Telecare technologies and isolation : some ethical issues

Telecare technologies involve the remote monitoring of patients who have health, rehabilitation or social needs. These technologies, although deployed unevenly in developed countries, represent a shift in the ways in which care is practiced. Research on the consequences of this shift away from more traditional ‘hands-on’ care has focused primarily on quantitative measurement (for example cost savings) with less attention paid to how recipients themselves experience these new care practices. This paper discusses two aspects of telecare technologies which are under researched; the potential for isolation which may arise as a result of the use of these technologies, and the ethical issues raised by this. The primary locus of the discussion is the United Kingdom, where a major public policy shift towards telecare is under way and where telecare research has been particularly well funded by government. The discussion concludes that isolation raises the potential for loneliness – which is increasingly recognised as a significant factor in overall health and well-being – and is not being sufficiently considered, in part because the ethical frameworks in use do not adequately address the issue of loneliness itself, given their bio-medical, rather than relational focus