Two Revolutions: Digital and Demographic

GATSBII (Georgia Tech Service Bot with Interactive Intelligence) hands a research participant a medication bottle. Atlanta, Georgia, United States, 2011.  ©KEITH BUJAK/ GEORGIA TECH NEWS CENTER

The progressive digitalization of the world has an unprecedented impact on every sphere of our lives. Over the past 20 years, technology has permeated every aspect of modern society, and the use of digital technology, in particular, is becoming an integral part of our everyday lives. Many services and resources are now accessible only through digital means. Robots and artificial intelligence (AI) will also radically transform our lives, including the concept of care of older persons.

Along with this trend, the world is experiencing a demographic revolution. Every country is seeing growth in the number and proportion of its older population, and it is estimated that by 2050, over 20 per cent of the world’s population will be 60 years of age or older. While the increase in the number of older persons will be greatest and most rapid in the developing world, Asia is the region with the largest number of older persons, and Africa is facing the largest proportionate growth.

Older persons are often perceived as a homogeneous group, while in fact, they represent the most heterogeneous of all age groups. Some older persons may be in good health and may be able to live independently or autonomously throughout their lives. Others will become increasingly dependent on assistance in old age for reasons such as illness, impairment or loss of mobility, and may require varying degrees of specific care. Ensuring that all older persons are in a position to lead autonomous lives to the greatest extent possible—irrespective of their physical, mental and other conditions—is an area where new technologies, including assistive devices, built-in environmental applications and robotics have great potential.

Assistive and robotics technology can be used in three main areas: to help monitor the behaviour and health of older persons; to assist them or the caregiver in their daily tasks; and to provide for social interactions.

Technology can allow machines to perform simple, routine tasks, such as bringing meals and medications to patients. Assistive devices and robotics can compensate for physical weaknesses by enabling older persons to eat, bathe, shop or get out of bed on their own. They can enhance the capacity of older persons to self-manage daily activities, such as shopping or cleaning, without being dependent on caregivers or family members.

Smart living environments, which utilize sensors and other applications to monitor older persons’ health and behaviour, and help prevent hazards, can enable them to live independently in their own homes and avoid entering assisted living settings. Electronic bracelets, assistance through a global positioning system, technology-augmented travel applications and other accessible solutions allow older persons, including those with cognitive impairments, to travel and move about alone. Memory and communication applications can support older persons’ cognitive capacity and, by extension, their independent living.

Robots may be able to perform tasks that human beings cannot or are unwilling to carry out, or cannot complete as well or as efficiently. The use of such machines would free up human staff who could dedicate themselves more to those elements or parts of care that require human interaction. As their development progresses, robots may take on more medical or caregiving tasks and operate increasingly autonomously. To some, this might sound like utopia, but for authority to shift from humans to algorithms, robotic performance only needs to exceed that of the average human being.

The application of assistive and robotic technology touches inevitably on the enjoyment by older persons of their human rights, their dignity, autonomy, informational self-determination, non-discrimination and equality. In addition to the huge potential of the progressive use of such new technologies, there are also challenges and ambiguities related to the human rights of older persons. The subject requires further reflection and eventual action to ensure that the human rights of older persons are effectively protected, today and in the future.

At present, there is no explicit reference to the right to assistive technologies in the United Nations Principles for Older Persons, the International Covenant on Civil and Political Rights, or the International Covenant on Economic, Social and Cultural Rights. In the absence of a specific instrument for older persons, and while it is only applicable to a specific segment of such persons, only the provisions of the Convention on the Rights of Persons with Disabilities may provide some guidance, as it recognizes the importance of access to assistive technologies.

The former High Commissioner for Human Rights, Navi Pillay, as well as a growing number of States, consider that it is necessary to move from principles to rights and to consider the elaboration of a legally binding multilateral instrument to set universal standards and obligations with respect to the human rights of older persons.

