This document summarizes a review of literature on value sensitive design (VSD) for assistive technologies that address age-related cognitive decline. The review found that VSD has focused on technologies that support physical functioning but not relationships or social personhood. The authors argue that issues of power in the understanding and application of technology need to be considered for VSD to help technologies better support personhood during cognitive decline. They propose a conceptual framework for VSD that incorporates an understanding of power relationships to design technologies that empower rather than dominate individuals experiencing age-related cognitive changes.

1. NITC / SEARCC
I am a Person
David Kreps & Oliver Burmeister
Colombo, Sri Lanka, Sept 2017
A review of value sensitive design for cognitive declines of
ageing, interpreted through the lens of personhood

2. Agenda
✤ Physical Personhood / Social Personhood
✤ Age Related Cognitive Decline
✤ Value Sensitive Design (VSD) - survey of the literature
✤ Power and technology
✤ Power, technology, personhood, and VSD

3. Physical Personhood
✤ Human individuals are both radically contingent, and unique
✤ individual cells are continually feeding,
growing, maturing, dying off, being replaced
✤ Red blood cells live for about four months
White blood cells live about twelve months
Skin cells live for about two or three weeks
Colon cells die off after about four days
Brain cells typically last an entire lifetime
✤ Our physicality is largely fluid
– a collection of temporarily captured solids
✤ YET our (constantly self-replicating) fingerprints, the patterns of our irises, and a
host of other molecular and genetic markers – especially our fundamental DNA -
are unique to each of us
NIAID

4. Dissipative Structures
Radically contingent bodies
✤ The spiral is a dissipative structure.
✤ The structure is not dependent upon
its contents, and exists only as they
pass through it.
✤ Such dissipative structures, for
environmental biologists, are the very
stuff of life, visible in both the biology
and behaviour of all living systems.
✤ The human individual is physically –
biologically - a dissipative structure,
with only a very few parts lasting its
(one) entire lifetime.
DaveShea

5. ✤ Languages, values, knowledge, skills are all absorbed,
passed on, through human communication and
socialisation: we are radically social beings.
✤ Social personhood is a dissipative structure, composed
of the many influences we absorb and extend
✤ Uniqueness and creativity are found in our own
combinations and fusions of contemporary common
elements of experience, knowledge, and skill
✤ In exercising our free will we shape these in a way that
distinguishes us from all others: we are unique
Social Personhood
Radically contingent selves
Georgie Pauwels

6. Mind-Body-Ageing
Libet, Bergson, and the processes of ageing
✤ Henri Bergson (French philosopher): our psychical life, while bound to its motor
accompaniment, is not governed by it
✤ Benjamin Libet (US neuroscientist): the “determinist materialist view” that would
reduce us to ‘a pack of neurons’ “is a belief system; it is not a scientific theory that
has been verified by direct tests.” On the contrary, “the nonphysical nature of subjective awareness,
including the feelings of spirituality, creativity, conscious will, and imagination, is not describable or
explainable directly by the physical evidence alone”.
✤ Ageing:
✤ Self-renewal process is not fixed and its efficiency changes with age
✤ Apoptosis (cells undergo programmed cell death) begins to accelerate, as we grow older
✤ Senescence – “the state where cells have irreversibly lost their proliferation ability” and become
resistant to apoptosis.
✤ Molecular damage in cells begins to proliferate, too; many cells try to go on undertaking their
function longer than they were meant to, unable to self-renew; problems mount up
https://thehumanevolutionblog.com/2015/01/07/is-violence-what-made-humans-smarter-than-other-animals/

7. Age related cognitive decline
The occlusion of social personhood
✤ Physical motor accompaniment to our mental and
emotional lives begins to deteriorate
✤ Social personhood:
✤ A separate non-physical reality made up of our
relationships, does not itself deteriorate
✤ It is not contained in or made up of the physical
cells whose life-processes are coming to an end
✤ Instead it becomes harder to reach, shining in
moments of lucidity through the relationships those
with cognitive decline maintain with their relatives
and carers.
andi aw masry

8. Assistive technologies
and Value Sensitive Design
✤ Assistive technologies can be designed in one of two ways:
✤ to support the physical functioning of bodies whose self-renewal mechanisms are almost
exhausted;
✤ or to support the continuing relationships and social personhood of the individual
✤ VSD employs an iterative methodology integrating conceptual, empirical, and technical
investigations.
✤ Human Values (not designer values) are sought from both direct and indirect
stakeholders.
✤ VSD seeks to explicitly support these human values by the technology
✤ When applied to assistive technologies for age-related cognitive decline, VSD must
focus upon supporting relationships, and upon respecting the personhood of those at the
end of their physical lives. The question we have, then, is: does it?

9. ✤ 27 point PRISMA protocol employed for review
✤ 15 of 21,500 in European Scopus and 5 of 28,000 in Web of Science
✤ “value sensitive design” OR "stakeholder values" OR "human
values"
AND
dementia OR cog*
AND
ageing OR aging OR "older people" or "older adults"
✤ 3 non-English and 3 non-relevant articles discarded, left 10 articles,
plus 5 on VSD and care robots relevant to age-related decline.
✤ Total 15 articles for further investigation
The literature survey: search
VSD and assistive technologies for cognitive decline

10. ✤ The focus of VSD to date has been on physically
supportive technology
✤ FINDINGS: Assistive technologies are designed to
support the physical functioning of bodies whose
self-renewal mechanisms are almost exhausted –
rather than supporting the continuing relationships
and social personhood of the individual whose
motor accompaniment is reaching its natural end.
✤ Why? : Our contention is that issues of power in
the understanding and application of technology are
at play, and that a better understanding of such
issues is required if VSD is to overcome this deficit.
Survey results
VSD and assistive technologies for cognitive decline
PRLOG

11. ✤ Technologies, including assistive technologies, are
always pregnant with power relations.
✤ VSD must understand power, and operate within a
framework that is sensitive to its workings.
✤ The exercise of power for the designer of technological
artefacts should always be as intentional as possible,
rather than intuitive or unconscious, in order best to
steer clear of the potential traps of the politics of
artefacts
✤ Awareness of power relations amongst practitioners of
VSD is crucial to reaching the best compromise if VSD
is to achieve any progress towards “the realization of a
society in which technology is a force for empowerment
rather than for domination”
Power and technology
VSD and assistive technologies for cognitive decline
Evine

12. Power, technology, and personhood in VSD
A conceptual framework

13. Contact
✤ Dr David Kreps
✤ http://david.kreps.org
✤ d.g.kreps@salford.ac.uk
✤ Dr Oliver Burmeister
✤ oburmeister@csu.edu.au
✤ Cover photo by Giorgio Grande