Caring in the in-between : a proposal to introduce responsible AI and robotics to healthcare

Altres ajuts: Acord transformatiu CRUE-CSICIn the scenario of growing polarization of promises and dangers that surround artifcial intelligence (AI), how to introduce responsible AI and robotics in healthcare? In this paper, we develop an ethical-political approach to introduce democratic mechanisms to technological development, what we call "Caring in the In-Between". Focusing on the multiple possibilities for action that emerge in the realm of uncertainty, we propose an ethical and responsible framework focused on care actions in between fears and hopes. Using the theoretical perspective of Science and Technology Studies and empirical research, "Caring in the In-Between" is based on three movements: the frst is a change of focus from the world of promises and dangers to the world of uncertainties; the second is a conceptual shift from assuming a relationship with robotics based on a Human-Robot Interaction to another focused on the network in which the robot is embedded (the "Robot Embedded in a Network"); and the last is an ethical shift from a general normative framework to a discussion on the context of use. Based on these suggestions, "Caring in the In-Between" implies institutional challenges, as well as new practices in healthcare systems. It is articulated around three simultaneous processes, each of them related to practical actions in the "in-between" dimensions considered: monitoring relations and caring processes, through public engagement and institutional changes; including concerns and priorities of stakeholders, with the organization of participatory processes and alternative forms of representation; and making fears and hopes commensurable, through the choice of progressive and reversible actions

Robots in healthcare? What patients say

Ajuts: This research was funded by "la Caixa" Foundation under agreement LCF/PR/RC17/10110004.In this paper, we analyse patients' perspectives on the introduction of artificial intelligence (AI) and robotic systems in healthcare. Based on citizens' experiences when hospitalised for COVID- 19, we explore how the opinions and concerns regarding healthcare automation could not be disas-sociated from a context of high pressure on the health system and lack of resources, and a political discourse on AI and robotics; a situation intensified by the pandemic. Thus, through the analysis of a set of interviews, a series of issues are identified that revolve around the following: the empirical effects of imagined robots, the vivid experience of citizens with the care crisis, the discomfort of the ineffective, the virtualised care assemblages, the human-based face-to-face relationships, and the automatisation of healthcare tasks. In light of these results, we show the variability in patients' perspectives on AI and robotic systems and explain it by distinguishing two interpretive repertoires that account for different views and opinions: a well-being repertoire and a responsibility repertoire. Both interpretative repertoires are relevant in order to grasp the complexity of citizens' approaches to automatisation of healthcare. Attending to both allows us to move beyond the dominant (politi-cal) discourse of technology markets as the only way to respond to healthcare challenges. Thus, we can analyse and integrate patients' perspectives to develop AI and robotic systems in healthcare to serve citizens' needs and collective well-being

Children’s imaginaries of human-robot interaction in healthcare

This paper analyzes children’s imaginaries of Human-Robots Interaction (HRI) in the context of social robots in healthcare, and it explores ethical and social issues when designing a social robot for a children’s hospital. Based on approaches that emphasize the reciprocal relationship between society and technology, the analytical force of imaginaries lies in their capacity to be embedded in practices and interactions as well as to affect the construction and applications of surrounding technologies. The study is based on a participatory process carried out with six-year-old children for the design of a robot. Imaginaries of HRI are analyzed from a care-centered approach focusing on children’s values and practices as related to their representation of care. The conceptualization of HRI as an assemblage of interactions, the prospective bidirectional care relationships with robots, and the engagement with the robot as an entity of multiple potential robots are the major findings of this study. The study shows the potential of studying imaginaries of HRI, and it concludes that their integration in the final design of robots is a way of including ethical values in itPeer ReviewedPostprint (published version

