Robot seals work too, apparently…
From a recent New York Times story:
When Linda Spangler asked her mother, in a video chat, what she would like as gift for her 92nd birthday, the response came promptly.
“I’d like a dog,” Charlene Spangler said. “Is Wolfgang dead?” Wolfgang, a family dachshund, had indeed died long ago; so had all his successors. Ms. Spangler, who lives in a dementia care facility in Oakland, Calif., has trouble recalling such history.
So Linda, who is a doctor, got her mother a dog.
Well, Mom thought it was a dog, anyway. It was a robot dog. Sensors allow it to pant, woof, wag its tail, nap and awaken, and users can feel a simulated heartbeat.
Hmmm.
Your Ethics Alarms Ethics Quiz of the Day:
Was this ethical?
One approach is to look at the robopet solution as a strict utilitarian win. The mother was lonely, and wanted a dog to keep her company. Now she thinks she has a dog, and is feeling better. Yes, the “dog,” not being a real dog, is a lie, but the benefits of this lie far exceed the harm. Jeremy Bentham and John Stuart Mill would approve.
On the other side of the issue, the Times story interviewed professionals who found the practice ethically dubious.
Opined one: “The promise [with such robotic pets] is that it becomes a companion and you have a relationship with it. As though there’s mutuality. There’s not mutuality. It’s a bunch of bits and bytes.”
“There’s an element of ethical dishonesty about it,” said another. Oh, I’d say there’s more than just an element. If someone is easy to lie to, does that make the lie more ethical? Instead of getting her mother a fake dog that she thinks is real, why doesn’t the daughter visit her mother more often?
Other thoughts:
- Would it be just as acceptable to give a dementia sufferer a brick and tell her it’s a dog, as long as the deception “works”?
- How about an invisible dog, like the one “owned” by one of the comic madwomen in “The Madwoman of Chaillot”?
- Is this more Ick Factor than unethical?
- Slightly off topic: the Times piece has this quote:
“Covid has created a bizarre world where nobody can hug anybody,” said Laurie Orlov, a veteran industry analyst and founder of the newsletter Aging and Health Technology Watch. “The idea of a pet you can hold — a tactile experience — transcends that somewhat.”
I am sick of the pandemic being used as a reflex excuse for incompetence, bad service, and misconduct.
Anyone else?
Ethics Alarms 
I have some questions:
Can Linda visit her mother? Does her state allow visitors to nursing homes and other facilities for the sick or elderly? She was, after all, video-chatting with her mom when the dog conversation happened.
Does the dementia-care facility allow live animals?
Is it ethical to give a living breathing animal to someone who can’t remember that all the previous family pets are dead? Who cares for pets in the facility, after all? The residents? The staff?
I don’t like the pandemic being used as an excuse either, but the mother wants some companionship and may not be up to caring for a real animal. This one won’t make messes, won’t require her to remember feeding times and won’t get sick and die.
…though it can run out of batteries.
if a Roomba can return to its charging station, I think K-9 there can manage it.
Ethical. The odds of a real dog being abused via neglect is way too high.
Why not just cut to the chase and replace Mom with a robot? (There was a Twilight Zone about that…)
“I sing the body electric”… which was written by the legendary Ray Bradbury
I don’t understand your analogy.
Not an analogy, but a slippery slope application. Extreme, to be sure.
That IS the question, though, isn’t it? As A.M. Golden also implied the well-being of a real animals has to be considered. Will it get fed? Will it get the attention it needs? Will it get cared for properly? Is there a plan in place for when Charlene dies (i.e. is Linda planning to take the dog back?)?
I don’t think that we have the answers to those questions. However, assuming the worst (that an animal placed in Charlene’s care would be at risk of not having its needs met), does the analysis change? Is the robo-dog the correct solution in those circumstances?
-Jut
Well, it gets my SEAL of approval. (Ark! Ark!)
Ark! Ark!
I’d vote ethical. A.M. Golden already covered many of my questions and concerns.
I’d also hesitate to presume that Mom hasn’t been visited on a frequent basis. From personal experience what is happening is real life doesn’t relate to what the dementia patient remembers. Having visited a direct relative almost every day during her last years, she would tell other family that I hadn’t been to see her in weeks. Add the accusations that one of her children was trying to poison her (this person lived across the country and could only call) and we knew that we couldn’t take much at face value.
If the robo dog gives comfort while not endangering a living animal I don’t see the ethical problem.
Jack, would it have been unethical to give Lennie a robot dog?
