Ethical Smart Care: Policy, Design, and Everyday Use

Smart care has become a realistic prospect for supporting people living with long-term conditions, promising tailored, responsive care through remote monitoring. The promise is more efficient and more effective care, allowing people with long-term conditions to live well for longer in the place of their choice. That promise, however, is offset by considerable risks such as intrusive or unacceptable surveillance, care that becomes more about data than human contact, hidden biases serving some populations at the expense of others. The question remains: Can we build what we value into smart technologies?

Ethical Smart Care explores how we move toward smart care infrastructures that provide more of the benefits and avoid the risks, offering provocative ideas for those involved both in the development and implementation of health care technologies. By considering how the smart care scenario plays out for those living at home with dementia, it explores how developers, healthcare professionals, carers, and users of smart care navigate day-to-day ethical challenges. This everyday perspective illustrates the diverse forms of expertise that come together, and sometimes collide, in the delivery of technologized care.

By considering ethics as something that we all do in our everyday lives, rather than as a set of abstract principles, Christine Hine conceptualizes ethics as emerging through the practices and languages deployed by everyone linked to smart care, from policy makers, designers, and researchers to clinicians, carers, and users. Hine identifies key moments in the design, implementation, and use of smart healthcare tools with ethical connotations for those involved, highlights the need for better communication to inform the design and rollout of smart care infrastructure, and considers how we can steer innovations in the field of smart care to maximize the work that they can do for good and minimize the risks of inadvertently causing harm.

Christine Hine is Professor of Sociology at the University of Surrey. Her research explores social and ethical dimensions of the development and use of digital technologies and artificial intelligence in relation to care at home. Her work includes Research Methods for Digital Work and Organization, edited with Gillian Symon and Katrina Pritchard, Ethnography for the Internet, and Virtual Ethnography. Her article ’Strategies for Reflexive Ethnography in the Smart Home’ won the 2021 SAGE Prize for Innovation/Excellence in Sociology.