Imaginar robots para los cuidados: ética, política y tecnología

Una de les principals incerteses del nostre món té a veure amb l’abast del que alguns anomenen la Nova Robòtica. Aquesta nova era de la robòtica està caracteritzada pel desenvolupament de robots pensats per a “col·laborar” amb els humans, dissenyats per ser introduïts en entorns quotidians. En l’àmbit de la salut hi ha un creixement exponencial d’investigacions i projectes relacionats amb la utilització d’aquest tipus de robots en processos terapèutics o de cura, els robots de cura. No obstant això, per la seva capacitat de mobilitzar les emocions i interpel·lar la nostra pròpia humanitat, el desenvolupament d’aquests artefactes desperta nombroses controvèrsies ètiques. Més enllà dels escenaris utòpics o distòpics que plantegen els debats ètics premonitoris que preconitzen el desenvolupament d’una sèrie de funcionalitats, en la present tesi proposo un debat ètic alternatiu que explora l’ètica en robòtica des de la discussió sobre el bé comú i el bon viure. A partir de la pregunta sobre quines són les formes de relació i l’ordre social que proposen els robots de cura, busco identificar i analitzar les controvèrsies al voltant del desenvolupament i introducció d’aquests robots, com un element previ per poder discutir sobre formes de desenvolupament tecnocientífic que persegueixin una bona vida en comú. Amb aquest objectiu he elaborat una aproximació pròpia a l’estudi de l’ètica dels robots, no des d’una ètica en majúscules o de grans principis, sinó des d’una ètica de batalla, quotidiana, negociable... feta i per fer. He realitzat l’acostament a aquestes qüestions des del marc teòric dels Science and Technology Studies (STS), utilitzant el principi d’heterogeneïtat i la idea de mediació tècnica com a conceptes centrals, introduint també algunes nocions desenvolupades des de la filosofia de la tecnologia, com la idea de moral materialitzada i de codis tècnics. En aquest marc conceptual hi he introduït també la noció d’imaginari, a partir de la meva lectura de l’obra de Castoriadis. Prenent els imaginaris com construccions col·lectives de les significacions del món comú, que alhora configuren als individus i són configurades per ells, els he utilitzat com a eina per analitzar des dels STS qüestions polítiques en l’ètica de les tecnologies. Mitjançant la realització d’un extens treball empíric (procés de disseny participatiu, Vision Assessment i entrevistes), he analitzat els imaginaris al voltant dels robots de cura, identificat diversos conflictes que confronten la lògica tecnocràtica amb una lògica que situa al centre del debat l’entramat de relacions de cures que sustenten els nostres mons i nosaltres mateixes. A partir d’aquests conflictes, al llarg de la tesi vaig configurant una sèrie de controvèrsies ètiques que fan referència a: la democratització de les tecnologies utilitzant processos participatius; la noció d’interacció humans-màquina; la direccionalitat de la cura; l’estabilitat de l’artefacte; la forma de les cures; i la lògica de funcionament. Finalment, des de la identificació d’aquestes controvèrsies, proposo l’articulació d’un marc ètic capaç de guiar la introducció i l’ús de robots de cura en l’àmbit de la salut, basat en el principi de precaució i l’acció mesurada.Una de las principales incertidumbres de nuestro mundo tiene que ver con el alcance de lo que algunos llaman la Nueva Robótica. Esta nueva era de la robótica está caracterizada por el desarrollo de robots pensados para “colaborar” con los humanos, diseñados para ser introducidos en entornos cotidianos. En el ámbito de la salud hay un crecimiento exponencial de investigaciones y proyectos relacionados con la utilización de este tipo de robots en procesos terapéuticos o de cuidados, los robots de cuidado. Sin embargo, por su capacidad de movilizar las emociones e interpelar nuestra propia humanidad, el desarrollo de estos artefactos despierta numerosas controversias éticas. Más allá de los escenarios utópicos o distópicos que plantean los debates éticos premonitorios que preconizan el desarrollo de una serie de funcionalidades, en la presente tesis propongo un debate ético alternativo que explora la ética en robótica desde la discusión sobre el bien común y el buen vivir. A partir de la pregunta sobre cuáles son las formas de relación y el orden social que proponen los robots de cuidado, busco identificar y analizar las controversias en torno al desarrollo e introducción de estos robots, como un elemento previo para poder discutir sobre formas de desarrollo tecnocientífico que persigan una buena vida en común. Con este objetivo he elaborado una aproximación propia al estudio de la ética de los robots, no desde una ética en mayúsculas o de grandes principios, sino desde una ética de batalla, cotidiana, negociable… hecha y por hacer. He realizado el