Environmental Cognitive Remediation in Schizophrenia: Ethical Implications of "Smart Home" Technology

By Stip, Emmanuel; Rialle, Vincent | Canadian Journal of Psychiatry, April 2005 | Go to article overview

Environmental Cognitive Remediation in Schizophrenia: Ethical Implications of "Smart Home" Technology


Stip, Emmanuel, Rialle, Vincent, Canadian Journal of Psychiatry


Objective: In light of the advent of new technologies, we proposed to reexamine certain challenges posed by cognitive remediation and social reintegration (that is, deinstitutionalization) of patients with severe and persistent mental disorders.

Method: We reviewed literature on cognition, remediation, smart homes, as well as on objects and utilities, using medical and computer science electronic library and Internet searches.

Results: These technologies provide solutions for disabled persons with respect to care delivery, workload reduction, and socialization. Examples include home support, video conferencing, remote monitoring of medical parameters through sensors, teledetection of critical situations (for example, a fall or malaise), measures of daily living activities, and help with tasks of daily living. One of the key concepts unifying all these technologies is the health-smart home. We present the notion of the health-smart home in general and then examine it more specifically in relation to schizophrenia.

Conclusion: Management of people with schizophrenia with cognitive deficits who are being rehabilitated in the community can be improved with the use of technology; however, such technology has ethical ramifications.

(Can J Psychiatry 2005;50:281-291)

Clinical Implications

* Cognitive deficits in schizophrenia can lead to the introduction and maintenance of a true handicap.

* New technologies, applied to the field of health, could serve as a cognitive prosthesis.

* Smart homes are an illustration of a possible environmental modification that would facilitate rehabilitation and community adaptation.

Limitations

* Altering the environment in a fashion suitable for persons with cognitive handicaps is not a common approach.

* There are significant ethical concerns related to smart homes, including issues of individual freedom, personal autonomy, informed consent, and confidentiality.

* There is limited literature evaluating the outcome and impact on the quality of life of persons using smart equipment.

Key Words: schizophrenia, dementia, cognition, mental disorder, rehabilitation, cybernetics, ethics, smart home, cognitive remediation

The cognitive remediation and social reintegration (that is, deinstitutionalization) of patients with severe and persistent mental disorders present challenges that psychiatry has been trying to meet for many years. Nowadays, the unprecedented development in communication and information technologies has redefined the terms of these challenges. Recent studies have attested to the flexibility, effectiveness, and growing affordability of these technologies (1-3). This article aims to demonstrate the potential these technologies may have with respect to research and the efforts made by psychiatric institutions that provide cognitive remediation to persons with schizophrenia. Our second objective is to start a debate on an unresolved matter: what are the ethical implications of new technologies in teaching cognitive skills and monitoring safety in schizophrenia patients?

Community care today has, in many respects, become a necessity, provided that acceptable conditions of safety and autonomy are met. A lower birth rate and a higher life expectancy together go a long way toward explaining the growing need for medical care for dependent seniors. As the number of dependent seniors increases, so do economic and sociomedical issues (for example, overloaded health facilities, higher health costs, desire for quality of life [QoL], and quality care). When a senior person is no longer capable of independent living, home living has always been the preferred choice over institutionalization. The advent of innovative technologies has today revived issues related to community care in terms of means and safety (4,5). At the technical level, adapting these technologies to the conditions specific to schizophrenia poses a priori difficulties that depend on a creative interaction between psychiatrists and technologists. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Environmental Cognitive Remediation in Schizophrenia: Ethical Implications of "Smart Home" Technology
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.