This is not a theoretical question. Robots are already widely used as ‘carers’ in Japan, the UK has a rapidly ageing population, an average of 900 care workers per day are leaving the profession due to low wages and tough conditions and there is a severe lack of new care workers joining the profession.
Enter the robots. The use of robotics and other technologies could help to alleviate these ever-increasing pressures by reducing staffing costs and relieving human carers of the physically demanding or more menial tasks, freeing up their time for face-to-face care of patients. Japan’s robot strategy claims that: ‘Robots will help release humans from cumbersome tasks and enrich interaction for a higher quality of life than ever.’
The potential is huge, and exciting. Robots, or robotic devices, can provide three types of assistance: physical, social and cognitive.
One of the most strenuous tasks for carers, which they must do regularly, is lifting a patient from a bed into a wheelchair, which can quickly become a cause of lower back pain. ‘Robear’ is an experimental bear-shaped robot that lifts and carries elderly or frail patients from beds into wheelchairs, or into the bath.
‘Stevie’ is designed to look a bit (but not too much) like a human, with arms and a head but also wheels. This helps people realise that they can speak to it and perhaps ask it to do things for them, such as reminding them to take medication or turn off an oven. A room sensor on ‘Stevie’ can detect if someone has fallen over and a human operator can then take control of it to investigate the event and perhaps contact emergency services. ‘Stevie’ can also regulate room temperatures and light levels to help to keep the user comfortable.
Then there is ‘Rex’, a robot for rehabilitation that can help people with multiple sclerosis or other neurological conditions to stand and to walk .
These are just examples of how robots can enable people to stay in their homes for longer rather than going into residential care. They can prevent hospitalisation through falls and can help keep people healthier for longer. And by doing the more mundane tasks of caring, robots can reduce social care costs and free up staff to do more personal caring.
‘Stevie’ deliberately only has a few human-like features, however ‘Chihira’ the robot very closely resembles a Japanese woman. ‘Chihira’ has been developed to do physical work with elderly people with conditions including dementia, but its human likeness is unsettling and raises interesting questions. Do all patients know they are dealing with a robot? Does the human likeness mean dementia patients are being deceived by a machine in some way? Or will it help dementia patients feel they have real company and help – a type of social assistance?
Robots can do more than simply detect and prevent falls, they can provide companionship and social engagement, monitor and improve wellbeing, or even help educate preschool children.
‘Paro’ a fluffy white robot seal is being integrated into care homes in the UK as a therapeutic intervention for people with dementia and learning disabilities. Pet therapy is widely used, so the idea of a robot pet is an obvious step. Research has shown that ‘Paro’ lessens stress and anxiety, promotes social interaction, facilitates emotional expression and improves mood and speech fluency.
‘Pepper’ is a widely used humanoid robot able to communicate at a very basic level with simple gestures. Cameras on ‘Pepper’ have shape-recognition software and microphones, allowing ‘Pepper’ to decipher voice tones and expressions in order to determine if people are happy. So in a residential home ‘Pepper’ can patrol around and seek out people to talk to. ‘Pepper’ has been trialled in Southend care homes already.
‘MiRo’ is another ‘pet’ robot, this time resembling a rabbit or small dog, specifically designed to engage emotionally with people, to combat loneliness and to offer reminders for tasks such as taking medicine. The ‘Giraff ‘ robot developed at the University of Lincoln monitors the health of elderly people living alone, or those with dementia, and allows them to have contact through a screen with carers or family and friends. It has been trialled in isolated communities and homes in Scotland.
Some robots, with human features, have been designed to help children with autism who find it difficult to read emotions and interpret behaviour, by helping them to socialise and communicate. Probably best known is the child-sized ‘Kaspar’ robot, helping children to understand which tactile behaviours are socially acceptable and which are more inappropriate. ‘Kaspar’ effectively provides basic cognitive assistance.
A doll-type robot, nodding ‘Kabochan’, has been found to improve users’ cognitive function and mental health in research trials in Japan. Virtual robots have been successfully used to assess the cognitive abilities of children while ‘Zora’ has been shown to help the cognitive and communication skills of children with severe physical disabilities.
The benefits of robots are undoubtedly many and the push for their use in social and nursing care is powerful, but what are the costs?
Counting the cost
Currently, robots are expensive, which may present a practical barrier to their wider use in social care. However, they are still cheaper than people and can work 24 hours a day without contracts or complaining, and the outlay costs will fall over time.
So, what are other costs? We can still only guess at this stage but here are some questions that need asking:
- Will robots give us an excuse to palm off human care and interaction to machines? Will they make the next generation of older people more independent or more isolated?
- Will the quality of social care diminish, or can robots fulfil the social and emotional needs of vulnerable care recipients?
- Does mimicking the human form and actions deceive or help the elderly or patients with dementia? Or children with autism?
- Will robots like Roho in Japan take over aspects of childcare? What do we think of our children making ‘friends’ with robot humanoids or robot pets?
- What about autonomy, privacy, security and legal and regulatory concerns (such as the legal liability for decisions made by robots)? Or the risk of malicious hacking or cyber-attacks?
- Who controls robots? What if a manufacturer or user (or a technical support engineer) creates or changes settings that move the robot’s behaviours outside of an ‘ethical envelope’?
- What is the ethical governance of robots and their actions and purpose? Is any needed? Could we even create ‘ethical’ robots if we wanted?
Underneath all these questions lie the bigger ones on human dignity, care and community. Robots of the future will undoubtedly be able to perform many of the more basic, tedious and strenuous physical tasks currently done by humans. But human intervention will continue to be fundamental. There will always be a need for the calm, reassuring, empathetic, compassionate and caring bedside interactions and decision-making of professional humans, particularly when it comes to caring for patients, young and old, with complex needs. The high degree of social and emotional human intelligence is still beyond machines, and always will be.
The designer of ‘Stevie’ says: ‘None of this will mean we won’t need human carers anymore. Stevie won’t be able to wash or dress people, for example. Instead, we’re trying to develop technology that helps and complements human care. We want to combine human empathy, compassion and decision-making with the efficiency, reliability and continuous operation of robotics.’
Right now, the extent to which robotic innovations will assist or replace humans in the future remains unknown.
However, we must not allow inauthentic relationships with robots to replace human relationships or undermine human value or dignity in any way. The Bible is clear that we are made for relationships, first to God through Jesus Christ and then to each other. The Bible teaches human interdependence. A machine can never meet the emotional and spiritual relational needs of elderly citizens, patients or children, nor indeed any human.
It may seem obvious, but robots are not humans and humans are not robots. While robots may bring many benefits, any blurring of either of these boundaries may dangerously diminish the dignity and value that being made in God’s Image gives to every human being. We need to tread the path ahead carefully and wisely.