Bert Gordijn

The aim of this paper is to analyse the ethical issues relating to privacy that arise in smart homes designed for people with dementia and for people with intellectual disabilities. We outline five different conceptual perspectives on privacy and detail the ways in which smart home technologies may violate residents’ privacy. We specify these privacy threats in a number of areas and under a variety of conceptions of privacy. Furthermore, we illustrate that informed consent may not provide a solution to this problem. We offer a number of recommendations that designers of smart homes for people with dementia and people with intellectual disabilities might follow to ensure the privacy of potential residents.

The development of “smart stadia”, i.e. the use of “smart technologies” in the way sports stadia are designed and managed, promises to enhance the experience of attending a live match through innovative and improved services for the audience, as well as for the players, vendors and other stadium stakeholders. These developments offer us a timely opportunity to reflect on the ethical implications of the use of smart technologies and the emerging Internet of Things (IoT). The IoT has the potential to radically transform society and is representative of the ways that novel technologies will alter human life. We use Dublin’s Croke Park stadium smart project as a case study for examining the development of smart stadia.

PurposeThe purpose of this paper is to develop a critique of value sensitive design (VSD) and to propose an alternative approach that does not depart from a heuristic of value(s), but from virtue ethics, called virtuous practice design (VPD).Design/methodology/approachThis paper develops a philosophical argument, draws from a philosophical method (i.e. virtue ethics) and applies this method to a particular case study that draws from a narrative interview.FindingsIn this paper, authors show how an approach that takes virtue instead of value as the central notion for aiming at a design that is sensitive to ethical concerns can be fruitful both in theory and in practice.Originality/valueThis paper presents the first attempt to ground an approach aimed at ethical technology design on the tradition of virtue ethics. As such, it presents VPD as a potentially fruitful alternative to VSD.

Zusammenfassung. Die niederländische Euthanasie-Politik erzeugt immer wieder Verwunderung in anderen Ländern: Grundsätzlich stellt Euthanasie sowohl in den Niederlanden als auch im Ausland einen strafbaren Tatbestand dar. Und hier wie dort werden unter bestimmten Umständen derartige Fälle geduldet. Im Ausland geschieht diese Duldung, falls überhaupt geduldet wird, im allgemeinen stillschweigend und inoffiziell. Die niederländischen Behörden dagegen regeln aktiv und öffentlich diejenigen Fälle von Euthanasie, in denen keine Strafverfolgung eingeleitet wird. Man gibt im voraus an, unter welchen Umständen der betreffende Arzt keine Strafverfolgung zu befürchten hat. Mit der vorliegenden Abhandlung wird mittels eines kurzen Rückblicks in die Geschichte der früheren Republik der Niederlande eine historische Erklärung des typisch niederländischen Phänomens des gedogen gegeben. Im Anschluß wird aufgezeigt, inwieweit gedogen im Bereich der niederländischen Euthanasie-Politik zum Tragen kommt.

This paper focuses on the practice of injecting patients who are dying with a relatively high dose of sedatives in response to a catastrophic event that will shortly precipitate death, something that we term ‘crisis sedation.’ We first present a confabulated case that illustrates the kind of events we have in mind, before offering a more detailed account of the practice. We then comment on some of the ethical issues that crisis sedation might raise. We identify the primary value of crisis sedation as allowing healthcare professionals to provide some degree of reassurance to patients, their families and the professionals who are caring for them. Next we focus on the issue of informed consent. Finally, we ask whether continuous deep sedation might be preferable to crisis sedation in scenarios where potential catastrophic events can be anticipated.

With few exceptions, the literature on withdrawing and withholding life-saving treatment considers the bare fact of withdrawing or withholding to lack any ethical significance. If anything, the professional guidelines on this matter are even more uniform. However, while no small degree of progress has been made toward persuading healthcare professionals to withhold treatments that are unlikely to provide significant benefit, it is clear that a certain level of ambivalence remains with regard to withdrawing treatment. Given that the absence of clinical benefit means treating patients is not only ethically questionable but also taxing on resources that could meet the needs of others, this ambivalence is troubling. Equally, the enduring ambivalence of professionals might be taken to indicate that the issue warrants further attention. In this paper, we review the academic literature on the ethical equivalence of withdrawing and withholding medical treatment. While we are not in outright disagreement with the arguments presented, we suggest that asserting theoretical and decontextualized claims about the ethical equivalence of withdrawing and withholding life-saving treatment does not fully illuminate the moral questions associated with the relevant clinical realities. We argue that what is required is a broader perspective, one rooted in an understanding that withdrawing and withholding life-saving treatment are different practices, the meanings of which are fully comprehensible only through an appreciation of their place within the practice of healthcare more generally. Such an account suggests that if one is to engage with the inappropriate protraction of life-saving treatment resulting from healthcare professionals’ disinclination to withdraw it, then the differences between these practices should be taken seriously.

This comment on Chalgoumi et al.’s article “Information Privacy for Technology Users with Intellectual and Developmental Disabilities: Why Does It Matter?” focuses on the concept of autonomy in order to expand the scope of the ethical discussion. First we explore the conceptual and practical relations between privacy and autonomy. Following this, we address the issue of underfunding of information technology for persons with intellectual and developmental disabilities in terms of distributive justice and provide some potential policy solutions.

The development of “smart stadia”, i.e. the use of “smart technologies” in the way sports stadia are designed and managed, promises to enhance the experience of attending a live match through innovative and improved services for the audience, as well as for the players, vendors and other stadium stakeholders. These developments offer us a timely opportunity to reflect on the ethical implications of the use of smart technologies and the emerging Internet of Things. The IoT has the potential to radically transform society and is representative of the ways that novel technologies will alter human life. We use Dublin’s Croke Park stadium smart project as a case study for examining the development of smart stadia.

This paper outlines the potential and necessity of the development of assistive technologies for people with intellectual disabilities. We analyse a policy recommendation designed to determine the contents of a basic health package supplied by the state, known as the Dunning Funnel. We contend that the Dunning Funnel is a useful methodology, but is weakened by a potentially relativistic understanding of “necessity” in relation to the requirements of people with IDs. We remedy this defect by using the capabilities approach as outlined by Martha Nussbaum. We argue that this approach provides a strong normative case for ensuring that communities provide help to people with IDs, if those communities are to achieve a minimal standard of justice. However, the capabilities approach does not offer much specific guidance on how AT ought to be distributed, nor does it offer guidance on risks, like the bottomless pit problem. We propose that the Dunning Funnel used in combination with the capabilities approach will provide a suitable heuristic for determining the distribution of AT in a basic health package.

In today'sbioethical debates, the concept of the person plays a major role. However, it does not hold this role justly. The purpose of this paper is to argue that the concept of the person is unsuited to be a central concept in bioethical debates, because its use is connected with serious problems. First, the concept is superfluous. Secondly, it is a confusing concept and it lacks pragmatic use. Thirdly, its use leads to simplifications. Finally, the concept can easily be used as a cover-up concept. Therefore, it is argued that relinquishing the concept of the person could enhance the clarity and quality of bioethical debate. Moreover, the historic origin of much of the present confusion surrounding the concept of the person is clarified. It is demonstrated that three influences resulting from Locke'sideas on the person and personal identity can be determined as contributing factors to the confusion and controversy within the present bioethical debates centering around the person.