acercamiento a estas cuestiones desde el marco teórico de los Science and Technology Studies (STS), utilizando el principio de heterogeneidad y la idea de mediación técnica como conceptos centrales, introduciendo también algunas nociones desarrolladas desde la filosofía de la tecnología, como la idea de moral materializada y de códigos técnicos. En este marco conceptual he introducido también la noción de imaginario, a partir de mi lectura de la obra de Castoriadis. Tomando los imaginarios como construcciones colectivas de las significaciones del mundo común, que a la vez configuran a los individuos y son configuradas por ellos, los he utilizado como herramienta para analizar desde los STS cuestiones políticas en la ética de las tecnologías. Mediante la realización de un extenso trabajo empírico (proceso de diseño participativo, Vision Assessment y entrevistas), he analizado los imaginarios alrededor de los robots de cuidado, identificado diversos conflictos que confrontan la lógica tecnocrática con una lógica que sitúa en el centro del debate el entramado de relaciones de cuidados que sustentan nuestros mundos y nosotras mismas. A partir de esos conflictos, a lo largo de la tesis voy configurando una serie de controversias éticas que hacen referencia a: la democratización de las tecnologías utilizando procesos participativos; la noción de interacción humanos-máquina; la direccionalidad de los cuidados; la estabilidad del artefacto; la forma de los cuidados; y la lógica de funcionamiento. Finalmente, desde la identificación de estas controversias, propongo la articulación de un marco ético capaz de guiar la introducción y el uso de robots de cuidado en el ámbito de la salud, basado en el principio de precaución y la acción mesurada.One of the main uncertainties of our world has to do with the development of what some call the New Robotics. This new era of robotics is characterized by the development of robots intended to “collaborate” with humans, designed to be introduced into everyday environments. In the health domain, there is an exponential growth in research and projects related to the use of this type of robots in therapeutic or care processes: the care robots. However, because of their ability to mobilize emotions and appeal to our own humanity, the development of these artifacts raises numerous ethical concerns. Beyond the utopian or dystopian scenarios posed by premonitory ethical debates that advocate the development of a series of functionalities, in the present thesis I propose an alternative ethical debate that explores ethics in robotics from the discussion of the common good and good living. Based on the question of what forms of relationship and social order are proposed by care robots, I seek to identify and analyze the controversies surrounding the development and introduction of these robots. This would make possible a discussion regarding which versions of techno-scientific development are aiming for a good life in common. With this objective I have elaborated my own approach to the study of the ethics of robots, not from an ethics in capital letters or of great principles, but from an ethics of battle, daily, negotiable... made and to be made. I have approached these questions from the theoretical framework of Science and Technology Studies (STS), using the principle of heterogeneity and the idea of technical mediation as central concepts, also introducing some notions developed from the philosophy of technology, such as the idea of materialized morality and technical codes. Within this conceptual framework I have also introduced the notion of the imaginary, based on my reading of Castoriadis’ work. Taking the imaginaries as collective constructions of the meanings of the common world, which at the same time configure individuals and are configured by them, I have used them as a tool to analyze political issues in the ethics of technologies from a STS perspective. By means of an extensive empirical work (participatory design process, Vision Assessment, and interviews), I have analyzed the imaginaries around care robots, identifying several conflicts that confront technocratic logic with a logic that places at the center of the debate the network of care relationships that sustain our worlds and ourselves. Based on these conflicts, throughout the thesis I have configured a series of ethical controversies that refer to: the democratization of technologies using participatory processes; the notion of human-machine interaction; the directionality of care; the stability of the device; the form of care; and the logic of functioning. Finally, from the identification of these controversies, I propose the articulation of an ethical framework capable of guiding the introduction and use of care robots in the area of health, based on the precautionary principle and measured action