It’s a beneficial deception, I think. The person with dementia is not aware that they’ve lost their faculties. If they’ve always loved dogs, they’ll be lonely without one, and continue to want one. A person with dementia, however, cannot reliably care for an animal, remember to walk it and feed it. It would be unfair to an animal to be put into such a situation. With the robot dog they get the fun of having a dog without the duties that come with a real dog, no danger of being snapped at if they don’t handle it properly, and no chance of accidentally hurting it. Even if they vaguely suspect it’s not a real dog, it will still bring them pleasure.
Dementia experts recommend that you do not continually correct a dementia sufferer and try to bring them into present day reality, but instead, that you enter their world. For instance, if your mother asks you every time you visit if her husband is dead, and for honesty’s sake, you tell her every time that he is, you force her to confront the reality of her husband’s death over and over again; every time she hears it will be the first time, the grief sudden and sharp. Instead, he’s at the store, visiting his brother, out for a while. I have invented stories for MIL’s friends, aunts, neighbors, whoever she was worried about any particular day. She had outlived everyone, and wondered why they didn’t drop by, so they were shopping, watching her house for her, babysitting their grandkids. These conversations are all forgotten, sometimes within minutes, but in the moment they can bring peace and settle a troubled mind. I see the robot dog as no different. If someone with dementia remembers over a number of visits that they want a dog, I think it’s something they want and need, and the robot offers a solution.
I wholeheartedly agree about not continually correcting a dementia patient. I used to argue with my sister and father because they would even get angry at my mother because she would repeat questions or forget conversations. I did, however, tease my younger brother by telling him that I was going to tell mom that it was a shame he hadn’t visited her in quite a while. He reminded me that he would tell her the same about me the following day.
Back to Jack’s question – we’ve been dog-sitting my son’s dog (he’s a Marine – the son, not the dog) for over a year and I have not failed to notice the comfort he brings to both me and my wife. I vote ethical.
Dementia is such a special case… I think this is an ethics incompleteness example. Or maybe a zugzwang. What’s the better choice?
Incompleteness. It is ethical to provide someone comfort; zugzwang implies ethical options are impossible. It is usually not ethical to lie. Sometimes the utility of a lie in a situation outweighs the utility of strict truth.
There are ethical considerations of lying to dementia patients. Each case has to be carefully considered, with the wellbeing of the patent first and foremost, with the need for family and caregivers to be consistent. There are certainly grossly unethical lies and scams one could pull on a patient. Providing a fluffy companion I don’t think is one of them.
It’s ethical. More on that later.
First, I have to explain that my perspective on animals is a bit skewed, partly because I grew up on a small farm with chickens, pigs, rabbits, pigeons, and a cow. Most, except for the cow, became food eventually, and the cow provided milk. My perspective was further skewed by my having been bitten in the face, severely, by a dog when I was a child, about 6 or 7-years-old, as I recall. I still remember well my grandfather (the dog’s owner) driving me to a doctor (no hospital within 50 miles) while I held a bloody towel to my face to stanch the flow.
Here’s an ethics question from that small farm: What do you do when you find out your outdoor cat has been killing the neighbor’s chickens? More on that later.
A fake dog is ethical, because, if the mother has enough awareness to understand it’s not a real dog, then she has enough awareness to understand why she cannot have a real dog. If she’s not that aware, then, no harm, no foul. As to mutuality (what kind of professional was that?), I’ve seen people establish mutuality with Alexa, thanking her for a weather update, for example.
A brick? No! Even with dementia far enough along that the mother wouldn’t know, the staff would. Don’t make her a laughingstock for them.
An invisible dog would not work for someone with memory problems, but a fake dog would.
For me, not an ick factor at all.
Now, back to that chicken-killing cat, and there is an ick factor. The solution at the time, applied by my father, was to send the cat to its final reward by means of a single shotgun blast. A fake cat never would have gone after the neighbor’s real chickens.
I say ethical, but I’m biased because my marriage proposal involved a robotic dog.
Man, I really hope the robotic dog was just carrying the ring or something, and not that the end of that story is, “And FidoBot said yes!” 😉
My father is in late stages of brain cancer. My parents no longer have pets, but they love my dog. If my dad, who is often confused, wanted a pet of his own, and a robopet gave him any degree of peace or comfort, I would move heaven and earth to get him one. It wouldn’t matter one bit to me if he thought is was real, or an aardvark, as long as it made him happy.
Looking over the comments here, there’s really not much I can add. I do think if the robotic dog brings comfort to the old woman and the rules of the facility prohibits pets, I do think it would be ok and ethical considering her condition.
