SURVEILLANCE FOR INDEPENDENCE: DISCURSIVE FRAMEWORKS IN SMART CARE FOR DEMENTIA

Abstract

Smart technologies promise a future in which the care needed by vulnerable people can be delivered at a distance, informed by Internet of Things-enabled remote sensing and by artificial intelligence used to identify problematic patterns in physiological readings and behavioural data. In this context, surveillance is widely portrayed as a means to maintain the independence of those being monitored. This paper examines the promise of smart care through analysis of documentation from policy, from research and development settings and from marketing materials aimed at carers, people living with dementia and social care agencies in the UK. For informal carers, the monitoring carried out by smart care systems is predominantly framed as reassurance for the carer, while for the person living with dementia a reassurance is offered that there will be help at times of need. For healthcare professionals, lack of knowledge is positioned as a limiting factor on providing optimal care and hence the monitoring offered by smart care becomes an ethical responsibility in the search for improved care as well as a means to increased efficiency. While smart care aims to promote independence, this form of surveillance and the AI-generated predictions that are built upon it can offer imperatives to action that may act against autonomy. To evaluate ethical implications more fully we need to move beyond the promotional discourse to find out more about how people live with such systems and how these systems become a part of the relations of expertise and responsibility that pervade care.