This book argues for the importance of writing to conceptions of language, technology, and civilization in the early modern era.

In this paper, we argue that the affective experience that permeates the employment of Assistive Technology (AT) in special needs education is crucial for the integration of AT. “AT integration” generally means the fluid and automatic employment of AT for fulfilling certain tasks. Pritchard et al. ( 2021 ) have proposed a more specific conceptualisation of AT integration by saying that AT is integrated when it is part of the user’s cognitive character. By discussing their proposal, we argue (...) that the user’s affective experience is crucial for AT integration. To better appreciate the relevance of the affective experience in AT integration, we suggest shifting the perspective from the functionalist extended cognition framework, as Pritchard et al. ( 2021 ) propose, to affective scaffoldings. In doing so we focus on the feeling of agency as the key experience to consider for understanding what AT does to the agent. We will put forth the hermeneutical tool of “phenomenal transformation” to explain how and why AT as an affective scaffolding can support the fundamental “I can” of the experience. (shrink)

Increasingly, commissioners and providers of services for people with intellectual disabilities are turning to assistive technology and telecare as a potential solution to the problem of the increased demand for services, brought about by an expanding population of people with intellectual disabilities in the context of relatively static or diminishing resources. While there are numerous potential benefits of assistive technology and telecare, both for service providers and service users, there are also a number of ethical issues. (...) The aim of this paper is to raise these issues and to set them within the ethical framework proposed by Beauchamp and Childress. There is a need for a wider debate as a first step in the development of strategies to address the issues raised in the paper. (shrink)

Purpose This study aims to explore the potential of mobile assistive technology as a vocational tool for blind workers. Specifically, it investigates: Can MAT-enabled BW to perform better at the workplace and will insight into MAT-enabled capabilities impact employer perception regarding BW employability. Design/methodology/approach Exploratory case study which draws on theories of fit to analyze observational and interview data at an organization familiar with employing, training and referring BW. Findings MAT can increase blind worker job fit, positively impacting (...) their performance, self-reliance and managerial perceptions regarding their employability. Research limitations/implications A conceptual framework is articulated which expands current literature on fit to better account for the assistive potential of mobile technology for differently abled workers. Practical implications The positive impact of MAT on managerial perceptions of BW fit and employability can inform the regimes of employers, job skills trainers, vocational rehabilitation specialists and policy makers. Social implications Insights on the use of MAT as a vocational tool can reduce the systemic workplace disenfranchisement of blind people. Originality/value This paper presents novel theory which accounts for the impact of MAT on the job fit of differently abled workers. (shrink)

Objections to the use of assistive technologies in elite sports are generally raised when the technology in question is perceived to afford the user a potentially “unfair advantage,” when it is perceived as a threat to the purity of the sport, and/or when it is perceived as a precursor to a slippery slope toward undesirable changes in the sport. These objections rely on being able to quantify standards of “normal” within a sport so that changes attributed to the (...) use of assistive technology can be judged as causing a significant deviation from some baseline standard. This holds athletes using assistive technologies accountable to standards that restrict their opportunities to achieve greatness, while athletes who do not use assistive technologies are able to push beyond the boundaries of these standards without moral scrutiny. This paper explores how constructions of fairness and “normality” impact athletes who use assistive technology to compete in a sporting venue traditionally populated with “able-bodied” competitors. It argues that the dynamic and obfuscated construction of “normal” standards in elite sports should move away from using body performance as the measuring stick of “normal,” toward alternate forms of constructing norms such as defining, quantifying, and regulating the mechanical actions that constitute the critical components of a sport. Though framed within the context of elite sports, this paper can be interpreted more broadly to consider problems with defining “normal” bodies in a society in which technologies are constantly changing our abilities and expectations of what normal means. (shrink)

Due to the socio-demographic change in most developed western countries, elderly populations have been continuously increasing. Therefore, preventive and assistive systems that allow elderly people to independently live in their own homes as long as possible will become an economical if not ethical necessity. These respective technologies are being developed under the term "Ambient Assistive Technologies". The EU-funded AAT-project Ambient Lighting Assistance for an Ageing Population has established the long-term goal to create an adaptive system capable of improving (...) the residential lighting conditions of single living elderly persons also aiming at supporting the preservation of their independence. Results of an earlier survey revealed that the elderly perceived their current lighting situation as satisfactory, whereas interviewers assessed in-house lighting as too dark and risk-laden. The overall results of ALADIN showed a significant increase in well-being from the baseline final testing with the new adaptive lighting system. Positive results for wellbeing and life quality suggest that the outcome effects may be attributed to the introduction of technology as well as to social contacts arising from participating in the study. The technological guidance of the study supervisors, in particular, may have produced a strong social reactivity effect that was first observed in the famous Hawthorne experiments in the 1930s. As older adults seem to benefit both from meaningful social contacts as well as assistive technologies, the question arises how assistive technology can be socially embedded to be able to maximize positive health effects. Therefore ethical guidelines for development and use of new assistive technologies for handicapped/older persons have to be developed and should be discussed with regard to their applicability in the context of AAT. (shrink)

