockholm.
The care workers at elder care facilities are identified as the main cause of the virus spreading. They unintentionally brought the virus into the care facilities, which then spread among the elderly. Caring for elderly people means to be close, to sit beside the bed, holding hands, listening, talking, and to be there for another human being when she needs it the most. Physical contact, social interaction, and empathy are at the heart of the caring practice. Paradoxically, these are the same abilities that now impose the greatest threat to those the care workers are trying to help. Humanity has unexpectedly transformed from being a strength to becoming a weakness. To avoid the danger of the virus spreading through interpersonal contact, some turn their attention to those who cannot be infected – robots.
Robots are often discussed as a solution to new societal challenges connected to the ageing population and increasingly demanding care apparatus. Research on robots in care has been criticized for being either technophobic or technophilic: overly optimistic concerning the possibility of new technology, or pessimistic about the risk that robotization of care will entail a dehumanization of patients. Some researchers argue that robots can play social, assistive, or therapeutic roles by interacting with individuals . In relation to groups that face difficulties related to building and maintaining social relationships, such as people with dementia, the robots may facilitate communication and promote well-being. However, other researchers raise ethical questions regarding the risk of increasing older people’s physical and social isolation when robots are introduced in care . For instance, a robot companion could be used as a justification for leaving elderly people alone for a longer period of time.
In the face of the Coronavirus pandemic, reports came in from different parts of the world regarding attempts to use robots in health care facilities, to help the overburdened medical workers in their work with Corona patients.
In Thailand, so called ninja robots are used to measure fever and act as a communication medium (through a video link) between the patients and the health care workers – helping the workers to keep physical distance from the patients. These robots were originally designed to monitor stroke patients, but with modifications, they are now useful to patients with Covid-19.
China has taken it one step further. A field hospital staffed by robots opened in Wuhan, where the pandemic began. Medical services in the facility are carried out by robots. Patients are wearing smart bracelets so their vital signs, including temperature, heart rate, and blood oxygen levels, are monitored. Humanoid robots, the so-called Cloud Ginger, are used to interact with, and to entertain, bored Corona patients living in quarantine, for example by leading various games and dance exercises in groups.
In other countries as well, for example the USA, various type of robots are used to bring food, drink, and medical supplies to the patients without any physical contact with the care workers. Autonomous robots are used indoors as well as outdoors to spray disinfectant and clean the floors. And in some hospitals, autonomous robots run around, stopping and checking people’s temperatures.
Suddenly, the robots’ main weakness – in terms of their lack of human sociality and empathy – has turned into their main strength: their inability to be infected and infect others with the virus. The robots may be a poor substitute for human contact, but they are safe from the virus. During the pandemic crisis, physical security is more important than social and empathic loss. It is reasonable to argue that we need to protect the elderly from physical illness by isolating them and let them be cared for by robots. But afterwards, then what?
Once the spread of the virus has been stopped through mass vaccination, or through other measures, the situation can go back to normal. Or so we may think. However, there will always be new pandemics. What did we learn from this pandemic, and what will we do better next time? More robots perhaps, which would mean safer physical environments for the elderly, but also less physical contact, less sociality, and less empathy. Being human means being a medical risk to one another. Then again, social isolation and loneliness are well documented risks for developing mental illness and depression. The questions are many and not easily answered. One thing we can be sure of is that the debate, between the advocates who want to introduce more robots in care facilities, and the critics who are afraid of dehumanized care, will begin as soon as the spread of the Coronavirus stops.
 Kangasniemi M, Karki S, Colley N, & Voutilainen A (2019) ‘The use of robots and other automated devices in nurses' work: An integrative review’. International Journal of Nursing Practice, 25(4):e12739.
 Vandemeulebroucke T, Dietckx de Casterlé B, & Gastman C (2018) ‘The use of care robots in aged care: A systematic review of argument-based ethics literature’. Archives of Gerontology and Geriatrics, 74: 15-25.
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