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Cited by 130Technology Use by Older AdultsTelemedicine and Telehealth ImplementationGeriatric Care and Nursing Homes

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

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Mort, Maggie, Roberts, Celia, Pols, Jeannette, Domenech, Miquel, Moser, Ingunn, The EFORTT investigators·2015·Health Expectations
DOI 10.1111/hex.12109PMC PMC5060789
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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).

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Authors
Mort, M., Roberts, C., Pols, J., Domenech, M., Moser, I., & The EFORTT investigators
Affiliations
  • Lancaster University (GB)
  • Amsterdam UMC Location University of Amsterdam (NL)
  • Department of Social Psychology Autonomous University of Barcelona Barcelona Spain
  • Diakonhjemmet School of Nursing Oslo Norway
Corresponding author
Mort, Maggie
ORCID
Venue
Health Expectations
Publisher
Wiley
Published
2013-08-06
Volume
18
Issue
3
Pages
438-449
ISSN
  • 1369-6513 (ISSN-L)
  • 1369-7625
DOI
10.1111/hex.12109
PMC
PMC5060789
OpenAlex
W2038600435
Cited by
130
References
26
Citations by year
2026: 5 · 2025: 26 · 2024: 7 · 2023: 6 · 2022: 16 · 2021: 6 · 2020: 13 · 2019: 6 · 2018: 9 · 2017: 18 · 2016: 10 · 2015: 5 · 2014: 3
FWCI
16.35
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Health Expectations (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • UvA-DARE (University of Amsterdam) (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, public-domain)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, public-domain)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
Funders
  • European Commission (217787)
  • FP7 Science in Society
Topics
  • Social Sciences › Demography › Technology Use by Older Adults
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
Keywords
telehomecare, telemedicine, older adults, ethical frameworks, citizen panels, participatory design, self-care, dependency, care networks
MeSH terms
Aged, Health Services for the Aged, Home Care Services, Humans, Patient Participation, Telecommunications, Telemedicine

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