LawStudy 7 | - Student
Oct 22, 2019 | #1
At present, Ubitools offers a wide variety of pervasive computing choices for the medical field, including the presence clock. While the presence clock has the ability to detect changes in routine in elderly persons and thus alert caregivers who are monitoring their movements, UbiTools is currently considering the development of an improved presence clock with additional applications that would monitor other aspects of the individual's life, such as whether or not there are clean towels, whether or not there is food in the refrigerator, how high (or low) the thermostat is set, and so forth. All data would be monitored via downloadable applications which could reside on the monitor's tablet computer (e.g. an iPad) and give notice when some aspect of the household is not according to set parameters. Given the potential inherent in this technology - the ability to monitor and protect not only elderly persons, but also physically and/or mentally disabled individuals as well as children - it makes sense for UbiTools to continue research and development into the improvement of the presence clock, as well as other ubiquitous computing technologies that can help safeguard the lives of millions of vulnerable individuals.
Opponents of such technologies launch the typical arguments against same: namely, that they take away self-determination for individuals; that they have the potential to be used by governments and corporations to monitor the lives of "ordinary" citizens who do not need such surveillance; that they introduce an aspect of "Big Brother" into a society that is presently struggling to maintain autonomy in the face of increased oversight. From such opposition springs UbiTools' conflict over whether or not to proceed in developing and marketing the improved presence clock (as well as other similar technologies in the future). This report will seek to convince the CEO that it is not only prudent, but necessary in a business sense, for UbiTools to continue to develop not only improvements in the presence clock, but also further types of ubiquitous computing technologies, as this is a trend that will not change. First, the report will detail some of the current (and potential) uses of ubiquitous computing in the health care fields. Next, it will present some of the opposing arguments against the use of such technology, followed by a discussion of ways corporations and individuals can build and implement such technologies to minimize the fear of negative applications of same. Next, thoughts concerning the general trade-off between privacy and security regarding pervasive technology will be presented, as will some of the benefits and limitations of ubiquitous computing. Finally, recommendations for developing and marketing the improved presence clocks will be offered. It is the hope of the author that the CEO of UbiTools will take this report into consideration before making any decisions regarding the presence clock.
Before engaging in a review of the current application of pervasive computing, it makes sense to note that the concept of "remote doctoring" is decades old. "Dowler and Hall considers TLM [telemedicine] being started as telediagnostics by psychiatrists as early as 1955 using interactive television" (Dowler & Hall, as cited in Rashvand, Salcedo, Sanchez, & Iliescu 2008, p. 238). However, the radio was used even earlier than that; in 1924, magazine covers heralding the arrival of the "Radio Doctor" were published (Rashvand, Salcedo, Sanchez, & Iliescu 2008). Thus, it is important to remember that computers merely improve and continue a tradition that began a long time ago. At present, Rashvand, Salcedo, Sanchez, and Iliescu down the current applications into four categories: Telecare Services; Continuous Care Support Service; Information Service to the Citizens; and Training and Provision of Information Services to Medical Staff.
Having said this, however, it is clear that ubiquitous computers are allowing a blossoming of medical-related technology. Given that, as well as the concurrence of aging populations, it stands to reason that there has been an influx of new ways to apply these technologies to health care for elderly people (Haux et al 2008). However, this confluence is not just an opportunity for growth; it is, in fact, becoming increasingly clear that "informatics support through health-enabling technologies leading to pervasive health care is one important option to be seriously considered" (Haux et al 2008, p. 79), since ubiquitous computing is becoming the norm, rather than the exception. Current applications include monitoring for emergencies, which can create alarms sent to caregivers; the management of disease (e.g. reminders to take insulin injections); and the ability to provide advice regarding general health care issues; potential applications include the ability to give often isolated elderly people social interaction, entertainment, education, and assistance with daily activities.
Stanley and Osgood (2011) note that sensor-based technologies can be used by an individual to monitor him/herself as well, keeping track of physiological functions, giving data regarding social networks, improving compliance with medical regimes by providing useful data, and so forth. Such sensor-based technology can also be tapped into by caregivers and health-care professionals, such that the collected data can be analyzed to determine everything from possible changes in medicine to whether or not an individual has fallen and is unable to get help. Kim et al (2008) take this a step further and explore a "stand-alone ubiquitous evolvable hardware (u-EHW) system" that consists of an embedded processor, a computer chip, and a hand-held terminal that essentially allows for a "mobile ECG" to be done, on a continuous basis, so that heart disease can be monitored all of the time, as opposed to only in periodic appointments when something could be missed. Beyond monitoring, wearable devices can not only keep track of particular medical conditions, but can also provide treatment.