The Open-ended Working Group on Ageing was established by the General Assembly in 2010 to consider the existing international framework of the human rights of older persons and identify possible gaps and how best to address them, including by considering, as appropriate, the feasibility of further instruments and measures. This year, for the first time, the Working Group began to focus its discussions on specific areas in which the enjoyment of human rights by older persons might be affected and require further protection.

At its next session in 2019, the Working Group will continue holding interactive discussions on normative elements. Both areas on which it will focus—autonomy and independence, and long-term and palliative care—will be affected by progressive digitalization. This will serve as a crucial opportunity to further study the elements of a right to support for the everyday life of older persons. The report of the Independent Expert presented to the Human Rights Council in 20171 on the impact of assistive and robotics technology, AI and automation on the human rights of older persons, will be one of the inputs for these normative discussions.

Autonomy is a key element in the discussions about assistive and robotics technology for older persons. It also extends to the right to refuse a certain form of support, such as that provided by a robot. This requires that simple and accurate information about the technology be provided to every older person in order for them to be able to assess the implications of the use of assistive and robotics technology prior to giving their consent.

The use of assistive and robotics technology will have a significant and unparalleled impact on the right to privacy, namely the protection of personal data and the right to informational self-determination. Information gathered through the use of assistive technology and robotics will be particularly sensitive, as it will pertain to the health of individuals; their life choices; political, philosophical and religious beliefs; and sexual habits. This may concern older persons themselves, but also their caregivers, families and friends.

The right to informational self-determination, as defined by the German Federal Constitutional Court, is intrinsic to an individual’s general right of personality and their dignity. It constitutes the authority of the individual to decide when and within what limits facts about his or her personal life shall be disclosed.2 Understanding the impact of autonomous robots on the right to informational self-determination and privacy requires an appreciation of the ways in which data are, and will be, utilized by care robots. The existing normative framework, such as article 17 of the International Covenant on Civil and Political Rights, which sets out the principle of reducing the number of data used, continues to provide essential guidance in this regard, even though robots and AI by definition require large amounts of data to function properly.

The use of assistive technology and robotics in the care of older persons can either enhance or compromise their dignity. It therefore needs to be rigorously scrutinized and it cannot be used as a substitute for human care. The extent to which it is appropriate to rely on a machine instead of a human will vary, depending on the context, task and the older person concerned. Grounded in a human rights-based approach, support should be available as a means to expand opportunities and not as a method of maintenance. Assistive technology should enable human capabilities and enhance human dignity. This aim should be integrated from the conception into the application of assistive devices and robotics.

Whereas most assistive technology and many of the currently deployed robots represent automatic systems that act according to a pre-programmed script, emerging technology operates with far greater levels of autonomy, ranging from systems that remain supervised by a human to fully autonomous robots enabled through AI that determine independently and dynamically if, when and how to execute a task.

A human rights-based approach therefore needs to be embedded in the design of assistive technology. Such a design ensures that the technology will not stigmatize older persons and will take into account their diverse needs and preferences, paying due attention to vulnerable groups, including those with high support needs, the cognitively and otherwise impaired, digital immigrants and others. There is also a need to further explore appropriate mechanisms of accountability and the monitoring of assistive technology, and in particular of robots, to ensure that such mechanisms adequately address the situation of older persons and are grounded in human rights standards.

In 1942, science fiction author Isaac Asimov formulated the “Three Laws of Robotics”: “1. A robot may not injure a human being or, through inaction, allow a human being to come to harm. 2. A robot must obey the orders given it by human beings except where such orders would conflict with the First Law. 3. A robot must protect its own existence as long as such protection does not conflict with the First or Second Law.”3 As forward-looking as these laws were at the time, even predating the Universal Declaration of Human Rights, the unprecedented impact of progressive digitalization in every sphere of our lives requires us to take the current debate on robotics and artificial intelligence a step further to ensure that the human rights framework adequately addresses the ensuing challenges for older persons.

 

Notes

1A/HRC/36/48.

2German Federal Constitutional Court, BVerfGE 65, 1, II 1 (a).

3Isaac Asimov, I, Robot (New York, GNOME press, INC., 1950).