Against the backdrop of an aging world population increasingly affected by a diverse range of abilities and disabilities as well as the rise of ubiquitous computing and digital app cultures, this paper questions how mobile technologies mediate between heterogeneous environments and sensing beings. To approach the current technological manufacturing of the senses, two lines of thought are of importance: First, there is a need to critically reflect upon the concept of assistive technologies as artifacts providing tangible solutions for a (...) specific disability. Second, the conventional distinction between user and environment requires a differentiated consideration. This contribution will first review James Gibson’s concept of “affordances” and modify this approach by introducing theories and methods of Science and Technology Studies and Actor-Network Theory. Then, we present two case studies where we explore the relations between recent “assistive” app technologies and human sensory perception. As hearing and seeing are key in this regard, we concentrate on two specific media technologies: ReSound LINX2, a hearing aid which allows for direct connect with iPhone, iPad, or iPod Touch, and Camassia, an IOS app for sonic wayfinding for blind people. We emphasize the significance of dis-/abling practices for manufacturing novel forms of hearing and seeing and drawing on sources like promotional materials by manufacturers, ads, or user testimonials and reviews. Our analysis is interested in the reciprocal relationships between users and their socio-technical and media environments. By and large, this contribution will provide crucial insights into the contemporary entanglement of algorithm-driven technologies, daily practices, and sensing subjects: the production of techno-sensory arrangements. (shrink)

Objectives: Technology can assist and support both people with dementia and caregivers. Recently, technology has begun to embed remote components. Timely with respect to the pandemic, the present work reviews the most recent literature on technology in dementia contexts together with the newest studies about technological support published until October 2020. The final aim is to provide a synthesis of the timeliest evidence upon which clinical and non-clinical decision-makers can rely to make choices about technology in (...) the case of further pandemic waves.Methods: A review of reviews was performed alongside a review of the studies run during the first pandemic wave. PsycInfo, CINAHL, and PubMed-online were the databases inspected for relevant papers published from January 2010.Results: The search identified 420 articles, 30 of which were reviews and nine of which were new studies meeting the inclusion criteria. Studies were first sorted according to the target population, then summarized thematically in a narrative synthesis. The studies targeting technologies for PWD were categorized as follows: monitoring and security purposes, sustaining daily life, and therapeutic interventions. Each category showed potential benefits. Differently, the interventions for caregivers were classified as informative, psycho-education programs, psychosocial-supportive, therapeutic, and cognitive/physical training. Benefits to mental health, skills learning, and social aspects emerged.Conclusions: The evidence shows that technology is well-accepted and can support PWD and caregivers to bypass physical and environmental problems both during regular times and during future pandemic waves. Nevertheless, the lack of a common methodological background is revealed by this analysis. Further and more standardized research is necessary to improve the implementation of technologies in everyday life while respecting the necessary personalization. (shrink)

Assistive technology is widely used in contemporary special needs education. Our interest is in the extent to which we can conceive of certain uses of AT in this educational context as a form of extended cognition. It is argued that what is critical to answering this question is that the relationship between the student and the AT is more than just that of subject-and-instrument, but instead incorporates a fluidity and spontaneity that puts it on a functional par with (...) their use of the student’s biological cognitive traits. It is claimed that AT use in special needs education offers an especially plausible case of extended cognition for just this reason. It is further maintained that understanding AT in this fashion has some important philosophical and practical ramifications, including how we should conceive of mainstream education, given that this is increasingly conducted within highly technologically-embedded environments. (shrink)

The use of Intelligent Assistive Technology in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations (...) in the design of current IATs. Our screening shows that a significant portion of current IATs is designed in the absence of explicit ethical considerations. These results suggest that the lack of ethical consideration might be a codeterminant of current structural limitations in the translation of IATs from designing labs to bedside. Based on these data, we call for a coordinated effort to proactively incorporate ethical considerations early in the design and development of new products. (shrink)

Fairness of access to assistive technology is important for its allocation on an equitable basis and for broader social justice and rights issues. Although the use of Daniels’s notion of “justice as fair opportunity” is helpful to the context of assistive technology, other aspects of Daniels’s broader conceptualisation of “just health” are not appropriate in this context. It is argued that fairness of access to assistive technology is crucial for the equitable attainment of the (...) sustainable development goals; however, such access will be achieved only by the sector developing a much stronger systems thinking and market shaping perspective. (shrink)