The context-aware mobile communication system (CHIS) is another application of ubiquitous computing technology when applied in a health care context. It allows context-aware messages to be sent among hospital personnel, so that messages are not delivered unless certain conditions are met; it allows monitors to be set up that, when specific people pass by them, display information relevant to those particular people (e.g. when a nurse passes by, it might be set to display all of the information about her patients); and it can allow people to monitor their own privacy, in an interesting twist (meaning that people can set the device to divulge to others only certain information about, say, their location). While this device is being tested in hospitals at present, the application to a home setting is clear. For example, messages could be exchanged between caregivers and the people whom they are watching, or those being monitored might hide their location from their watchers when they use the bathroom.
These are just a few of the current health-care related applications of pervasive computing. While a comprehensive review is beyond the scope of this report, it does bear saying that one review of the literature, written in 2008, listed a full 67 different systems and devices currently on the market. Their review was not meant to be exhaustive, meaning that these were merely their own selections of devices that had been written about in previously published studies, indicating that the actual number of items on the market was, of course, much higher.
Arguments against the use of ubiquitous computer technology range from the practical to the more abstract. In terms of the latter, one of the largest concerns is that "technology is altering, or defiling, the sacredness of human life" (Winter 2008, p. 200). While one might consider this an argument of those who are too old, too obstinate, or too "religious" to be considered part of the mainstream, the fact is that many ethicists believe that the very definition of what it means to be human will necessarily change - and must be addressed - in the coming years, as pervasive computing surrounds us with more intensity and volume. What will it mean when we are literally surrounded by machines that are smarter than we are? What will it mean when humans no longer make decisions related to, for example, our own health care? These and other questions might seem ridiculous now, but when one imagines a world in which we are outnumbered by intelligent devices we ourselves have set in place, it is clear that a redefinition is far better done sooner than later; and the concern, of course, is that we will not get around to it until too late.
Opponents who argue against the use of ubiquitous computing see this future world as "sinister" (Pimple 2011, p. 29). They worry that when machines are created to think for themselves, those who created the machines will be exonerated if and when things go wrong, allowing them a sort of "moral passcode" for doing as they wish. They worry that the very nature of pervasive computing devices leads their users down the road to "coercion, surveillance, and control" (Shilton, as cited in Pimple 2011, p. 30), much as the very existence of nuclear weapons is concerning to those who believe that "absolute power corrupts absolutely." Moreover, they are concerned about issues such as consent, and cases in which an agreement to use ubiquitous computing devices, such as the presence clock, might appear to be consensual on the outside, but are not.
The primary way for ubiquitous computing devices and systems to be designed and implemented without the taint of coercion or undue control is deceptively simple: ensure that all parties involved consent to their use. However, it is also clear, from the arguments presented above, that this is easier said than done. What is consent to a 90-year-old woman who is terrified to say no to anything her son proposes because he's threatened to lock her up in a nursing home the minute she does? What is consent to a mentally capable, but physically incapacitated, teenager whose parents are sick of him and would rather lock him in a room with a monitor than interact with him?
One can create such scenarios almost ad infinitum. Having said that, it is also the case that one can also do so with any technology in the world. Sell a gun and the manufacturer might be responsible for a break-in where three people are murdered, or it might be responsible for saving the lives of soldiers in Iraq. Can the manufacturer be held liable for either action? Regulations differ from nation to nation, but that is indeed where to begin. Thus, those in the ubiquitous computing industry, like UbiTools, are well advised to be proactive when it comes to regulation. This will be addressed in more detail in the marketing section below, but this is indeed the first step in how to build such systems that are as free as possible from possible negative uses. The second step is to openly engage in direct dialogue with the public about all of the ramifications, good and bad, about pervasive computing devices and systems, and show how the good far outweighs the bad. For example, researchers concerned with "granny cams" and other surveillance devices that have been controversial in the past suggest that
in addition to a research mission statement, a data safety monitoring board comprised of research investigators, nursing home administration and staff, as well as cognitively intact residents, family members, and an ethicist, could be implemented by the LTC facility to regularly and proactively identify and remedy potential problems that arise during the course of a research project. (Bharucha et al 2006, p. 619)
Finally, safeguards can be built into the technology itself, such that, for example, unauthorized users who attempt to change or otherwise manipulate the devices cause them to shut down and alert those who are "monitoring the monitors" (e.g. police, health officials, etc.). Such safeguards can and should be made public knowledge so as to deter crime as opposed to providing a tool to solve it, much as the advertisement of alarm systems on fancy homes serves to deter those who would break into them.
