Bioethics Forum Essay

Robot and Frank, and Maybe Me

If movies are one window into the soul of America, “Robot and Frank” has some funny/sad things to say about our current approach to aging. Frank (Frank Langella, as charismatic as ever) is a retired cat burglar, losing his memory and generally deteriorating in his country home. Hunter, his concerned son, brings a robot to take care of him. The robot stays, Hunter says, or else you will have to go to a “memory center.” Despite Frank’s initial resistance, he gets used to the robot and finds some unprogrammed uses for its memory and dexterity skills. Fortunately for Frank, the robot has not been programmed with any moral sense. It knows what stealing is but not that it is wrong. (Note to bioethicists: Here is a job opportunity for the future – programming the capacity for ethical analysis into robots.)

The plot is farcical but it allows for some trenchant commentary on American society. The library in town is being replaced by a community center that will offer a “library experience” without any books. The library assistant is a robot named Mr. Darcy, a nice literary note, perhaps the only tie to the printed word that will survive.

The movie is set in the “near future,” but the montage of shots in the closing credits showing robots at work suggest that the future is now.  In this world, older people will be tethered to or continuously monitored by technology, thus reducing the need for human intervention of the professional or familial kind. No less an authority than Tom Friedman, the New York Times foreign affairs columnist, sees this as a way to balance the costs of supporting foreign regimes against the costs of nursing home care, while stimulating economic growth. This will “require breakthroughs like remote diagnosis equipment in every home that can track a patient’s weight, blood sugar or lung capacity and dispatch it to a hospital, or clothing with sensors woven into the fabric that will be able to track all physical indicators around the clock,” In other words, Depends meets Life Alert. I can only imagine what hospitals would think about receiving and reviewing an avalanche of this generally useless data.

Furthermore, how this would save money is not clear, since the current home care workforce is largely unpaid family members or poorly paid home care aides. And to my knowledge there is no building boom in nursing homes.

But the appeal of technology is undeniable. The Xbox Kinect gaming system is being touted as a new way to monitor older people aging in place. Already one independent living center in Missouri has a Kinect mounted on each room’s ceiling to provide 360-degree monitoring, in combination with separate sensors over each doorway. More sensors are embedded in mattresses to detect restlessness or frequent trips to the bathroom.  Every home should have one, or several, say the advocates. Privacy concerns? No problem, since the image is only a silhouette, not a picture of Mom on the toilet.

In these scenarios, technology never fails. Technology is supposed to free family caregivers of worry. Anyone who has to deal with cable TV, a computer, smart phone, and any of the other machines that we have come to depend on knows that you are only one glitch away from disaster. And dealing with computer-generated “customer service” centers is frustration personified (or would be if an actual person were involved).

But the biggest flaw is the lack of recognition that what older people – indeed, all of us – need most is human contact, not just when our blood pressure reading is a “little high,” but in myriad ways. Loneliness and isolation are common problem of aging. Many studies have shown the power of touch to comfort. Families provide this connection and so do home care and nursing home workers.

As for me, I totally reject the idea of being wired with sensors and having an all-seeing camera monitor every step I take, ostensibly to protect me from myself.  But, lacking a human companion, I wouldn’t mind a nice congenial robot like Frank’s to prepare nutritious meals, go for a walk, and guide me through my yoga exercises. Frank calls the robot his “friend,” but the robot in the movie reminds him that it is not a person. You could have fooled me.

Carol Levine is director of the Families and Health Care Project of the United Hospital Fund and a Hastings Center Fellow.

Posted by Susan Gilbert at 08/23/2012 10:04:17 AM |

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