In this paper, I argue that disabled people have a right to assistive technology, but this right cannot be grounded simply in a broader right to health care or in a more comprehensive view like the capabilities approach to justice. Both of these options are plagued by issues that I refer to as the problem of constriction, where the theory does not justify enough of the AT that disabled people should have access to, and the problem of overextension, (...) where the theory cannot adequately identify an upper limit on the AT that people have a right to. As an alternative to these justificatory frameworks, I argue that disabled people are owed access to AT at the expense of nondisabled people as a matter of compensatory justice. That is, I defend the position that disabled people are owed AT as part of due compensation for the harms they experience from being disadvantaged by society’s dominant cooperative scheme and the violation of their right to equality of opportunity that such disadvantage entails. I also propose a method for identifying an upper limit to what this right to AT requires. In this way, I argue that compensatory justice avoids both the problem of constriction and the problem of overextension. (shrink)

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. (shrink)

Assistive technology has great potential to contribute to health, functioning, and quality of life. To date, as exemplified in the Canadian context, variations and inequities in access to assistive technology are evident; the development of legislation, policies, and programs has not kept up with the increasing use of assistive technology. In this article, we apply ;Daniels’s (2008) theory of just health to argue that equitable access to assistive technology funding and services is (...) necessary for justice. In doing so, we offer theoretical guidance for the development of legislation, policies, and programs to guide such access in health and social services. (shrink)

It is the purpose of this paper to address ethical issues concerning the development and application of Assistive Technology at Workplaces (ATW). We shall give a concrete technical concept how such technology might be constructed and propose eight technical functions it should adopt in order to serve its purpose. Then, we discuss the normative questions why one should use ATW, and by what means. We argue that ATW is good to the extent that it ensures social inclusion (...) and consider four normative domains in which its worth might consists in. In addition, we insist that ATW must satisfy two requirements of good workplaces, which we specify as (a) an exploitation restraint and (b) a duty of care. (shrink)

This paper aims to explore the role assistive technologies might play in helping people with autism spectrum disorder and a concomitant responsibility deficit become more morally responsible. Toward this goal, the authors discuss the philosophical concept of responsibility, with a reliance on Nicole Vincent’s taxonomy of responsibility concepts. They then outline the ways in which ASD complicates ascriptions of responsibility, particularly responsibility understood as a capacity. Further, they explore the ways in which ATs might improve a person’s capacity so (...) that responsibility can be properly ascribed to them. After demonstrating that although assistive technologies are likely to be able to enhance a person’s capacity in such a way so that responsibility can be ascribed to them, the authors assert that these technologies will have a number of additional effects on the other aspects of the concept of responsibility. (shrink)

Scenarios involving the introduction of artificially intelligent (AI) assistive technologies in health care practices raise several ethical issues. In this paper, I discuss four objections to introducing AI assistive technologies in health care practices as replacements of human care. I analyse them as demands for felt care, good care, private care, and real care. I argue that although these objections cannot stand as good reasons for a general and a priori rejection of AI assistive technologies as such (...) or as replacements of human care, they demand us to clarify what is at stake, to develop more comprehensive criteria for good care, and to rethink existing practices of care. In response to these challenges, I propose a (modified) capabilities approach to care and emphasize the inherent social dimension of care. I also discuss the demand for real care by introducing the ‘Care Experience Machine’ thought experiment. I conclude that if we set the standards of care too high when evaluating the introduction of AI assistive technologies in health care, we have to reject many of our existing, low-tech health care practices. (shrink)

Background Despite the great benefits of intelligent assistive technology (IAT) for dementia care – for example, the enhanced safety and increased independence of people with dementia and their caregivers – its practical adoption is still limited. The social and ethical issues pertaining to IAT in dementia care, shaped by factors such as culture, may explain these limitations. However, most studies have focused on understanding these issues within one cultural setting only. Therefore, the aim of this study was to (...) explore and compare the attitudes of Israeli and German dementia experts toward IAT in dementia care, to contribute to a more cultural-comparative perspective. Methods Semi-structured interviews were conducted with 35 experts (15 Israelis and 20 Germans) in key roles in health and community services for people with dementia as well as in the fields of dementia and IAT (e.g., computer science, electrical/biomedical engineering, ethics, nursing, and gerontology). Thematic content analysis was used to analyze the data. Findings Israeli and German experts identified the same social accelerators in the development and implementation of IAT in dementia care (i.e., changes in family structure and social digitization) and benefits of adopting IAT (e.g., enhancing the safety of people with dementia and increasing their independence). However, there were differences in inhibitor/risk assessments between the two groups. Namely, economic considerations and the cognitive capacity of people with dementia were identified by both groups as inhibitors, while Israeli experts additionally reported stigma and ageism. Whereas both groups agreed that IAT might reduce human connection, and that the technology is not yet reliable enough, German experts highlighted concerns regarding privacy; in contrast, Israeli experts prioritized safety over privacy. Conclusions Our research findings allow for the identification of relevant similarities but also important differences between German and Israeli experts’ perspectives. As such, an important basis has been provided for a more in-depth discussion regarding where, why, and how culturally-sensitive technology development is needed. (shrink)

