EXTENDED SUMMARY

The population is rapidly aging in many regions and countries around the world. With the aging of the population, there will undoubtedly be an increased need for health services and long-term care services due to dementia and multiple diseases seen in the elderly population. Care services have long been a focus of feminist social scientists as a type of labour that is primarily provided by women to family members, unpaid, and often overlooked and devalued, due to gender inequalities worldwide. The COVID-19 pandemic has exposed the unsustainability of care being primarily based on women’s paid and unpaid labour and the fragility of care systems. International organizations, particularly the UN and the EU, emphasize the need to recognize care as a social right at the center of human well-being, for the state to act as a regulatory actor in this area, and for paid and unpaid care to be a quality and accessible service for everyone through the allocation of social spending. There is a need for sufficient and qualified workforce to provide quality and accessible care services for everyone. However, due to demographic changes and challenging working conditions, there is a labour shortage in this field, and only a limited portion of the elderly population has access to services. To address this labour shortage, recommendations include improving working conditions to increase the labour supply, as well as opening regular migration channels to bring in migrant care workers.

Another topic of discussion is the potential of new technologies to meet the needs of the elderly in terms of long-term care services. Various digital technologies that support existing care workers and lighten their workload have become quite widespread. Among new technologies, humanoid robots, which are not yet widely used but could become more widespread as they become cheaper, are increasingly attracting attention and becoming a topic of debate. Care robots are classified into companion robots, health monitoring and reminder robots, entertainment robots, fall detection/prevention robots, etc. Although concerns about the use of robots in the literature on care ethics are strongly expressed, discussions are underway on what can be done to enable robots to assist care workers and meet the needs of elderly people who use robots themselves, based on the view that it is not possible to abandon robots.

Approaches based on human rights and common human values emphasize the rights of older adults, like all people, to live in adequate conditions of health and well-being, to have a private life, and to be protected from discrimination, torture, and degrading treatment. The widespread use of robots in care raises ethical concerns, particularly regarding the reduction of human interaction, loss of privacy, deception and infantilization, loss of control, loss of personal freedom, and the question of who is responsible when something goes wrong with the robot.

Studies on the use of robots in care work have revealed that robots can affect the physical and psychosocial working environment of caregivers in both positive and negative ways. In particular, technologies that enable patients to be monitored at night can reduce the stress of night shifts. Toy robots can serve as a calming influence in response to violent behaviour that may be directed at caregivers by patients with dementia and Alzheimer’s disease. While robots are used to reduce the physical and mental workload of caregivers, as seen in examples such as bathing and feeding robots, operating and monitoring robots while they work can increase their workload.

In Japan, one of the countries with the fastest aging populations and a leader in robot technology, studies on the use of robots have shown that they do not replace migrant care workers, but rather that the use of robots has increased alongside the employment of migrant workers. Researches conducted both in Japan and various European countries have revealed that care workers view assistive technologies that facilitate monitoring positively; however, they are reluctant to use humanoid robots due to the difficulties associated with their use, frequent malfunctions, and the fact that they exacerbate the already demanding work pace. A critical perspective on robot use requires further research. Additionally, the importance of value-sensitive design approaches in the design process of robots and the benefits of involving care workers who will use robots in the design process are emphasized.

On the other hand, robots are very expensive technologies, and their widespread use is not possible until it is clear who will finance them. However, current developments point to the potential for increased production and lower costs in this field. In the coming period, rapid advances in robot technology can be expected in China, which is facing significant aging issues. Care robots supported by artificial intelligence are expected to become increasingly affordable and accessible. The creation of a new profitable production area for robots in capitalist economies, coupled with governments redirecting resources from public care services to companies in this sector, suggests that robots—particularly AI-supported humanoid robots—will develop very rapidly in other advanced capitalist countries as well. Competition between China and other capitalist countries, led by the US, will accelerate this process