Electronic tracking devices in dementia care: A systematic review of argument-based ethics literature |
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| Institution: | 1. Centre for Biomedical Ethics and Law, KU Leuven, Kapucijnenvoer 35 Box 7001, 3000 Leuven, Belgium;1. Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University;2. Department of Clinical Thanatology and Geriatric Behavioral Science, Graduate School of Human Sciences, Osaka University;3. Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology;4. Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University;5. Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University;6. Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan;1. Clinical Gerontology Department, CHU Bordeaux, 33000, Bordeaux, France;2. Department of Dentistry and Oral Health, CHU of Bordeaux, Bordeaux, France;3. Department of Oral Public Health, UFR of Odontology, Bordeaux University, Bordeaux, France;4. Handicap, Activité, Cognition, Santé, U1219 Bordeaux, Population, Health, INSERM, Bordeaux, France;6. CRMSB, UMR 5536, CNRS/Bordeaux University, Bordeaux, France;1. Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea;2. Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK;3. Clinical Research Management Team, Ilsan hospital, National Health Insurance Service, Goyang-shi, South Korea;4. Department of Neurology, Dementia Center, Ilsan hospital, National Health Insurance Service, Goyang-shi, South Korea;1. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia;2. Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia;3. School of Public Health and Community Medicine, Medicine, UNSW, Sydney, NSW, Australia;4. Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia;5. Centre for Healthy Brain Ageing, School of Psychiatry, Medicine, University of New South Wales, Sydney, Australia;1. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany;2. Faculty II – Institute of Psychology, Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany;3. Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany;4. Institute of General Practice, Medical Faculty, Kiel University, Christian-Albrechts-Platz 4, 24118 Kiel, Germany;5. Institute of General Practice, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany;6. Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Theodor Kutzer-Ufer 1 – 3, 68167 Mannheim, Germany;7. Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany;8. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Ritterstraße 26, 04109 Leipzig, Germany;9. Department of Psychiatry, Technical University of Munich, Arcisstraße 21, 80333 Munich, Germany;10. Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany;11. German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127 Bonn, Germany;1. Removable Prosthodontics, Nihon University Graduate School of Dentistry at Matsudo, Chiba, Japan;2. Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan;3. The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan;4. Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba, Japan;5. Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan;6. Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan |
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| Abstract: | Background: Wandering is a behavioral symptom of dementia that often results in patients eloping from home or care facilities, leading to high-risk situations for injury or death. To mitigate this serious problem, caregivers use electronic tracking devices (ETDs) to manage wandering. As these devices can track, record, and monitor wearers, profound ethical questions are raised related to their use in this vulnerable population. The objective of this review was to identify the ethical frames, concepts, and arguments used in the normative literature that focused on ETDs in dementia care.Methods: We conducted a systematic literature review of normative literature that focused on ETDs in dementia care.Results: Twenty-two articles met the inclusion requirements. The majority of articles utilized a principlist approach, with arguments concerning ETDs largely falling under the four principles of biomedical ethics: respect for autonomy, non-maleficence, beneficence, and justice. Privacy and informed consent were specifically emphasized. The normative literature recognizes that ETDs may have a dual effect, potentially bolstering or eroding the values connected to each principle.Conclusions: The prevailing use of principlism in the normative literature on ETDs indicates that there is a need to pursue new ethical approaches and expand upon the few non-principlist approaches already in use. In addition, many of the ethical issues around ETD use involve value-laden questions present during their design. Therefore, future ethical orientations or frameworks should account for ethical questions that exist along the design continuum on the use of ETDs. |
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