Wednesday, October 31, 2018

Care Robots

Guest Blogger

Paul Vincent Tongsy

For the Symposium on The Law And Policy Of AI, Robotics, and Telemedicine In Health Care.

            The use of Artificial Intelligence (AI) and care robotics are currently viewed as two separate branches of advancements in modern medicine. For now, AI and care robots are considered as advanced tools to augment the skills and intelligence of human professionals who provide most of the care. There will be a time in the not-so-distant future, when AI achieves general or superintelligence. Simultaneously, they will become more independent and mobile, while other specific medical devices/robots will become more miniaturized and advanced. In vivo, in vitro/prosthetics and other therapeutic robots will all likely become more advanced and prevalent.

Done right, AI will likely merge with robotics and these resulting care robots will have so much potential to enhance care. Envision the common use of robots as care providers throughout the human lifespan (e.g. nannies, companions/assistants, and other possibilities). This prospect is both exciting for some people, and terrifying for others. For better or worse, it is rather common for care robots to become ubiquitous at a rapid pace once they overcome the hurdles of reaching successful initial adoption.

In formal settings or institutions like hospitals, AI adoption is complicated and undertaken by a multi-disciplinary team. Outside of formal settings, AI adoption will be dependent on multiple variables. These variables may include but are not limited to: competition, government sponsorship or regulation, and an economy driven market. Once the shock value wears off and the care robots are found effective and safe, it is likely that the public will demand “the best, brightest and newest” care robot. Prohibitively expensive at first, care robot makers might still sell out and profit tremendously, much like the best smart phone or car companies of today.

Naturally, there already are or will be glaring issues before, during and after the “robot invasion”.  For healthcare in particular, these issues will include paramount concerns for patient safety and privacy. Reevaluating ethics for both humans (bioethics) and robots (roboethics) will also become crucial as more care robots are designed, produced and adopted. For these robots to be successful, a lot of care and caring will have to be taught to them by their human creators. These teachings will include what care looks like and how to provide it safely. The nursing profession and its theories of care can definitely be a valuable resource for care robot learning.

Nursing, as the most prevalent medical profession, should take a keen interest on this subject as technology advances and affects their practice in patient care delivery. There may be a genuine concern that robots will compete for every job, in every industry. There are arguments that the extent of robot advancement will make them better than their human counterparts at everything and every task bar none. They might even flip the script where humanity will have new robotic overlords or “we [are so] dead” 1. Thankfully, this particular case would be implausible if humanity is careful when creating AI. From robot design to actual adoption, explainable/open AI, safety protocols and proper regulations are all important in preventing the worse case scenarios from coming to pass.  The AI Asilomar Principles are a set of guidelines or declarations for research, ethics and values, which has gained thousands of signatories to date 2. They may be too aspirational or idealistic for some people, but they are definitely worth the attention and good faith effort of those individuals, organizations and governments involved in the design and creation of AI.

AI and care robots should neither be viewed solely through optimistic eyes, nor pessimistic ones… but rather, very pragmatic ones. More than ever, practical considerations should outweigh the theoretical, and sensibility should override sensationalism. It helps to keep a rational outlook and a sense of humor, even as new, potentially unexpected issues arise. The answer to new philosophical questions will be of value to every major profession including nursing, medicine and law. Once we teach a robot to care for people, will it be genuinely empathetic or will it merely echo what appears like empathy as a result of its design?  Will that matter if the effect on human care remains the same? Will there be a massive deterioration in human contact, care and compassion?

There are no ready answers and personal predictions are never perfect. However, it seems as though there will be an enduring demand for human professionals for a while longer in certain professions or occupations. Registered nursing in particular is safer than others when jobs are outsourced to robots 3. There is an overall graying population, the retirement of the baby boomer generation, and the difficulty of outsourcing the highly regulated, technical and complex skills of immediate bedside nurses to care robots. It is likely that highly developed care robots may become patient care assistants in charge of basic tasks and patients’ activities of daily living. Then, in cases of severe human professional shortages in healthcare, the care robots may serve as a nurse assistant. This may only be done under the close supervision of human nurses or as a stopgap measure. Not everyone will be comfortable with this possibility. No one should delegate the sole administration of IV medications or narcotics to a robot anytime soon, especially if there are better alternatives. It is a possibility nonetheless in cases of emergency, disaster or other rare and unusual situations.

In some industries, there may be fewer jobs for humans if AI/robots become too prevalent. Some professional jobs may also move overseas. However, the “lived” human experience and the genuine empathy of human professionals will both remain valuable assets to professionals in nursing, medicine, law and many other professions. As for their responsibilities, it is likely that the basic and time consuming tasks or skillsets will be delegated to AI/robots. Afterwards, complex tasks will be performed by humans and machines together. AI/robots will continue to augment human abilities or humans will continue to supervise the AI/robot’s performance of its tasks. Finally, there are some licensed tasks, professions or occupations that will likely remain mostly monopolized by human beings on purpose.

Care robots may all end up with “non-threatening designs” ala Baymax of Disney’s Big Hero 6 4.  However, the more miraculous advancement would be a robot that can reach the level of care, caring and empathy of humans. Creating such a robot will be very difficult, to say the least. Then in the unlikely event that robotic emotional intelligence also reaches the level of humans and/or the robot is no longer a mere tool but an exceptional human creation, care robots should be granted protection and legal personhood. An AI that is capable of genuine love would likely qualify, just as “David” does in the film, AI: Artificial Intelligence by Steven Spielberg 5. In real life, there are already decades’ worth of resources and arguments regarding any subject or issue in AI, be they from the internet, current events, technological advancement, film/fiction, academic literature, and expert or entrepreneur opinion. Some predictions are so influential, they may ultimately become self-fulfilling prophecies.

This nurse in particular, cautiously predicts a reasonably safe future for humanity using well-designed and carefully created care robots, resulting in one small step at a time for care robots, one giant leap overall for humanity.

Paul Vincent Tongsy, BSN, RN, CCRN, PHN, is a Masters in Legal Studies Student at Loyola Law School Los Angeles. You can reach him by e-mail at ptongsy at


Online Articles
1 Catherine Clifford, 9 of the most jaw-dropping things Elon Musk said about robots and AI in 2017, CNBC, Dec. 18, 2017,
2 Future of Life Institute, Asilomar AI Principles, 2017,

3 Sue Chang, This chart spells out in black and white just how many jobs will be lost to robots, MarketWatch, Sep. 02, 2017,


4 Big Hero 6 (DisneyWorks, 2014)

5 A.I. Artificial Intelligence (Amblin / Stanley Kubrick, 2001).

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