title: Smart homes, private homes? An empirical study of technology researchers' perceptions of ethical issues in developing smart-home health technologies.
abstract: Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology's potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engineers themselves. By exploring the views of engineering researchers in a large smart-home project, we sought to contribute to dialogue between ethics and the engineering community.
  
  
  
  Either face-to-face or using Skype, we conducted in-depth qualitative interviews with 20 early- and mid-career smart-home researchers from a multi-centre smart-home project, who were asked to describe their own experience and to reflect more broadly about ethical considerations that relate to smart-home design. With participants' consent, interviews were audio-recorded, transcribed and analysed using a thematic approach.
  
  
  
  Two overarching themes emerged: in 'Privacy', researchers indicated that they paid close attention to negative consequences of potential unauthorised information sharing in their current work. However, when discussing broader issues in smart-home design beyond the confines of their immediate project, researchers considered physical privacy to a lesser extent, even though physical privacy may manifest in emotive concerns about being watched or monitored. In 'Choice', researchers indicated they often saw provision of choice to end-users as a solution to ethical dilemmas. While researchers indicated that choices of end-users may need to be restricted for technological reasons, ethical standpoints that restrict choice were usually assumed and embedded in design.
  
  
  
  The tractability of informational privacy may explain the greater attention that is paid to it. However, concerns about physical privacy may reduce acceptability of smart-home technologies to future end-users. While attention to choice suggests links with privacy, this may misidentify the sources of privacy and risk unjustly burdening end-users with problems that they cannot resolve. Separating considerations of choice and privacy may result in more satisfactory treatment of both. Finally, through our engagement with researchers as participants this study demonstrates the relevance of (bio)ethics as a critical partner to smart-home engineering.
authors.affiliation: Centre for Ethics in Medicine, University of Bristol, Bristol, UK. giles.birchley@bristol.ac.uk.
authors.forename: Giles
authors.identifier: 0000-0002-2973-2163
authors.initials: G
authors.lastname: Birchley
authors.affiliation: Centre for Ethics in Medicine, University of Bristol, Bristol, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Huxtable
authors.affiliation: Policy, Ethics and Life Sciences, Newcastle University, Newcastle, UK.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Murtagh
authors.affiliation: Centre for Ethics in Medicine, University of Bristol, Bristol, UK.
authors.forename: Ruud
authors.initials: R
authors.lastname: Ter Meulen
authors.affiliation: Department of Computer Science, University of Bristol, Bristol, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Flach
authors.affiliation: School of Clinical Sciences, University of Bristol, Bristol, UK.
authors.forename: Rachael
authors.initials: R
authors.lastname: Gooberman-Hill
mesh_terms: D001290:Attitude; D026688:Bioethical Issues; D002755:Choice Behavior; D003219:Confidentiality; D003695:Delivery of Health Care / Q000379:methods*; D004738:Engineering / Q000941:ethics*; D005260:Female; D006699:Home Care Services / Q000941:ethics*; D006801:Humans; D008297:Male; D018907:Privacy; D012108:Research Personnel / Q000941:ethics*; D013672:Technology
keywords: Choice; Empirical ethics; Engineering ethics; Health technology; Privacy; Qualitative research; Research ethics; Smart-home; Ubiquitous computing