Wearable Technologies and Stress: Toward an Ethically Grounded Approach

Int J Environ Res Public Health. 2023 Sep 11;20(18):6737. doi: 10.3390/ijerph20186737.

Abstract

The widespread use of digital technologies that can be worn on our bodies-wearables-is presented as a turning point for various areas of biomedical research and healthcare, such as stress. The ability to constantly measure these parameters, the perceived quality of measurement, and their individual and personal level frame wearable technology as a possibly crucial step in the direction of a more accurate and objective definition and measurement of stress for clinical, research, and personal purposes. In this paper, we discuss the hypothesis that the use of wearables for stress is also beneficial from an ethical viewpoint. We start by situating wearables in the context of existing methods and limitations of stress research. On this basis, we discuss the ethics of wearables for stress by applying ethical principles from bioethics (beneficence, non-maleficence, autonomy, justice), which allows us to identify ethical benefits as well as challenges in this context. As a result, we develop a more balanced view of the ethics of wearables for stress, which we use to present recommendations and indications with a focus on certification, accessibility, and inclusion. This article is, thus, a contribution towards ethically grounded wearable and digital health technology for stress.

Keywords: digital health; ethics; philosophy of technology; stress; wearables.

Grants and funding

The work of S.C. was supported by the Fondazione Silvio Tronchetti Provera (Project: Etica e tecnologie emergenti), Regione Lombardia (Project: BASE5G, ID 1155850) and the PNRR-PE-AI FAIR project funded by the NextGeneration EU program. The work of A.A. was funded by the National Plan for NRRP Complementary Investments (PNC, established with the decree-law 6 May 2021, n. 59, converted by law n. 101 of 2021) in the call for the funding of research initiatives for technologies and innovative trajectories in the health and care sectors (Directorial Decree n. 931 of 6 June 2022)—project n. PNC0000003—AdvaNced Technologies for Human-centrEd Medicine (project acronym: ANTHEM). This work reflects only the authors’ views and opinions, neither the Ministry for University and Research nor the European Commission can be considered responsible for them.