[Ethical implications in the development of functional training in mixed and augmented reality environments to treat hypertension in old age: A qualitative content analysis]

Abstract

Background: E-Health is of increasing importance in ensuring demand-oriented health care. In addition to technical feasibility, issues concerning the normative requirements for their use are growing. This paper discusses the ethical, legal and social implications of the use of mixed reality (MR) and augmented reality (AR) technologies in the therapy of elderly people with hypertension. It is based on the results of a study conducted as a part of the BMBF project BewARe.

Methods: In the context of the above-mentioned background, an expert workshop was held with various stakeholders in an early phase of the BewARe project in accordance with the MEESTAR model, in which ethical, social and legal requirements for the development and use of AR/MR technologies were anticipated. The results of the workshop were subsequently evaluated using content analysis.

Results: Content analysis identified eight main challenges for the development and use of AR/MR technologies in the therapy of elderly people with hypertension: ethical challenges for the decision-making and action capacity of older users (1), stereotyping (2), user-oriented development and implementation (3), data protection (4), support (5), health risks (6), social participation (7), and the need for an integrative approach (8).

Discussion: In line with other studies, it can be shown that orientation towards medical guidelines and behavioral principles is essential to promote acceptance and adherence among end users and to minimize potential health risks. In addition, end users should be more strongly involved in the development process to overcome existing user stereotypes and establish qualification strategies for health-promoting use. Finally, legal and health economic framework conditions must be created to ensure data security and sustainable application concepts.

Conclusion: For a successful diffusion of AR/MR applications in health care, a holistic implementation concept is required which must involve various groups of social actors. In this context, the article discusses eight main challenges that can be understood as current challenges in this process.

Keywords: ELSI; ELSIAR; Ethical challenges; Ethical requirements; Ethisch relevante Anforderungen; Ethische Herausforderungen; Exergame; MEESTAR.