Repensando a robótica e a inteligência artificial a partir da ética do cuidar

In this paper I propose the use of the ethics of care as a theoretical and political framework for rethinking ‘robotics’ and ‘artificial intelligence’ (AI) in healthcare. Using the theoretical perspective of Science and Technology Studies, I develop an approach based on the idea of a continuum between care, politics, ethics and technologies. I propose a reflection on the controversies surrounding robotics and AI from a non-naïve position, from a logic of conflict and confrontation with the imaginaries that accompany the technological innovation market. Conceptually, this proposal revolves around two notions: heterogeneity and creativity, and how they express the radical potential of the ethics of care as a utopia that challenges neoliberal utopia. From these considerations I articulate a way of understanding human-robot relations that seeks to overcome the traditional dyadic human-machine relationship. Taking as a unit of analysis the network of care relations in which the robot is embedded (Robot Embedded in a Network -REN-), new controversies emerge that make visible the daily practices of care with these artefacts, and the relations of inequality that accompany them. Similarly, in order to guarantee the design and introduction of responsible technologies, at the service of the common good and individual and collective well-being, I suggest the need to integrate the various actors involved in care into the debate, as well as to establish mechanisms for monitoring and permanent public scrutiny of the design and introduction of robots in healthcare.En este artículo propongo la utilización de la ética de los cuidados como marco teórico y político para repensar la ‘robótica’ y la ‘inteligencia artificial’ (IA) en el ámbito de la salud. Utilizando la perspectiva teórica de los Estudios de Ciencia y Tecnología, desarrollo una aproximación a partir de la idea de continuum entre cuidados, política, ética y tecnologías. Propongo una reflexión sobre las controversias en torno a la robótica y la IA desde un posicionamiento no ingenuo, desde una lógica de conflicto y confrontación con los imaginarios que acompañan el mercado de la innovación tecnológica. Conceptualmente esta propuesta gira en torno a dos nociones: la heterogeneidad y la creatividad, nociones que expresan la potencia radical de la ética de los cuidados como utopía que desafía la utopía neoliberal. A partir de estas consideraciones articulo una manera de comprender las relaciones entre los humanos y los robots que busca superar la tradicional relación diádica humano-máquina. Tomando como unidad de análisis el entramado de relaciones de cuidados de las que participa el robot (Robot Embedded in a Network -REN-), emergen nuevas controversias que permiten visibilizar las prácticas cotidianas de cuidados con estos artefactos, y las relaciones de desigualdad que las acompañan. Del mismo modo, para poder garantizar un diseño e introducción de tecnologías responsables, al servicio del bien común y del bienestar individual y colectivo, apunto a la necesidad de integrar en el debate a los diversos actores que participan en los cuidados, así como también de establecer mecanismos de vigilancia y escrutinio público permanente en el diseño e introducción de robots en el ámbito de la salud.Neste artigo, proponho o uso da ética do cuidado como referencial teórico e político para repensar a ‘robótica’ e a ‘inteligência artificial’ (IA) no campo da saúde. Utilizando a perspectiva teórica dos Estudos de Ciência e Tecnologia, desenvolvo uma abordagem baseada na ideia de continuum entre cuidado, política, ética e tecnologias. Proponho uma reflexão sobre as polêmicas em torno da robótica e da IA ​​a partir de uma postura não ingênua, de uma lógica de conflito e confronto com os imaginários que acompanham o mercado de inovação tecnológica. Conceitualmente, essa proposta gira em torno de duas noções: heterogeneidade e criatividade, noções que expressam o poder radical da ética do cuidado como utopia que desafia a utopia neoliberal. A partir dessas considerações, analiso uma forma de compreender as relações entre humanos e robôs que busca superar a tradicional relação diádica homem-máquina. Tomando como unidade de análise a rede de relações de cuidado da qual o robô participa (Robô Embutido em Rede -REN-), novas controvérsias emergem que permitem tornar visíveis as práticas cotidianas de cuidado com esses artefatos, e as relações desiguais que os acompanham. . Do mesmo modo, para garantir a concepção e introdução de tecnologias responsáveis, ao serviço do bem comum e do bem-estar individual e coletivo, aponto a necessidade de integrar no debate os diversos atores que participam no cuidado, bem como estabelecer mecanismos permanentes de escrutínio público e vigilância na concepção e introdução de robôs no campo da saúde.Neste artigo, proponho o uso da ética do cuidado como referencial teórico e político para repensar a ‘robótica’ e a ‘inteligência artificial’ (IA) no campo da saúde. Utilizando a perspectiva teórica dos Estudos de Ciência e Tecnologia, desenvolvo uma abordagem baseada na ideia de continuum entre cuidado, política, ética e tecnologias. Proponho uma reflexão sobre as polêmicas em torno da robótica e da IA ​​a partir de uma postura não ingênua, de uma lógica de conflito e confronto com os imaginários que acompanham o mercado de inovação tecnológica. Conceitualmente, essa proposta gira em torno de duas noções: heterogeneidade e criatividade, noções que expressam o poder radical da ética do cuidado como utopia que desafia a utopia neoliberal. A partir dessas considerações, analiso uma forma de compreender as relações entre humanos e robôs que busca superar a tradicional relação diádica homem-máquina. Tomando como unidade de análise a rede de relações de cuidado da qual o robô participa (Robô Embutido em Rede -REN-), novas controvérsias emergem que permitem tornar visíveis as práticas cotidianas de cuidado com esses artefatos, e as relações desiguais que os acompanham. . Do mesmo modo, para garantir a concepção e introdução de tecnologias responsáveis, ao serviço do bem comum e do bem-estar individual e coletivo, aponto a necessidade de integrar no debate os diversos atores que participam no cuidado, bem como estabelecer mecanismos permanentes de escrutínio público e vigilância na concepção e introdução de robôs no campo da saúde