In a small town, the cliché goes, a child can steal a candy bar from a store on one end of Main Street at 4 PM, and his mother will know about it ten minutes later, before he gets to his home on the other end of Main Street. This is because everyone knows everyone else; everyone is looking out for everyone else; and people feel a sense of responsibility toward each other to inform them of goings-on that concern them. Some might argue that in small towns, there is a loss of privacy because of this "snooping" mentality; such people are more comfortable in the anonymity of large cities where no one appears to care what they are doing. For those people, the devices and systems associated with pervasive computing are definitely not worthwhile; to them, privacy trumps security, and they would rather risk a stolen car than living with the knowledge that someone, somewhere, might well be watching to see who might be stealing their car.
And that is all well and good. Such technologies, as with all technologies, have the potential to be freely chosen, just as people will choose to live in a small town or a big city, depending upon their personal goals and inclinations. The word "potential" is used because, as discussed in the arguments against ubiquitous computing, it is certainly possible to misuse such technologies and turn them into instruments of terror (at worst) and benign, non-consensual surveillance (at best). That is true with every weapon, every tool, every technology, and always has been. It is important, however, that the mere raising of the issue of "privacy versus security" be met with the truth: such has always been the case, ever since humans decided to live with one another in tribes, small towns, civilizations of all kind, and it always will be. The challenge, of course, is to ensure that this balance works as well as it can for the benefit of the greatest numbers of people as possible. But to decide that such technologies are not worth pursuing because there is a chance that the free will of people will be over-ridden by them is to decide not to develop some of the most potentially positive life-changing tools to appear on the horizon in a very long time.
One of the clear benefits of ubiquitous computing, despite some of the arguments against it, is the fact that it blends into the background. Compare a sensor in a clock that otherwise appears normal with, say, an enormous machine designed to pick up and broadcast signals across a distance to a caregiver. The mere presence of that machine tells the individual all the time that s/he is vulnerable and being watched, whereas the clock looks like a clock; that is, the individual can forget about being monitored by her son or daughter and get on with his/her life. Back in 1991, Mark Weiser, the creator of the term "ubiquitous computing," had this to say: "The most profound technologies are those that disappear. They weave themselves into the fabric of everyday life until they are indistinguishable from it" (Weiser 1991, as cited in Hargraves 2007, p. 4). This profundity - this ability to blend into daily life until it is forgotten - is perhaps the greatest gift of such technology, as it acts as an assistant instead of a nagging reminder. Weiser further argues that it is only the fact that computers are newer technologies - as opposed to the written word, for example, which is ubiquitous without argument - that makes them feel "arcane" and thus set apart (1991, as cited in Hargraves 2007, p. 4). In other words, computers are still new, especially to elderly people, but they continue to feel less and less so, and once we, as a society, can make the jump to accepting their presence in our lives, they will feel as "regular" as the written word which surrounds us.
Once in place, ubiquitous computing has the opportunity to revolutionize what "independence" means, especially to those who are vulnerable and need a higher degree of care. Orwat, Graefe, and Faulwasser (2008) note that, "Some of its capabilities, such as remote, automated patient monitoring and diagnosis, may make pervasive computing a tool advancing the shift towards home care, and may enhance patient self-care and independent living" (p. 2). In other words, people who might otherwise be forced to remain in rehabilitation facilities, nursing homes, or other places of assisted living, might instead be able to return to their own homes because they will have the protection of ubiquitous tools surrounding them, monitoring them, keeping them safe.
The notion of ambient intelligence takes pervasive computing a step further and takes the field into a future previously only imagined in science fiction novels. Yet it is critical to remember that such steps are achievable within our lifetime, and those who take these steps stand to benefit greatly for having the courage to take them. Imagine an environment that is "aware of the user's context" which provides information to the user when s/he needs it, in the amount needed, no more, no less; an environment that provides said information in an effortless, simple, invisible fashion; and an environment that learns from, and adapts to, the user such that it can be of greater use in the future (RodrÃguez, Favelaa, Preciado & VizcaÃn 2005). Imagine, then, living in a place where not only your weight, blood pressure, heart rate, and other physiological markers are monitored, but where virtual reality allows you to wake up in a simulation of an ocean-side apartment, or visit a museum where a lighted pathway appears, just for you, guiding you to the paintings and exhibits you most want to see (Tucker 2006). This is the promise of ambient intelligence, the next generation of pervasive computing. Futurists predict we will live in an "AmI" world by 2020 (Tucker 2006); those who take steps now to be at the forefront of this technology only stand to benefit.
