Citizens' declaration on robotics in geriatric care

On 15 July 2024, participants in a randomly selected citizens' conference presented a declaration on robotics in geriatric care at the Federal Ministry of Health. This declaration, drawn up by citizens of Potsdam, contains ethical points of reference for the responsible use of robotics in care. It emphasises the need for robotics to be used only as a support and not as a substitute for human care.

"Robots cannot replace care provided by human staff. However, through the conceivable widespread use of robotics in the future, we hope that carers can be relieved of repetitive, supportive activities in order to gain more time for high-quality care activities and individual support," reads the declaration of the citizens' conference.

20 demands

A total of 20 demands were formulated to ensure the responsible use of robotics. For example, the Citizens' Conference recommends that solutions from the field of social robotics should only be used if they represent proven added value for both the carer and the person being cared for.

Social robotics should by no means replace human care, but rather be used to support it. Advancing the use of social robotics in care is necessary. However, the expansion of alternative care options should not be neglected. Social robotics must also be developed for home care in order to improve it and enable carers to live in their familiar surroundings for longer.

Studies needed

The Citizens' Conference is calling for "studies that map the realities and potential of social robotics in care for carers and those being cared for". This knowledge is a fundamental basis for ensuring good care. They are the starting point for the future development of (social) robotics for care and its sensible use.

According to the Citizens' Conference, the use of social robotics must fulfil the conditions of good care. From the characteristics of good care, the participants demanded that robots should never be used as a substitute for human care, but only to support it.

Right to good care

Comprehensive studies on the psychological and physical effects of social robotics on those in need of care are absolutely essential before they can be used across the board. "Individual wishes regarding the use of social robotics must be formulated in a legally secure manner, e.g. in a living will," said the citizens' conference. Everyone has the right to good care, regardless of their consent to social robotics. Under no circumstances should there be any compulsion to use social robotics.

The use of social robotics must prevent an unequal distribution of utilisation options and ensure equal access for all. "If there is a risk that human-like robots are not recognised as such by those in need of care, they may only be used under supervision to avoid deception," demands the mini-public.

"Digitalisation strategy indispensable"

Studies and applications on social robotics should be included in training and further education programmes for care staff. In addition, qualifications and skills should be recognised accordingly. A digitalisation strategy for the care sector is indispensable.

"The basis for data protection is the EU General Data Protection Regulation and the Federal Data Protection Act. They should serve as a guideline for further guidelines, standards and norms for the care sector. These should be regularly reviewed and updated if necessary," recommends the Citizens' Conference. In the view of the participants, a current regulatory gap in strict liability must be closed. In addition, the new obligations to update and continue to monitor systems should be clarified.

Quality assurance and standardisation

In order to be able to prove the financial benefits of robotics in care, it is first necessary to determine key figures on the costs incurred in all forms of care. Quality assurance and standardisation for robotic systems in care appear to be essential. The expansion of the necessary infrastructure must be given political priority and implemented as quickly as possible.

The Citizens' Conference calls for the development and implementation of uniform technical standards for open interfaces. The legislator should create the necessary framework conditions in cooperation with the responsible bodies. To ensure its financing, assistive robotics should be legally recognised and secured as a service provided by care and health insurance.

Regularly determine needs

The needs in the care sector and the technical possibilities of social robotics should be determined at regular intervals and further development and application should be adapted in line with future technical and social developments in order to maximise the benefits for users as efficiently as possible.

The final demand is "that the use of artificial intelligence, especially self-learning systems, is handled with appropriate sensitivity and responsibility". With self-learning systems, social robots should always remain controllable.

Citizens' conference as part of the E-cARE project

The citizens' conference has been organised as part of the E-cARE project. The project is researching the responsible use of robotics in elderly care. A team of scientists from the Junior Professorship for Medical Ethics is developing an ethics guideline on the appropriate use of technical assistance systems for the Federal Ministry of Health.

The E-cARE project aims to analyse the conditions for the responsible use of (social) robotics in the care of older people.

Questions

The project focusses on the following questions:

• What ethical opportunities and risks are evident in the use of social robotics in elderly care?
• What changes in terms of care interactions and relationships are perceived through the use of social robotics?
• How can an ethically appropriate integration of (social) robotics be realised from the perspective of those (potentially future) affected?
• Which ethical principles should guide the use of robotic assistance systems (in the future)?

The aim of the project is to provide guidance on the areas and ways in which supplementing or replacing care work with (social) robotics may be responsible or even necessary.

"The future of care should not just be decided by experts. The opinions of citizens must also be heard in the public and political debate," is the justification for the citizens' conference.

25 participants

In cooperation with the city of Potsdam, 3,500 randomly selected citizens were invited to the conference. From the pool of those willing to participate, a group of 25 participants of different ages, professional backgrounds and levels of experience on the topic were selected according to various characteristics.

The participants came together over three weekends to develop a set of rules for the responsible use of robotics. The dates were 27/28 April, 25/26 May and 15/16 June 2024. As part of the citizens' conference, experts were heard and questioned by the participants. Participants also had the opportunity to familiarise themselves with the robots that could be used in elderly care in the future.

Organisation and moderation

The Citizens' Conference was organised by the Junior Professorship for Medical Ethics with a focus on digitalisation at the Faculty of Health Sciences Brandenburg. The citizens' conference was supported by a moderation team from the think and do tank neuland21. Neuland21 focuses on the possibilities of digitalisation to improve the quality of life, particularly in rural areas.

Learn more: Citizens' Conference: Robotics in Elderly Care?