Beyond the surface : an exploration in healthcare robotics in Japan

In this study we have analysed both the more superficial aspects (tatemae) and the underlying content (honne) of healthcare robotics in Japan: the official promises and popular media images, and the hardware and software behind the façade that make the systems work. Our initial premise was that in Japan, as in many other countries, people are living longer and fewer babies are being born. This will lead both to a rise in the demand for healthcare and a drop in the number of people providing this care. We have investigated the extent to which robotic technologies will be able to provide a solution to this upcoming challenge. We found a wide range of different robotics technologies in use in healthcare. These ranged for example from humanoid robots mimicking human behaviour that played a role in fundamental research on the workings of the human body and people’s reaction to robots to simpler robotic systems mimicking body parts to help students and researchers to learn more about the function of the human body. We also encountered high-tech mechanical systems which can help surgeons to perform more precise operations, alongside a range of robotic systems for rehabilitation and care. These included for example, sensitive devices with wheels or joints to take some of the load off carers, to support disabled people during the rehabilitation process and to help older people to live more independently and to enhance their quality of life. Despite this broad variety of robotics applications in healthcare, we noted that most research efforts and funding seem to be focused on the very high-tech end of the robotics scale. Popular media and the scientists and engineers working on these systems combined to project the image of multifunctional humanoid robots, which may one day replace carers. Such ambitious goals are successful in unleashing public funds for fundamental research in the field of robotics. However, such advanced humanoids are not likely to enter the healthcare sector in the foreseeable future. This makes it important to look beyond the surface of the media hype and focus on the wide range of robotic technologies that do stand a realistic chance of supporting healthcare workers in their daily activities and care recipients in their daily life. A paradoxical example is the therapeutic robot seal Paro, which has been shown in trials to be reasonably costeffective and well accepted. This achieves its therapeutic effect by being taken care of by patients instead of caring for them. It seems to empower the patients. We may conclude that while robotics applications may not be the final solution in facing the challenge of an aging society, they are certainly worth considering. And in order to develop technologies that can be used in society and not just in the laboratory, a shift in policy focus is needed towards robotic technologies that address real needs in the healthcare sector. A more user-oriented, multi-disciplinary approach is required. Engineers may already find it difficult to exchange some of their knowledge with colleagues, since hands-on experience is less easy to transfer than words. Still, in the end, they will only be able to continue their work if there is a public demand for it. The successful development of new robotic technologies will demand close attention to a range of ethical, social, legal and innovation issues now. The need to address safety issues is commonly agreed upon in Japan. Unfortunately, much less attention is paid to ethical issues, and privacy issues are generally ignored. Engineers should realise that a more socially sensitive approach would not hamper the development of robotics, but would actually help them to formulate common concrete challenges. What should robotic applications look like? What kind of tasks and decisions can be delegated to the machine? Do we need high-tech solutions, or will low-tech ones suffice? There are important lessons to be learnt in this field for Japan but also for the Netherlands. Moreover, these are matters of concern not just to engineers, but to society as a whole