Clearly, we are still in 2011, and the world of 2020 - the world in which we all get to wake up by the sea - is far away. This is the primary limitation of ubiquitous computing: that ideas and uses run far ahead of existing technology, making it seem almost impossible to achieve the hoped-for ideal of perfect awareness and absolute protection. It is also the case that even when such devices and systems have been developed, not all people will have access to them. Technology is expensive when first developed, and while costs come down rapidly once sales volume increases, it still takes time; and even time isn't enough to overcome the poverty in many parts of the world. This, then, is a second limitation of pervasive computing: the reality that not everyone will be able to afford it, especially when so many of its health-care applications are clearly so beneficial. A final limitation is expressed in the old adage: "garbage in, garbage out." Such technology is only as good as those who create it, program it, and use it; and unfortunately, the world will always contain sub-par manufacturers, inventors, designers, and so forth.
In light of the previous discussion, it is strongly recommended that UbiTools proceed with developing the presence clock such that its applications can be broadened, and, ideally, such that the device can ultimately interface with other pervasive computing tools to be developed in the future. Moreover, it is strongly recommended that such development be granted full resources, without "skimping;" to do so would compromise the quality of the end results, and savings now will thus definitely mean shortcomings later.
Marketing the presence clock should begin with a public information "blitz," starting with focus groups and research studies that show that users themselves - that is, for now, elderly people, but in the future people with physical and mental disabilities - welcome the device as a way to improve their lives. As van Hoof, Kort, Rutten, & Duijnstee (2011) found in their study of 18 elderly people living in communities that help them with an intensive list of needs, users by and large find ubiquitous computing devices and systems increase their sense of health and safety in their own homes. When people hear such things "from the horse's mouth," as it were, they tend to give them far more weight than when "some company" tells them the same thing. Once underway, marketing should continue to focus upon education, enhancement, and enlightenment as the "Three Es" of this "new era" of safety, health, and happiness. As Pimple (2011) said, "[w]hen presented properly, the benefits of pervasive IT are obvious" (p. 30). UbiTools must ensure that pervasive computing devices and systems are always presented properly.
Conclusions
While it is beyond the scope of this report to present a full marketing campaign for the presence clock, rest assured that such a campaign could easily be created. The technology to create a world in which people are surrounded by pervasive computing devices and systems already exists. Ambient intelligence will pervade the environments of the future regardless of what anyone might wish to the contrary. Moreover, this technology is sound, and it is ethical, allowing us the means to protect and help far more people than ever before. Given all of these things, I urge UbiTools to become the name associated with this technology; if we don't, someone else surely will - and they will be the ones to reap both social and financial benefits from their efforts.
REFERENCES
Bharucha, AJ, London, AJ, Barnard, D, Wactler, H, Dew, MA, & Reynolds, CF, 2006, 'Ethical considerations in the conduct of electronic surveillance research', Journal of Law, Medicine and Ethics, vol. 34, no. 3, pp. 611-619.
Favela, J, Tentori, M, & Gonzalez, VM, 2010, 'Ecological validity and pervasiveness in the evaluation of ubiquitous computing technologies for health care', International Journal of Human- Computer Interaction, vol. 26, no. 5, pp. 414-444.
Hargraves, I, 2007, 'Ubicomp: fifteen years on', Knowledge, Technology, and Policy, vol. 20, pp. 3-10.
Haux, R, Howe, J, Marschollek, M, Plischke, M, & Wolf, KH, '2006, Health-enabling technologies for pervasive health care: on services and ICT architecture paradigms', Informatics for Health and Social Care, vol. 33, no. 2, pp. 77-89.
Kim, TS, Lee, H, Park, J, Lee, CH, Lee, YM, Choi, CS, Hwang, SG, Kim, D, & Min, CH, 2008, 'Ubiquitous evolvable hardware system for heart disease diagnosis applications', International Journal of Electronics, vol. 95, no. 7, pp. 637-651.