Background Advances in artificial intelligence, robotics and wearable computing are creating novel technological opportunities for mitigating the global burden of population ageing and improving the quality of care for older adults with dementia and/or age-related disability. Intelligent assistive technology is the umbrella term defining this ever-evolving spectrum of intelligent applications for the older and disabled population. However, the implementation of IATs has been observed to be sub-optimal due to a number of barriers in the translation of novel applications (...) from the designing labs to the bedside. Furthermore, since these technologies are designed to be used by vulnerable individuals with age- and multi-morbidity-related frailty and cognitive disability, they are perceived to raise important ethical challenges, especially when they involve machine intelligence, collect sensitive data or operate in close proximity to the human body. Thus, the goal of this paper is to explore and assess the ethical issues that professional stakeholders perceive in the development and use of IATs in elderly and dementia care. Methods We conducted a multi-site study involving semi-structured qualitative interviews with researchers and health professionals. We analyzed the interview data using a descriptive thematic analysis to inductively explore relevant ethical challenges. Results Our findings indicate that professional stakeholders find issues of patient autonomy and informed consent, quality of data management, distributive justice and human contact as ethical priorities. Divergences emerged in relation to how these ethical issues are interpreted, how conflicts between different ethical principles are resolved and what solutions should be implemented to overcome current challenges. Conclusions Our findings indicate a general agreement among professional stakeholders on the ethical promises and challenges raised by the use of IATs among older and disabled users. Yet, notable divergences persist regarding how these ethical challenges can be overcome and what strategies should be implemented for the safe and effective implementation of IATs. These findings provide technology developers with useful information about unmet ethical needs. Study results may guide policy makers with firsthand information from relevant stakeholders about possible solutions for ethically-aligned technology governance. (shrink)

Disability activists have sometimes claimed their disability has actually increased their well-being. Some even say they would reject a cure to keep these gains. Yet, these same activists often simultaneously propose improvements to the quality and accessibility of assistive technology. However, for any argument favoring assistive over curative technology to work, there must be a coherent distinction between the two. This line is already vague and will become even less clear with the emergence of novel technologies. (...) This paper asks and tries to answer the question: what is it about the paradigmatic examples of curative and assistive technologies that make them paradigmatic and how can these defining features help us clarify the hard cases? This analysis will begin with an argument that, while the common views of this distinction adequately explain the paradigmatic cases, they fail to accurately pick out the relevant features of those technologies that make them paradigmatic and to provide adequate guidance for parsing the hard cases. Instead, it will be claimed that these categories of curative or assistive technologies are defined by the role the technologies play in establishing a person’s relational narrative identity as a member of one of two social groups: disabled people or non-disabled people. (shrink)

This paper examines the ethics of using assistive technology such as video surveillance in the homes of people living with dementia. Ideation and concept elaboration around the introduction of a camera-based surveillance service in the homes of people with dementia, typically living alone, is explored. The paper reviews relevant literature on surveillance of people living with dementia, and summarises the findings from ideation and concept elaboration workshops, designed to capture the views of those involved in the care of (...) people living with dementia at home. The research question relates to the ethical considerations of using assistive technologies that include video surveillance in the homes of people living with dementia, and the implications for a person living with dementia whenever video surveillance is used in their home and access to the camera is given to the person’s family. The review of related work indicated that such video surveillance may result in loss of autonomy or freedom for the person with dementia. The workshops reflected the findings from the related work, and revealed useful information to inform the service design, in particular in fine-tuning the service to find the best relationship between privacy and usefulness. Those who took part in the workshops supported the concept of the use of camera in the homes of people living with dementia, with some significant caveats around privacy. The research carried out in this work is small in scale but points towards an acceptance by many caregivers of people living with dementia of surveillance technologies. This paper indicates that those who care for people living with dementia at home are willing to make use of camera technology and therefore the value of this work is to help shed light on the direction for future research. (shrink)

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed by a critical assessment of (...) some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

