Ethical issues in assistive technology

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Ethical issues in assistive technology
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Outline

• Introduction and definitions
• Any conflicts between goals of therapists and
  engineers?
• Advantages and disadvantages of AT
• Some examples
• Use and abandonment of assistive technology
• Conclusions

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Definitions

• Occupational therapy
• helps people regain, develop, and build skills
  that are essential for independent functioning,
  health, and well-being.
• Rehabilitation engineering
• the application of science and technology to
  improving the quality of life of a persons with
  disabilities.

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More definitions

• Assistive technology
• products, devices or equipment that are used to
  maintain, increase or improve the functional
  capabilities of individuals with disabilities
  (1998 Tech Act)

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Any conflicts?

• OTs, (and PTs, SLPs, etc.) and Rehab Engineers
  have similar goals
• Each uses different techniques to achieve those
  goals
• Therapists work directly with clients to help
  them develop skills needed for independent living
• Engineers work with clients, too, but they design
  and build things to help the client

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The potential conflict

• Engineers (and others) can get carried away with
  what we can accomplish with technology
• Sometimes, technology isnt the most appropriate
  solution

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Advantages and disadvantages of an AT device

• Advantages
• It can always be there
• It can be powerful
• Disadvantages
• It may not always work as intended in every
  possible situation
• It doesnt grow with the client
• It may break
• It may encourage the consumer to rely on
  (imperfect) technology instead of developing
  their own skills

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Some examples follow

• To build or not to build
• Are there alternatives to AT
• When are the alternatives appropriate?
• When is the AT appropriate?

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Prosthetics

• Prosthetics can provide functionality for a lost
  limb
• However, it is imperfect technology
• Are there alternatives?
• Yes, children, in particular, can learn to
  compensate for a lost limb
• They may not realize they are missing anything
• When are the alternatives appropriate?
• When is a prosthetic device appropriate?

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Cochlearimplants

• The cochlear implant technology is still
  relatively new
• The cochlea (inner ear) is very complex
• Cochlear implants do not nearly match the
  performance of the human cochlea
• Are there alternatives?
• Yes, children and adults can learn to communicate
  using sign language
• When are the alternatives appropriate?
• When is a cochlear implant appropriate?

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ClimbingWheelchair

• Wheelchairs have been developed that can climb
  stairs
• With this wheelchair, people with disabilities
  can access more places
• But will this work on any type of stairs? And
  what if it malfunctions?
• Are there alternatives?
• modify the environment instead
• When are the alternatives appropriate?
• When is a climbing wheelchair appropriate?

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Case studylaptop computer

• Jim has cerebral palsy with poor motor control
• A laptop computer was given to him in
  kindergarten because he had difficulty with
  handwriting
• His teachers and therapists assumed that he would
  eventually rely on a laptop for all his writing
• But, Jim wanted to be like everyone else and was
  motivated to write like everyone else
• His therapist worked with him on handwriting
  skills for the next four years
• By fourth grade, his handwriting was adequate for
  his age level

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Laptop computer, continued

• An individual who has poor motor control can use
  a laptop for writing
• Are there alternatives?
• Yes, work with an OT and PT on handwriting
• When are the alternatives adequate?
• When is it appropriate to use a laptop for
  writing?

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Use and abandonment of AT

• Studies show that up to 75 of AT devices are
  abandoned within 3 years
• This may be a positive thing
• Consumer no longer needs AT
• Consumer needs a more complex device
• However, it is often a negative thing

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Why abandon AT?

• Not well matched to individual
• Little or no training provided
• Families not accepting of technology
• Family members from varying cultures may have
  different perceptions of the need for technology
• Consumer or their family doesnt want to stand
  out by using the technology
• School or workplace not accepting of technology

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To be successful

• Insure that your device will help the client and
  their family achieve their goals
• Work as a team with client, family, therapists,
  teachers, supervisors, etc.
• Communication is crucial

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What does this mean?

• Should engineers continue research on cochlear
  implants, etc?
• What is the role of the engineer and the
  clinician in discussions of new technologies for
  clinical use?
• Be careful many clinicians are fascinated by
  technology, just like engineers

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References

• 1 Assistive Technology Training Online Project
  (ATTO). http//atto.buffalo.edu/
• 2 Michigans assistive technology resource.
  http//www.matr.org/
• 3 Family-Centered Decision Making in Assistive
  Technology
• http//jset.unlv.edu/15.1/parette/first.html

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The end

• The benefits of technology are as extensive as
  the abilities and goals of the students using
  them. However, professionals and parents should
  exercise certain cautions. Technology must not
  been seen as a panacea. 1