Orwat, C, Graefe, A, & Faulwasser, T, 2008, 'Toward pervasive computing in health care - a literature review', BMC Medical Infomatics and Decision Making, vol. 8, no. 26, pp. 118.
Pimple, KD 2011, 'Surrounded by machines: a chilling scenario portends a possible future', Communications of the ACM, vol. 54, no. 3, pp. 29-31.
Rashvand, HF, Salcedo, VT, Sanchez, EM, & Iliescu, D, 2008, 'Ubiquitous wireless telemedicine', IET Communications, vol. 2, no. 2, pp. 237-254.
Rodriguez, MD, Favela, J, Preciado, A, & Vizcaino, A, 2005, 'Agent-based ambient intelligence for healthcare', AI Communications, vol. 18, no. 3, pp. 201-216.
Scheffler, M, & Hirt, E, 2005, 'Wearable devices for telemedicine', Journal of Telemedicine and Telecare, vol. 11, suppl. 1, pp. S1-S14.
Stanley, KG & Osgood, ND, 2011, 'The potential of sensor-based monitoring as a tool for health care, health promotion, and research', Annals of Family Medicine, vol. 9, no. 4, pp. 296-298.
Tucker, P, 2006, 'At home with ambient intelligence', Futurist, vol. 40, no. 2, pp. 68, 66. van Hoof, J, Kort, HSM, Rutten, PGS, Duijnstee, MSH, 2011, 'Ageing in place with the use of ambient intelligence technology: perspectives of older users', International Journal of Medical Infomatics, vol. 80, no. 5, pp. 310-331.
Winter, JS, 2008, 'Emerging policy problems related to ubiquitous computing: negotiating stakeholders' visions of the future', Knowledge, Technology, and Policy, vol. 21, pp. 191 203.
Opponents of such technologies launch the typical arguments against same: namely, that they take away self-determination for individuals; that they have the potential to be used by governments and corporations to monitor the lives of "ordinary" citizens who do not need such surveillance; that they introduce an aspect of "Big Brother" into a society that is presently struggling to maintain autonomy in the face of increased oversight. From such opposition springs UbiTools' conflict over whether or not to proceed in developing and marketing the improved presence clock (as well as other similar technologies in the future). This report will seek to convince the CEO that it is not only prudent, but necessary in a business sense, for UbiTools to continue to develop not only improvements in the presence clock, but also further types of ubiquitous computing technologies, as this is a trend that will not change. First, the report will detail some of the current (and potential) uses of ubiquitous computing in the health care fields. Next, it will present some of the opposing arguments against the use of such technology, followed by a discussion of ways corporations and individuals can build and implement such technologies to minimize the fear of negative applications of same. Next, thoughts concerning the general trade-off between privacy and security regarding pervasive technology will be presented, as will some of the benefits and limitations of ubiquitous computing. Finally, recommendations for developing and marketing the improved presence clocks will be offered. It is the hope of the author that the CEO of UbiTools will take this report into consideration before making any decisions regarding the presence clock.Current and Potential Uses of Ubiquitous Computing in the Health Care Fields
Before engaging in a review of the current application of pervasive computing, it makes sense to note that the concept of "remote doctoring" is decades old. "Dowler and Hall considers TLM [telemedicine] being started as telediagnostics by psychiatrists as early as 1955 using interactive television" (Dowler & Hall, as cited in Rashvand, Salcedo, Sanchez, & Iliescu 2008, p. 238). However, the radio was used even earlier than that; in 1924, magazine covers heralding the arrival of the "Radio Doctor" were published (Rashvand, Salcedo, Sanchez, & Iliescu 2008). Thus, it is important to remember that computers merely improve and continue a tradition that began a long time ago. At present, Rashvand, Salcedo, Sanchez, and Iliescu down the current applications into four categories: Telecare Services; Continuous Care Support Service; Information Service to the Citizens; and Training and Provision of Information Services to Medical Staff.
Having said this, however, it is clear that ubiquitous computers are allowing a blossoming of medical-related technology. Given that, as well as the concurrence of aging populations, it stands to reason that there has been an influx of new ways to apply these technologies to health care for elderly people (Haux et al 2008). However, this confluence is not just an opportunity for growth; it is, in fact, becoming increasingly clear that "informatics support through health-enabling technologies leading to pervasive health care is one important option to be seriously considered" (Haux et al 2008, p. 79), since ubiquitous computing is becoming the norm, rather than the exception. Current applications include monitoring for emergencies, which can create alarms sent to caregivers; the management of disease (e.g. reminders to take insulin injections); and the ability to provide advice regarding general health care issues; potential applications include the ability to give often isolated elderly people social interaction, entertainment, education, and assistance with daily activities.