It is a common experience among care professionals that persons with dementia often say ‘no’ to conventional caring measures such as taking medication, eating or having a shower. This tendency to say ‘no’ may also concern the use of assistive technologies such as fall detectors, mobile safety alarms, Internet for social contact and robots. This paper provides practical recommendations for care professionals in home health care and social care about how to respond to such resistiveness towards assistive technologies. (...) Apart from the option of accepting the ‘no’, it discusses a number of methods for influencing persons with dementia in order to overcome the ‘no’. These methods range from various non-coercive measures—including nudging—to coercion. It is argued that while conventional caring measures like those mentioned are essential for survival, health or hygiene, assistive technologies are commonly merely potentially beneficial supplements. With this in mind, it is concluded that care professionals should be more restrictive in using methods of influence involving some degree of pressure regarding assistive technologies than regarding conventional caring measures. (shrink)

Technology advancement provide more effective and efficient ways for the people to perform individual and or collective roles and execution of responsibilities, and this has also resulted to tenacious upsurge in peoples' dependence on technology. As the right for people with disabilities increases, the need to cater for their educational right like every other learner brought about the quest to provide for AT that can best serve those special students. Application of AT can help students with one or (...) more deficiencies, aid information collection process and increase learning motivation. The aim of this study is to conduct content analysis of studies on AT in education and the research sample consist of research publications on AT in education published on Scopus between 2018-2022. Content analysis was conducted on the research publications related to the research and the data gotten were evaluated through descriptive statistical methods with the intention that research findings will add to the body of literature and create more quest for research interest on AT in education. The findings indicated that, more studies were conducted in the year 2021 compared to others, qualitative research method was applied more in those studies, followed by quantitative and mixed methods, the larger percentage of the studies under review were conducted under special education, and the greater part of co-authorship were local collaboration. (shrink)

This special issue explores the evolving role of assistive technology in health and medicine, with 3 original articles and 5 commentaries. The following introduction provides an overview of the issue’s unifying themes and the articles’ aims and concerns, as well as reflection on some critical points for discussion raised in the commentaries. Assistive technology finds itself at a pivotal point of development and integration into current systems, where sound and innovative ethical guidance is crucial. With this (...) issue we hope to build capacity for realizing the potential of assistive technology—effectively, sustainably, and ethically. (shrink)

AgeTech involves the use of emerging technologies to support the health, well-being and independent living of older adults. In this paper we focus on how AgeTech based on artificial intelligence (AI) may better support older adults to remain in their own living environment for longer, provide social connectedness, support wellbeing and mental health, and enable social participation. In order to assess and better understand the positive as well as negative outcomes of AI-based AgeTech, a critical analysis of ethical design, digital (...) equity, and policy pathways is required. A crucial question is how AI-based AgeTech may drive practical, equitable, and inclusive multilevel solutions to support healthy, active ageing. In our paper, we aim to show that a focus on equity is key for AI-based AgeTech if it is to realize its full potential. We propose that equity should not just be an extra benefit or minimum requirement, but the explicit aim of designing AI-based health tech. This means that social determinants that affect the use of or access to these technologies have to be addressed. We will explore how complexity management as a crucial element of AI-based AgeTech may potentially create and exacerbate social inequities by marginalising or ignoring social determinants. We identify bias, standardization, and access as main ethical issues in this context and subsequently, make recommendations as to how inequities that stem form AI-based AgeTech can be addressed. (shrink)

This article discusses how technological official aids influence sporting competitions in terms of fairness and flow. It addresses the main arguments against technological official aids used to assist refereeing in binary referee situations. First, I argue that the criticism directed at the use of ball tracking devices (‘reconstructed track devices’) is mainly unjustified and that these devices provide the opportunity to make refereeing in certain types of sport fairer. In this regard, I also argue that empirical findings about referees’ decision-making (...) and potential biases must be considered when deciding how technological official aids influence the fairness of sporting competitions. Then I attempt to refute the argument that no situations are more decisive than others in sports with no fixed breaks, such as football. Finally, I scrutinise the argument that human fallibility in refereeing is somehow valuable in itself. Consequently, this article concludes that there are no convincing arguments against the use of technological official aids in binary referee situations. (shrink)

Persons with aphasia suffer from a loss of communication ability as a consequence of a brain injury. A small strand of research indicates effec- tiveness of dialogic interventions for communication development for persons with aphasia, but a vast amount of research studies shows its effectiveness for other target groups. In this paper, we describe the main parts of the hitherto technological development of an application named Dialogica that is (i) aimed at facilitating increased communicative participation in dialogic settings for persons (...) with aphasia and other communication disorders, (ii) based on comput- er game technology as well as on theory in dialogic education and argumenta- tion theory, and (iii) designed for mobile devices with larger screens. (shrink)

