Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2015 Jun;18(3):438-49.
doi: 10.1111/hex.12109. Epub 2013 Aug 6.

Ethical implications of home telecare for older people: a framework derived from a multisited participative study

Maggie Mort  1 , Celia Roberts, Jeannette Pols, Miquel Domenech, Ingunn Moser; EFORTT investigators
Collaborators, Affiliations
Multicenter Study

Ethical implications of home telecare for older people: a framework derived from a multisited participative study

Maggie Mort et al. Health Expect. 2015 Jun.

Abstract

Context: Telecare and telehealth developments have recently attracted much attention in research and service development contexts, where their evaluation has predominantly concerned effectiveness and efficiency. Their social and ethical implications, in contrast, have received little scrutiny.

Objective: To develop an ethical framework for telecare systems based on analysis of observations of telecare-in-use and citizens' panel deliberations.

Design: Ethnographic study (observation, work shadowing), interviews, older citizens' panels and a participative conference.

Setting: Participants' homes, workplaces and familiar community venues in England, Spain, the Netherlands and Norway 2008-2011.

Results: Older respondents expressed concerns that telecare might be used to replace face-to-face/hands-on care to cut costs. Citizens' panels strongly advocated ethical and social questions being considered in tandem with technical and policy developments. Older people are too often excluded from telecare system design, and installation is often wrongly seen as a one-off event. Some systems enhance self-care by increasing self-awareness, while others shift agency away from the older person, introducing new forms of dependency.

Conclusions: Telecare has care limitations; it is not a solution, but a shift in networks of relations and responsibilities. Telecare cannot be meaningfully evaluated as an entity, but rather in the situated relations people and technologies create together. Characteristics of ethical telecare include on-going user/carer engagement in decision making about systems: in-home system evolution with feedback opportunities built into implementation. System design should be horizontal, 'two-way'/interactive rather than vertical or 'one-way'. An ethical framework for telecare has been developed from these conclusions (Table 1).

Keywords: ageing; citizens’ panels; ethical framework; technology; telecare.

PubMed Disclaimer

Figures

Figure 1
Figure 1
EFORTT research process.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Audit Commission . Implementing Telecare. London: Audit Commission, 2004.
    1. Department of Health . Building Telecare in England. London: Department of Health, 2005.
    1. Walker K. Britain's Age Timebomb. http://www.dailymail.co.uk/news/article-2009269/Cost-1-4m-extra-pensione.... Daily Mail, 29 June 2011 (accessed 29 March 2013).
    1. Office of the Deputy Prime Minister/Department of Health . Preventative Technology Grant 2006/07 – 2007/08, Local Authority Circular, LAC (2006) 5.
    1. 3millionlives . Improving access to telehealth and telecare. http://3millionlives.co.uk/ (accessed 29 March 2013).

Publication types