Repensar la robótica y la inteligencia artificial desde la ética de los cuidados

In this paper I propose the use of the ethics of care as a theoretical and political framework for rethinking ‘robotics’ and ‘artificial intelligence’ (AI) in healthcare. Using the theoretical perspective of Science and Technology Studies, I develop an approach based on the idea of a continuum between care, politics, ethics and technologies. I propose a reflection on the controversies surrounding robotics and AI from a non-naïve position, from a logic of conflict and confrontation with the imaginaries that accompany the technological innovation market. Conceptually, this proposal revolves around two notions: heterogeneity and creativity, and how they express the radical potential of the ethics of care as a utopia that challenges neoliberal utopia. From these considerations I articulate a way of understanding human-robot relations that seeks to overcome the traditional dyadic human-machine relationship. Taking as a unit of analysis the network of care relations in which the robot is embedded (Robot Embedded in a Network -REN-), new controversies emerge that make visible the daily practices of care with these artefacts, and the relations of inequality that accompany them. Similarly, in order to guarantee the design and introduction of responsible technologies, at the service of the common good and individual and collective well-being, I suggest the need to integrate the various actors involved in care into the debate, as well as to establish mechanisms for monitoring and permanent public scrutiny of the design and introduction of robots in healthcare.Neste artigo, proponho o uso da ética do cuidado como referencial teórico e político para repensar a ‘robótica’ e a ‘inteligência artificial’ (IA) no campo da saúde. Utilizando a perspectiva teórica dos Estudos de Ciência e Tecnologia, desenvolvo uma abordagem baseada na ideia de continuum entre cuidado, política, ética e tecnologias. Proponho uma reflexão sobre as polêmicas em torno da robótica e da IA ​​a partir de uma postura não ingênua, de uma lógica de conflito e confronto com os imaginários que acompanham o mercado de inovação tecnológica. Conceitualmente, essa proposta gira em torno de duas noções: heterogeneidade e criatividade, noções que expressam o poder radical da ética do cuidado como utopia que desafia a utopia neoliberal. A partir dessas considerações, analiso uma forma de compreender as relações entre humanos e robôs que busca superar a tradicional relação diádica homem-máquina. Tomando como unidade de análise a rede de relações de cuidado da qual o robô participa (Robô Embutido em Rede -REN-), novas controvérsias emergem que permitem tornar visíveis as práticas cotidianas de cuidado com esses artefatos, e as relações desiguais que os acompanham. . Do mesmo modo, para garantir a concepção e introdução de tecnologias responsáveis, ao serviço do bem comum e do bem-estar individual e coletivo, aponto a necessidade de integrar no debate os diversos atores que participam no cuidado, bem como estabelecer mecanismos permanentes de escrutínio público e vigilância na concepção e introdução de robôs no campo da saúde.En este artículo propongo la utilización de la ética de los cuidados como marco teórico y político para repensar la ‘robótica’ y la ‘inteligencia artificial’ (IA) en el ámbito de la salud. Utilizando la perspectiva teórica de los Estudios de Ciencia y Tecnología, desarrollo una aproximación a partir de la idea de continuum entre cuidados, política, ética y tecnologías. Propongo una reflexión sobre las controversias en torno a la robótica y la IA desde un posicionamiento no ingenuo, desde una lógica de conflicto y confrontación con los imaginarios que acompañan el mercado de la innovación tecnológica. Conceptualmente esta propuesta gira en torno a dos nociones: la heterogeneidad y la creatividad, nociones que expresan la potencia radical de la ética de los cuidados como utopía que desafía la utopía neoliberal. A partir de estas consideraciones articulo una manera de comprender las relaciones entre los humanos y los robots que busca superar la tradicional relación diádica humano-máquina. Tomando como unidad de análisis el entramado de relaciones de cuidados de las que participa el robot (Robot Embedded in a Network -REN-), emergen nuevas controversias que permiten visibilizar las prácticas cotidianas de cuidados con estos artefactos, y las relaciones de desigualdad que las acompañan. Del mismo modo, para poder garantizar un diseño e introducción de tecnologías responsables, al servicio del bien común y del bienestar individual y colectivo, apunto a la necesidad de integrar en el debate a los diversos actores que participan en los cuidados, así como también de establecer mecanismos de vigilancia y escrutinio público permanente en el diseño e introducción de robots en el ámbito de la salud