A large body of literature considers the ethico-legal and regulatory issues surrounding assisted conception. Surrogacy, however, within this body of literature is an odd-fit. It involves a unique demand of another person—a form of reproductive labour—that many other aspects of assisted conception, such as gamete donation do not involve. Surrogacy is a form of assisted gestation. The potential alternatives for individuals who want a genetically related child but who do not have the capacity to gestate are ever increasing: with the (...) advent of uterus transplantation, and the anticipated development of artificial placentas.In this paper, I highlight the pertinent conceptual differences between technologies assisting conception and those assisting gestation to demonstrate that distinct issues arise when assisted gestative technologies are used. I argue that there is utility in considering AGTs as a genus of technologies. These technologies perform the same function from the perspective of putative parents and might exist on a spectrum of alternatives when they become more available. Moreover, since many of the same or very similar ethical, social and legal issues are raised by surrogacy, UTx and ectogestation, analysis of these issues will be better contextualised by considering these technologies together. Many of the matters currently being highlighted for reform in the context of surrogacy will inevitably impact on how other forms of assisted gestation are governed. The conversation should be broadened; we should consider how far other emerging technologies might be accommodated in revised regulatory schemes. (shrink)

This study investigated Chinese university students’ technology-assisted self-regulated learning strategies and whether the technology-based SRL strategies mediated the associations between English language self-efficacy, English enjoyment, and learning outcomes. Data were collected from 525 undergraduate students in mainland China through three self-report questionnaires and the performance on an English language proficiency test. While students reported an overall moderate level of SRL strategies, they reported a high level of technology-based vocabulary learning strategies. A statistically significant positive relationship was noted (...) between the use of technology-based SRL strategies and students’ English learning outcomes. English language self-efficacy and English language enjoyment were both related to technology-based SRL strategies. Furthermore, SRL strategies fully mediated the relationship between English enjoyment and English learning outcomes, but the association between English enjoyment and SRL strategies was only partially mediated by English language self-efficacy. Pedagogically, findings of this study suggest that training and instruction aimed at promotion of modern educational technology among students need to give attention to developing their strategic awareness of motivation regulation in optimizing effectiveness of their technology use in learning the target language. (shrink)

We live in an era when increasing numbers of babies are conceived through assisted reproduction technologies (ART). Using a comprehensive approach, the present research seeks to contribute to the understanding of gender differences in experiencing and coping with infertility, and in dealing with ART treatment. Our sample consisted of 10 heterosexual couples aged 24 to 43 and the data were collected through semi-structured interviews. In the studied sample, gender differences existed not only in experiences of infertility, but also in understanding (...) it, and in dealing with ART treatment. Responses to stress caused by infertility were stronger in women and they also perceived this stress more intensely than men. For women the central aspect of infertility was the desire for a child, while for men it was perceived more as a socially imposed obligation to fulfill the male role. (shrink)

Socially Assistive Robots are increasingly conceived as applicable tools to be used in aged care. However, the use carries many negative and positive connotations. Negative connotations come forth out of romanticized views of care practices, disregarding their already established technological nature. Positive connotations are formulated out of techno-deterministic views on SAR use, presenting it as an inevitable and necessary next step in technological development to guarantee aged care. Ethical guidance of SAR use inspired by negative connotations tends to be (...) over-restrictive whereas positive connotations tend to provide over-permissive guidance. To avoid these extremes, we report on the development and content of 21 ethical orientations regarding SAR use in aged care. These orientations resulted from a multi-phased project, which consisted of empirical-ethical research focusing on older adults’ intuitions regarding SAR use and philosophical-ethical research focusing on philosophical-ethical argumentations regarding SAR use. This project led to the Socio-historical contextualization of the ethics of SAR use, in which the ethical impact of SAR use is localized on three interrelated analysis levels: societal, organizational, and individual-relational. The 21 novel orientations regarding SAR use are structured according to these levels and further categorized into foundational and applied orientations. The first category leads to critical reflection on SAR use while the latter category inspires decision-making processes regarding this use. While going beyond the care-romantic and techno-deterministic gaze of SAR use in aged care, the described orientations balance themselves between their over-restrictiveness and over-permissiveness. (shrink)