Stanley and Osgood (2011) note that sensor-based technologies can be used by an individual to monitor him/herself as well, keeping track of physiological functions, giving data regarding social networks, improving compliance with medical regimes by providing useful data, and so forth. Such sensor-based technology can also be tapped into by caregivers and health-care professionals, such that the collected data can be analyzed to determine everything from possible changes in medicine to whether or not an individual has fallen and is unable to get help. Kim et al (2008) take this a step further and explore a "stand-alone ubiquitous evolvable hardware (u-EHW) system" that consists of an embedded processor, a computer chip, and a hand-held terminal that essentially allows for a "mobile ECG" to be done, on a continuous basis, so that heart disease can be monitored all of the time, as opposed to only in periodic appointments when something could be missed. Beyond monitoring, wearable devices can not only keep track of particular medical conditions, but can also provide treatment.
The context-aware mobile communication system (CHIS) is another application of ubiquitous computing technology when applied in a health care context. It allows context-aware messages to be sent among hospital personnel, so that messages are not delivered unless certain conditions are met; it allows monitors to be set up that, when specific people pass by them, display information relevant to those particular people (e.g. when a nurse passes by, it might be set to display all of the information about her patients); and it can allow people to monitor their own privacy, in an interesting twist (meaning that people can set the device to divulge to others only certain information about, say, their location). While this device is being tested in hospitals at present, the application to a home setting is clear. For example, messages could be exchanged between caregivers and the people whom they are watching, or those being monitored might hide their location from their watchers when they use the bathroom.
These are just a few of the current health-care related applications of pervasive computing. While a comprehensive review is beyond the scope of this report, it does bear saying that one review of the literature, written in 2008, listed a full 67 different systems and devices currently on the market. Their review was not meant to be exhaustive, meaning that these were merely their own selections of devices that had been written about in previously published studies, indicating that the actual number of items on the market was, of course, much higher.
Arguments Against the Use of Ubiquitous Computing
Arguments against the use of ubiquitous computer technology range from the practical to the more abstract. In terms of the latter, one of the largest concerns is that "technology is altering, or defiling, the sacredness of human life" (Winter 2008, p. 200). While one might consider this an argument of those who are too old, too obstinate, or too "religious" to be considered part of the mainstream, the fact is that many ethicists believe that the very definition of what it means to be human will necessarily change - and must be addressed - in the coming years, as pervasive computing surrounds us with more intensity and volume. What will it mean when we are literally surrounded by machines that are smarter than we are? What will it mean when humans no longer make decisions related to, for example, our own health care? These and other questions might seem ridiculous now, but when one imagines a world in which we are outnumbered by intelligent devices we ourselves have set in place, it is clear that a redefinition is far better done sooner than later; and the concern, of course, is that we will not get around to it until too late.
Opponents who argue against the use of ubiquitous computing see this future world as "sinister" (Pimple 2011, p. 29). They worry that when machines are created to think for themselves, those who created the machines will be exonerated if and when things go wrong, allowing them a sort of "moral passcode" for doing as they wish. They worry that the very nature of pervasive computing devices leads their users down the road to "coercion, surveillance, and control" (Shilton, as cited in Pimple 2011, p. 30), much as the very existence of nuclear weapons is concerning to those who believe that "absolute power corrupts absolutely." Moreover, they are concerned about issues such as consent, and cases in which an agreement to use ubiquitous computing devices, such as the presence clock, might appear to be consensual on the outside, but are not.
Building Pervasive Information Systems Without Negative Implications
The primary way for ubiquitous computing devices and systems to be designed and implemented without the taint of coercion or undue control is deceptively simple: ensure that all parties involved consent to their use. However, it is also clear, from the arguments presented above, that this is easier said than done. What is consent to a 90-year-old woman who is terrified to say no to anything her son proposes because he's threatened to lock her up in a nursing home the minute she does? What is consent to a mentally capable, but physically incapacitated, teenager whose parents are sick of him and would rather lock him in a room with a monitor than interact with him?