Get some local volunteer group that brings dogs to nursing homes and long term care facilities to bring by an actual dog to visit the mother on a regular basis. A real dog is what she needs, every few days or so for half an hour or so. There are dogs trained to provide such company and any alleged Covid complications can be overcome. The solution is out there, it just needs to be deployed. A robotic dog is not a dog. Why use a robotic dog when actual dogs are available and ready to go on duty. This isn’t an ethics problem, this is a lack of common sense problem.
And please don’t tell me St. Anthony of Fouci says dogs can infect humans with Covid.
“If it brings comfort…” sounds like an unethical rationalization.
Drinking large amounts of vodka also brings comfort. Paying drug addicted prostitutes for sex brings comfort. Playing video games for 16 hours straight brings comfort. Burning down buildings is apparently bringing comfort. Telling yourself a pretty lie is better than an ugly truth brings comfort. Fooling those with illness brings comfort, especially to those who can’t be bothered to care for their own family members in a meaningful way.
I think this is a low hanging fruit “solution” that puts the onus on a machine to do what humans should be doing. We discard our old and sick to what my grandmother (who almost lived to 103) called senior jail. She luckily was well loved and visited constantly but she still hated being away from all the real comforts of a real home.
Multigenerational households are good for kids, adults, and elders. When an elder absolutely needs more help, there are in-home solutions that can be exhausted before a nursing home is necessary. Perhaps a robot “dog” is a substitute for being close to loved ones or perhaps it’s just yet one more way we show our loved ones we can’t be bothered. While I understand the covid-19 excuses, I still don’t buy that this is an ideal solution.
I think that’s why we’re considering it ethics zugzwang. We don’t know Linda’s situation. She may be an only child; she may not have anyone who can care for her mother while she’s working; her mother may need round-the-clock care (if she has dementia to the extent that she seems to have, it’s a certainty) that Linda can’t provide. Visits may be forbidden or highly restricted during the pandemic. It would be ideal if Mom could be cared for at home with a large extended family to watch out for her and keep her occupied, but not every adult child has that option.
That’s very true. Stories like this leave out certain details.
“Drinking large amounts of vodka also brings comfort. Paying drug addicted prostitutes for sex brings comfort. Playing video games for 16 hours straight brings comfort. Burning down buildings is apparently bringing comfort. Telling yourself a pretty lie is better than an ugly truth brings comfort. Fooling those with illness brings comfort, especially to those who can’t be bothered to care for their own family members in a meaningful way.”
These are all HORRIBLE comparisons. Can you identify any harm done to anyone or anything in giving a dementia patient a fake dog?
Playing a human being for a fool? Sure, she might not be terribly sentient all the time, but she’s still a human being and this woman’s mother.
Is that really an accurate description of what’s going on though? Is the point mockery? Hell…. Is the outcome mockery?
See the sentence about a pretty lie. Where there is deception there is harm. Perhaps my bias is that I’m often considering where things will lead. In this case, knowing what big tech is attempting to lead us towards, I’d say my comparisons are only slightly hyperbolic in the short term.
Well we really don’t know what stage of dementia she’s in. Can she remember who family members are when they make a visit? Perhaps she’s combative at times and difficult to manage at home. The nursing home memory unit could be top quality with plenty of attention from staff and regular communication to her relatives. So since we don’t know all the facts it would be premature to call this an unethical decision.
Exactly. I could tell you all about ‘combative’, I had everything from jars of jam to ashtrays launched my way over the years, been kicked, slapped and scratched. Thankfully those episodes were few and far between. When it’s constant, there’s only so much family can do.
We were not allowed to care for MIL at home once she developed serious swallowing issues. We were told (and had observed) that she no longer had much of a gag reflex, and did not have the strength to cough out anything that might become lodged in her throat. She needed constant care. Before that, I had gone from full time to part time work when FIL got dementia. After he passed and MIL got symptoms a couple of years later, I couldn’t see myself going through the visits at the hospital several days a week and going into work on Sunday to do a week’s worth of work again (I was the bookkeeper for my husband’s business) Admittedly, that would be years after her diagnosis, but I recalled all that, shuddered, and quit my job.
For five years (in the early stages) I drove to the family home 5-6 days a week and was there from 9 or 10am until I saw her fall asleep at night (she stubbornly refused to move in with us). Finally we convinced her to move into our neighborhood (she was still adamant that she would NOT live with us), less than100 yards away. That was easier, she would walk over often, I could walk to her house. We’d eat at her house or ours, as the mood struck her. She’d sleep at our house often, and was happy to as it was her decision.