Care robots for the common good: ethics as politics

The development of care robots has been accompanied by a number of technical and social challenges, which are guided by the question: “What is a robot for?” Debates guided by this question have discussed the functionalities and tasks that can be delegated to a machine that does not harm human dignity. However, we argue that these ethical debates do not offer any alternatives for designing care robots for the common good. In particular, we stress the need to shift the current ethical discussion on care robots towards a reflection on the politics of robotics, understanding politics as the search for the common good. To develop this proposal, we use the theoretical perspective of science and technology studies, which we integrate into the analysis of disagreement inspired by a consensus-dissensus way of thinking, based on discussing and rethinking the relationships of care robots with the common good and the subjects of such good. Thus, the politics of care robots allows for the emergence of a set of discussions on how human-machine configurations are designed and practiced, as well as the role of the market of technological innovation in the organisation of care

Children's imaginaries of human-robot interaction in healthcare

Acknowledgments: This study was supported by the TECSAL Research Project (CS-2014-59136-P) of the Spanish Ministry of Economy and Competitiveness and the Casper Research Project (2014LLV00033) of the Catalan GovernmentThis paper analyzes children's imaginaries of Human-Robots Interaction (HRI) in the context of social robots in healthcare, and it explores ethical and social issues when designing a social robot for a children's hospital. Based on approaches that emphasize the reciprocal relationship between society and technology, the analytical force of imaginaries lies in their capacity to be embedded in practices and interactions as well as to affect the construction and applications of surrounding technologies. The study is based on a participatory process carried out with six-year-old children for the design of a robot. Imaginaries of HRI are analyzed from a care-centered approach focusing on children's values and practices as related to their representation of care. The conceptualization of HRI as an assemblage of interactions, the prospective bidirectional care relationships with robots, and the engagement with the robot as an entity of multiple potential robots are the major findings of this study. The study shows the potential of studying imaginaries of HRI, and it concludes that their integration in the final design of robots is a way of including ethical values in i

Children’s imaginaries of human-robot interaction in healthcare

This paper analyzes children’s imaginaries of Human-Robots Interaction (HRI) in the context of social robots in healthcare, and it explores ethical and social issues when designing a social robot for a children’s hospital. Based on approaches that emphasize the reciprocal relationship between society and technology, the analytical force of imaginaries lies in their capacity to be embedded in practices and interactions as well as to affect the construction and applications of surrounding technologies. The study is based on a participatory process carried out with six-year-old children for the design of a robot. Imaginaries of HRI are analyzed from a care-centered approach focusing on children’s values and practices as related to their representation of care. The conceptualization of HRI as an assemblage of interactions, the prospective bidirectional care relationships with robots, and the engagement with the robot as an entity of multiple potential robots are the major findings of this study. The study shows the potential of studying imaginaries of HRI, and it concludes that their integration in the final design of robots is a way of including ethical values in itPeer Reviewe