One can create such scenarios almost ad infinitum. Having said that, it is also the case that one can also do so with any technology in the world. Sell a gun and the manufacturer might be responsible for a break-in where three people are murdered, or it might be responsible for saving the lives of soldiers in Iraq. Can the manufacturer be held liable for either action? Regulations differ from nation to nation, but that is indeed where to begin. Thus, those in the ubiquitous computing industry, like UbiTools, are well advised to be proactive when it comes to regulation. This will be addressed in more detail in the marketing section below, but this is indeed the first step in how to build such systems that are as free as possible from possible negative uses. The second step is to openly engage in direct dialogue with the public about all of the ramifications, good and bad, about pervasive computing devices and systems, and show how the good far outweighs the bad. For example, researchers concerned with "granny cams" and other surveillance devices that have been controversial in the past suggest that
in addition to a research mission statement, a data safety monitoring board comprised of research investigators, nursing home administration and staff, as well as cognitively intact residents, family members, and an ethicist, could be implemented by the LTC facility to regularly and proactively identify and remedy potential problems that arise during the course of a research project. (Bharucha et al 2006, p. 619)
Finally, safeguards can be built into the technology itself, such that, for example, unauthorized users who attempt to change or otherwise manipulate the devices cause them to shut down and alert those who are "monitoring the monitors" (e.g. police, health officials, etc.). Such safeguards can and should be made public knowledge so as to deter crime as opposed to providing a tool to solve it, much as the advertisement of alarm systems on fancy homes serves to deter those who would break into them.
The Trade-Off Between Privacy and Security for Pervasive Computing: Some Thoughts
In a small town, the cliché goes, a child can steal a candy bar from a store on one end of Main Street at 4 PM, and his mother will know about it ten minutes later, before he gets to his home on the other end of Main Street. This is because everyone knows everyone else; everyone is looking out for everyone else; and people feel a sense of responsibility toward each other to inform them of goings-on that concern them. Some might argue that in small towns, there is a loss of privacy because of this "snooping" mentality; such people are more comfortable in the anonymity of large cities where no one appears to care what they are doing. For those people, the devices and systems associated with pervasive computing are definitely not worthwhile; to them, privacy trumps security, and they would rather risk a stolen car than living with the knowledge that someone, somewhere, might well be watching to see who might be stealing their car.
And that is all well and good. Such technologies, as with all technologies, have the potential to be freely chosen, just as people will choose to live in a small town or a big city, depending upon their personal goals and inclinations. The word "potential" is used because, as discussed in the arguments against ubiquitous computing, it is certainly possible to misuse such technologies and turn them into instruments of terror (at worst) and benign, non-consensual surveillance (at best). That is true with every weapon, every tool, every technology, and always has been. It is important, however, that the mere raising of the issue of "privacy versus security" be met with the truth: such has always been the case, ever since humans decided to live with one another in tribes, small towns, civilizations of all kind, and it always will be. The challenge, of course, is to ensure that this balance works as well as it can for the benefit of the greatest numbers of people as possible. But to decide that such technologies are not worth pursuing because there is a chance that the free will of people will be over-ridden by them is to decide not to develop some of the most potentially positive life-changing tools to appear on the horizon in a very long time.
Benefits and Potential of Ubiquitous Computing
One of the clear benefits of ubiquitous computing, despite some of the arguments against it, is the fact that it blends into the background. Compare a sensor in a clock that otherwise appears normal with, say, an enormous machine designed to pick up and broadcast signals across a distance to a caregiver. The mere presence of that machine tells the individual all the time that s/he is vulnerable and being watched, whereas the clock looks like a clock; that is, the individual can forget about being monitored by her son or daughter and get on with his/her life. Back in 1991, Mark Weiser, the creator of the term "ubiquitous computing," had this to say: "The most profound technologies are those that disappear. They weave themselves into the fabric of everyday life until they are indistinguishable from it" (Weiser 1991, as cited in Hargraves 2007, p. 4). This profundity - this ability to blend into daily life until it is forgotten - is perhaps the greatest gift of such technology, as it acts as an assistant instead of a nagging reminder. Weiser further argues that it is only the fact that computers are newer technologies - as opposed to the written word, for example, which is ubiquitous without argument - that makes them feel "arcane" and thus set apart (1991, as cited in Hargraves 2007, p. 4). In other words, computers are still new, especially to elderly people, but they continue to feel less and less so, and once we, as a society, can make the jump to accepting their presence in our lives, they will feel as "regular" as the written word which surrounds us.