She started off with short stays in the hospital when she had problems, and over the next few years she declined enough that she couldn’t be left alone at all, her doctor said she needed to be in a facility, and she went in. This was 8 years in, 13 years since FIL fell ill. I went twice a week, stayed all afternoon, and fed her dinner. I stayed with her daily when she needed it, went less often when she was good. As my husband is an only child, we were it. There was no one else. I didn’t see my friends in person more than once a year for almost a decade. With home helpers in the last two years at home,(once or twice a week, 1 1/2 hours per visit) I managed to go to the gym once or twice a week, get the shopping done, and could occasionally book a cooking class for respite.
I think most people go through a similar process. I was on a caregiver support board for years. We were all going through similar processes. You start going over, eventually you move them in, or closer to you. You know that eventually they need full time care, but when? We all agonized over our decisions . I volunteered in a rehab center all through high school. I know full well that there are seniors who never have visitors, and families who can’t be bothered, but for every family like that are many more that do what they can until they can do no more.
MIL had Lewy Body dementia. Different from Alzheimer’s, they stay sharp in ways AD patients do not; she would have known the dog was not real and would have pooh-poohed it. FIL would have loved it.
I have that cruel and intolerant disposition regarding ends and their not justifying any means absolutely, so my thumb is down — unless I’m Caesar and this is the Coliseum, then it’s up. Perhaps the whole world will erupt into a never-before witnessed age of prosperity, splendor, and virtue, but telling one’s ailing mother that a toy is a dog would still be an inadmissible means.
I remember hearing about an old Chinese proverb in which a courtier intends to overthrow the emperor but doesn’t know whether he has the support of enough of the other nobles. One day the emperor asks for a horse, so the scheming courtier brought a deer. The nobles who sided with him agreed, contrary to plain sense, that the deer was a horse, and by that sign the betrayer knew that he had enough allies. Apparently the act of telling an obvious lie for the sake of showing loyalty is known as “calling a deer a horse”. I can’t ever help but think the sort of people who show their loyalty with lies can’t be expected to be loyal at all, and the whole concept is self-defeating. Plus, that’s a terrible way to treat one’s mother.
Thanks Benjamin. If I’d read your comment before posting mine above, I wouldn’t have had to post mine.
Tell the truth?
– I know you asked for a dog, but could you just try this robot dog, and see how you get on with it? It looks fun, and it won’t need as much looking after as a real dog. If it’s no good I can take it back to the store.
A+
Dementia patients have sudden and unexpected moments of lucidity. I would suspect the sudden realization that you’d been had by your closest relatives might weigh in on the ethical considerations here.
What say you?
I saw that with my Dad, Michael. He’d be sharp as a tack one day and out to lunch the next. May have been too many medications at age 90, but the death certificate said “Alzheimer’s.” See also, “King Lear” for moments of irrationality followed by moments of lucidity. Old Willie S. was a pretty observant son of a bitch.
Me? I say that smart, informed, stable and rational people should vote, and everyone else is hurting the Republic and subjecting themselves to unethical manipulation, undermining the point of democracy. My dad decided not to drive because he felt his skills were declining. The same should apply to voting.
This was under the robot dog post. Not the manipulating dementia patients to vote Democrat post.
I observed this same situation at my father’s nursing home and it seemed very satisfactory. The lady was happy to hold her stuffed dog and it caused neither her nor anyone else any harm. Their worlds shrink. Anything tactile should help ease the anxiety that caregivers often see in their patients.
Jack’s question reminds me of this movie:
Ethical deception, IMO.
“ I would suspect the sudden realization that you’d been had by your closest relatives might weigh in on the ethical considerations here.
What say you?”
Periods of lucidity are periods of being more aware than they have been, but not at the level of pre-dementia lucidity. Likely they’d see the robot dog, say, “What the heck is that?” which is your cue to say ,”I picked it up because I thought you’d like it”. When the period of lucidity is over (15 minutes to an hour or so later) and they tell you Sparky is such a well- behaved dog, and they love him, you go along with that, too. In the default dementia state, they don’t remember the lucid states, and when lucid, they don’t remember the times they’re not. It’s not uncommon for those in a period of lucidity to ask about things that have been in their room for days or weeks, as if they’re seeing them for the first time, like Mother’s Day flowers three days after they got them.
Ethical.
All the rest is commentary.
And for some reason, your comment is completely unsurprising.
5 years of living 24/7 with increasingly demented in laws will do that. Both made it into their late 90s with a good quality of life, until the last month, when it became existing rather than living.
Fortunately I had a partner, so one could do shopping, sleep, look after our house etc while the other was on duty.
Try to be kind.