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Ethical and practical concerns of surveillance technologies in residential care for people with dementia or intellectual disabilities: an overview of the literature

Published online by Cambridge University Press:  04 March 2010

Alistair R. Niemeijer*
Department of Nursing Home Medicine/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
Brenda J. M. Frederiks
Department of Public and Occupational Health/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
Ingrid I. Riphagen
Unit for Applied Clinical Research, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Johan Legemaate
Department of Public and Occupational Health/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
Jan A. Eefsting
Department of Nursing Home Medicine/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
Cees M. P. M. Hertogh
Department of Nursing Home Medicine/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
Correspondence should be addressed to: Alistair R. Niemeijer, Department of Nursing Home Medicine. EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT AmsterdamThe Netherlands Tel: +31 204 449332. Fax: +31 204448234. Email:


Background: Technology has emerged as a potential solution to alleviate some of the pressures on an already overburdened care system, thereby meeting the growing needs of an expanding population of seriously cognitively impaired people. However, questions arise as to what extent technologies are already being used in residential care and how ethically and practically acceptable this use would be.

Methods: A systematic literature review was conducted to explore what is known on the moral and practical acceptability of surveillance technologies in residential care for people with dementia or intellectual disabilities, and to set forth the state of the debate.

Results: A total of 79 papers met the inclusion criteria. The findings show that application and use of surveillance technologies in residential care for vulnerable people generates considerable ethical debate. This ethical debate centers not so much around the effects of technology, but rather around the moral acceptability of those effects, especially when a conflict arises between the interests of the institution and the interests of the resident. However, the majority of articles lack in depth analysis.

Furthermore, there are notable cultural differences between the European literature and American literature whereby in Britain there seems to be more ethical debate than in America. Overall however, there is little attention for the resident perspective.

Conclusion: No ethical consensus has yet been reached, underlining the need for clear(er) policies. More research is thus recommended to determine ethical and practical viability of surveillance technologies whereby research should be specifically focused on the resident perspective.

Review Article
Copyright © International Psychogeriatric Association 2010

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