In an age of rapid advances inlife-prolonging treatment, patients and caregivers areincreasingly facing tensions in making end-of-lifedecisions. An examination of the history of healthcare in the United States reveals technological,economic, and medical factors that have contributed tothe problems of terminal care and consequently to themovement of assisted suicide. The movement has itsroots in at least two fundamental perceptions andexpectations. In the age of technological medicineenergized by the profit motive, dying comes at a highprice in suffering and in personal economic loss. (...) Thefailure to provide affordable resources for terminalcare is the result of the marketplace in health care. The medical profession has been painfully slow inresponding to the challenges of terminal care, mainlybecause of the pressures of the marketplace and lackof adequate training. This has occurred at a time ofrapid advances in life-sustaining treatment and ofexpanding public awareness of personal rights underthe law. Overly aggressive treatment in the finalstages of terminal illness has enhanced anxieties overa painfully prolonged and expensive dying. Thesefactors have promoted the movement to assistedsuicide. In the U.S. debate of the issues, ethiciststend to argue abstractly without examiningadequately the context of terminal care that is thehealth care system. It is a system in dire need of areform that will remove it from the marketplace. (shrink)

This article examines the construction of parenthood, drawing on Brazilian cisgender, heterosexual, and homosexual couples' experiences in using assisted reproduction technologies (ART), particularly the surrogacy. For that purpose, we interviewed: 1) a lesbian woman who had her daughter through her partner's pregnancy, using ART with anonymous donor semen; 2) a gay man who, together with his partner, used a surrogacy service under contract via a specialised offshore agency; 3) a woman who was a surrogate, in Brazil, for her sister-in-law and (...) brother who lived abroad and, from abroad, sent an embryo fertilised for surrogacy; 4) a woman who resorted to her sister-in-law in order to be a mother by surrogacy, with ovules from the woman herself fertilised with semen from her husband; and 5) the sister-in-law mentioned in 4), who acted as surrogate for her brother and his wife. These interviews made it possible to think about the discursive construction of the legitimacy of such parenthoods, as it is produced by access to, and manipulation and circulation of, reproductive technologies and persons. This biomedical management of bodies sets up a material and discursive circuit that, in turn, produces a complex web of personal, normative, legal, professional and market relationships, particularly with a view to construction of a parenthood anchored in a notion of biologically-constituted origin. In this respect, biological, affective and social bonds merge to produce a precise placement of who is the father and/or who is the mother, as well as who are the important others and how they are linked to the child in a broader web of parenthood. (shrink)

In Australia and other countries, certain groups of women have traditionally been denied access to assisted reproductive technologies . These typically are single heterosexual women, lesbians, poor women, and those whose ability to rear children is questioned, particularly women with certain disabilities or who are older. The arguments used to justify selection of women for ARTs are most often based on issues such as scarcity of resources, and absence of infertility , or on social concerns: that it “goes against nature”; (...) particular women might not make good mothers; unconventional families are not socially acceptable; or that children of older mothers might be orphaned at an early age. The social, medical, legal, and ethical reasoning that has traditionally promoted this lack of equity in access to ARTs, and whether the criteria used for client deselection are ethically appropriate in any particular case, are explored by this review. In addition, the issues of distribution and just “gatekeeping” practices associated with these sensitive medical services are examined. (shrink)

Innovation is a key driver of care provision in assisted reproductive technologies (ART). ART providers offer a range of add‐on interventions, aiming to augment standard in vitro fertilization protocols and improve the chances of a live birth. Particularly in the context of commercial provision, an ever‐increasing array of add‐ons are marketed to ART patients, even when evidence to support them is equivocal. A defining feature of ART is hope—hope that a cycle will lead to a baby or that another test (...) or intervention will make a difference. Yet such hope also leaves ART patients vulnerable in a variety of ways. This article argues that previous attempts to safeguard ART patients have neglected how the use of add‐ons in commercial ART can exploit patients’ hopes. Commercial providers of ART should provide add‐ons only free of charge, under a suitable research protocol. (shrink)

In the paper Assisted Gestative Technologies, Elizabeth Chloe Romanis advocates for the creation of a new category, which includes technological interventions that allow ‘persons who want to reproduce, potentially using their own genetic material, but are unable, or potentially unwilling, to undertake gestation’.1 Romanis conceptualises these technologies as a unified kind, a ‘genus’, and argues that they ‘collectively raise distinct ethical, legal and social issues from those related to assisted conception’.1 As I understand Romanis’ paper, her aims are twofold. The (...) first is conceptual: Romanis construes assisted gestative technologies as a separate kind with shared attributes and purposes, which differ from those of technologies that enable conception. The second is normative: Romanis champions the distinction between AGTs and other technologies as a useful way to tease apart relevant ‘ethical, legal and social issues’ that specifically concern AGTs. The reason for this, according to Romanis, is that gestation is ‘such a unique and demanding form of labour’.1 I agree with Romanis: gestation is indeed a unique and demanding form of labour, one with associated biological, cultural and political specificities with distinctive moral significance. It is for this very same reason that I believe that AGTs should not conceptually be considered as a unified category and should not be morally appraised as such, for relevant political and moral aspects of these technologies would be overlooked in the process. To clarify: Romanis’ use of genealogy to aid normative inquiry is a worthy endeavour. And I concur with the very convincing case she makes for the distinction between conception and gestation. My disagreement with Romanis rather concerns the conceptualisation of technologies such as gestational surrogacy, uterine transplantation and artificial placentas as a unified category, and the normative inquiry grounded in …. (shrink)

