Exploration on the challenges and ethical countermeasures of artificial intelligence intervening in the care decision-making of older adults with disabilities
10.12026/j.issn.1001-8565.2026.05.14
- VernacularTitle:人工智能介入失能老人照护决策的挑战与伦理对策探析
- Author:
Runying WANG
1
;
Yiyao ZHANG
1
;
Huan DU
1
;
Yingchun PENG
1
Author Information
1. School of Medical Humanities， Capital Medical University， Beijing 100069， China
- Publication Type:Journal Article
- Keywords:
older adults with disabilities artificial intelligence;
care decision-making;
ethical countermeasure
- From:
Chinese Medical Ethics
2026;39(5):656-662
- CountryChina
- Language:Chinese
-
Abstract:
Artificial intelligence （AI） is gradually being applied in the field of decision-making support for the daily care of the older adults with disabilities. However， due to their limited cognitive functions， information asymmetry with medical staff and technical parties， and a certain degree of emotional deprivation， the older adults with disabilities are in a structurally vulnerable position. Against this background， several ethical dilemmas arise when AI technology intervenes in care decision-making. First， the informed consent process is difficult to genuinely implement. Second， algorithms based on average models tend to ignore individual differences， leading to “de-personalization” of services. Third， over-reliance on technology may further weaken humanistic care， thereby undermining the individual dignity of the older adults with disabilities. Fourth， in the care decision-making involving the joint participation of the older adults with disabilities， caregivers， medical teams， and AI systems， the boundaries of responsibility among all parties remain unclear， making it difficult to assign accountability when adverse outcomes occur. Drawing on the theories of vulnerability ethics， interactive ethics， and care ethics， this paper proposes a “vulnerability-interaction-care” path and put forward three-tiered countermeasures. The first was baseline safeguards， preventing the exploitation of the vulnerability of the older adults with disabilities and their caregivers， and requiring further safeguards for their dignity. The second was process protection， enhancing transparency and accountability within the human-machine collaboration framework， as well as establishing a multi-party consultation mechanism. The third was capacity empowerment， improving the subjectivity of the older adults with disabilities through age-appropriate interaction， structured expression of intentions， and caregiver participation.