Once in place, ubiquitous computing has the opportunity to revolutionize what "independence" means, especially to those who are vulnerable and need a higher degree of care. Orwat, Graefe, and Faulwasser (2008) note that, "Some of its capabilities, such as remote, automated patient monitoring and diagnosis, may make pervasive computing a tool advancing the shift towards home care, and may enhance patient self-care and independent living" (p. 2). In other words, people who might otherwise be forced to remain in rehabilitation facilities, nursing homes, or other places of assisted living, might instead be able to return to their own homes because they will have the protection of ubiquitous tools surrounding them, monitoring them, keeping them safe.
The notion of ambient intelligence takes pervasive computing a step further and takes the field into a future previously only imagined in science fiction novels. Yet it is critical to remember that such steps are achievable within our lifetime, and those who take these steps stand to benefit greatly for having the courage to take them. Imagine an environment that is "aware of the user's context" which provides information to the user when s/he needs it, in the amount needed, no more, no less; an environment that provides said information in an effortless, simple, invisible fashion; and an environment that learns from, and adapts to, the user such that it can be of greater use in the future (RodrÃguez, Favelaa, Preciado & VizcaÃn 2005). Imagine, then, living in a place where not only your weight, blood pressure, heart rate, and other physiological markers are monitored, but where virtual reality allows you to wake up in a simulation of an ocean-side apartment, or visit a museum where a lighted pathway appears, just for you, guiding you to the paintings and exhibits you most want to see (Tucker 2006). This is the promise of ambient intelligence, the next generation of pervasive computing. Futurists predict we will live in an "AmI" world by 2020 (Tucker 2006); those who take steps now to be at the forefront of this technology only stand to benefit.
Limitations to Ubiquitous Computing
Clearly, we are still in 2011, and the world of 2020 - the world in which we all get to wake up by the sea - is far away. This is the primary limitation of ubiquitous computing: that ideas and uses run far ahead of existing technology, making it seem almost impossible to achieve the hoped-for ideal of perfect awareness and absolute protection. It is also the case that even when such devices and systems have been developed, not all people will have access to them. Technology is expensive when first developed, and while costs come down rapidly once sales volume increases, it still takes time; and even time isn't enough to overcome the poverty in many parts of the world. This, then, is a second limitation of pervasive computing: the reality that not everyone will be able to afford it, especially when so many of its health-care applications are clearly so beneficial. A final limitation is expressed in the old adage: "garbage in, garbage out." Such technology is only as good as those who create it, program it, and use it; and unfortunately, the world will always contain sub-par manufacturers, inventors, designers, and so forth.
Recommendations for Development and Marketing of the Improved Presence Clock
In light of the previous discussion, it is strongly recommended that UbiTools proceed with developing the presence clock such that its applications can be broadened, and, ideally, such that the device can ultimately interface with other pervasive computing tools to be developed in the future. Moreover, it is strongly recommended that such development be granted full resources, without "skimping;" to do so would compromise the quality of the end results, and savings now will thus definitely mean shortcomings later.
Marketing the presence clock should begin with a public information "blitz," starting with focus groups and research studies that show that users themselves - that is, for now, elderly people, but in the future people with physical and mental disabilities - welcome the device as a way to improve their lives. As van Hoof, Kort, Rutten, & Duijnstee (2011) found in their study of 18 elderly people living in communities that help them with an intensive list of needs, users by and large find ubiquitous computing devices and systems increase their sense of health and safety in their own homes. When people hear such things "from the horse's mouth," as it were, they tend to give them far more weight than when "some company" tells them the same thing. Once underway, marketing should continue to focus upon education, enhancement, and enlightenment as the "Three Es" of this "new era" of safety, health, and happiness. As Pimple (2011) said, "[w]hen presented properly, the benefits of pervasive IT are obvious" (p. 30). UbiTools must ensure that pervasive computing devices and systems are always presented properly.
Conclusions
While it is beyond the scope of this report to present a full marketing campaign for the presence clock, rest assured that such a campaign could easily be created. The technology to create a world in which people are surrounded by pervasive computing devices and systems already exists. Ambient intelligence will pervade the environments of the future regardless of what anyone might wish to the contrary. Moreover, this technology is sound, and it is ethical, allowing us the means to protect and help far more people than ever before. Given all of these things, I urge UbiTools to become the name associated with this technology; if we don't, someone else surely will - and they will be the ones to reap both social and financial benefits from their efforts.
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