The article critically examines the Assisted Reproductive Technology (Regulation) Act 2021, its development process spanning 15 years, and its potential shortcomings in addressing the needs of India’s 27 million infertile couples. By scrutinizing the recommendations presented in the Parliamentary Standing Committee on Health and Family Welfare’s 129th report, the critique argues that the Act may not effectively cater to the diverse reproductive rights of the population. The article claims that most of its suggestions are in opposition to redefining families (...) and accepting inclusive family structures other than heterosexual marriages. The study posits that the Act, with its inherent limitations, perpetuates the reinforcement of patriarchal family structures that medical science intends to disrupt. In order to foster inclusivity and comprehensibility, the article advocates for necessary amendments that align with the interest of the general populace. (shrink)

The impact of culture and religion on sexual and reproductive health and behavior has been a developing area of study in contemporary time. Therefore, it is crucial for people using reproductive procedures to understand the religious and theological perspectives on issues relating to reproductive health. This paper compares different perspectives of three Abrahamic faiths, i.e., Judaism, Christianity, and Islam on ARTs. Procreation, family formation, and childbirth within the context of marriage have all been advocated by these three major religions of (...) the world. Judaism permits the use of all assisted reproductive technologies when the oocyte and sperm come from the husband and wife, respectively. The different denominations of Christianity have diverse views on reproductive practices. Although the Vatican does not approve of assisted reproduction, Protestant, Anglican, and other religious groups are free to use it. ARTs are acceptable in Sunni Islam, although they can only be carried out if the couples are married. Shia Islam, however, permits third-party donations to married couples under specific restrictions. This comparison reveals that while the three major world religions utilize assisted reproduction in distinct ways, there are also many comparable aspects of each religion. (shrink)

Recent developments in Western bioethics and biomedicine have called for the need to be culture-sensitive in handling certain bioethical issues. As a result of this anthropological turn in bioethics and biomedicine, there are cultural differences in moral attitudes such as disclosure of terminal illnesses, reproductive technologies, stem cell research, prenatal screening, genetic screening, therapeutic cloning, organ transplant, brain death, physician assisted suicide and so on.This paper offers an examination of the socio-culturally framed ways of dealing with Western and African bioethics (...) particularly as it relates to assisted reproductive technology. It focuses on the ethical issues surrounding assisted reproductive technology from an African perspective making special reference to their religious beliefs by drawing on the Christian and Islamic culture. Effort is made to distinguish between Western and African approaches to assisted reproduction stressing the fact of cultural diversity in issues relating to these reproductive techniques. It argues for the need to take social and cultural meanings embedded in various bioethical issues into consideration in arriving at different conclusions about issues in assisted reproduction in order to give room for adequate understanding.The paper concludes by emphasizing the need to acknowledge cultural diversity in bioethics giving reasons why this diversity is crucial and suggesting ways of handling this diversity. (shrink)

When things go wrong with assisted reproduction we should look at what’s best for everyone in the particular circumstancesA RTBs, as we must now call them, are becoming more and more frequent. In the recent United Kingdom case Mr and Mrs A, a “white” couple, gave birth to twins described as “black”. The mix up apparently occurred because a Mr and Mrs B, a “black” couple, were being treated in the same clinic and Mrs A’s eggs were fertilised with Mr (...) B’s sperm. Mr and Mrs A love the twins and wish to keep them and the facts seem to be that Mrs A is the genetic mother of the twins but her partner is not the genetic father. Under English law, in assisted reproduction, the woman who gives birth to the child is the legal mother and this is true also in cases of surrogacy. I think there is no doubt in this case that English law has taken the right path and that it would be unconscionable to contemplate taking a child away from the woman who had undergone the risks and pains of pregnancy and childbirth and the bonding process that goes along with that when she wishes to keep the child particularly when there is no substantial and pressing evidence that she would be an unsafe parent. I argued this in my book The Value of Life4 and I think it is still true. So in this case justice, morality, and decency are served by confirming Mr and Mrs A as the parents of the children. Since in English law there is some ambiguity over paternity and how that is to be assigned and since Mr A is apparently not the genetic father, I think it is important …. (shrink)