1. Balancing caregivers' needs with patients' liberties: the need for multidisciplinary reflectionPrior to proceeding, it is nevertheless of the essence to pause and recognize the terrible burden, along with the enormous courage, of those who care for their loved ones suffering from Alzheimer and age related dementia. Credit is similarly due to the Alzheimer's society, whose tireless efforts are nothing but laudable. The merits of the "Safely Home"41 programme are certainly not at issue, nor will I attempt to resolve the continued use of GPS here.
Indeed, while not suggesting that this programme "safe return" (or "safely home") be dismantled or that GPS never be used in this context42, this paper will espouse the urgent need for inter-disciplinary dialogue, leading to the development of a coherent, principled approach43 to the use of assistive technologies in dementia care. From a human rights perspective, such an approach would first recognize the primordial character of personhood and the multiplicity of interests of the elderly, beyond physical concerns, irrespective of capacity, in order to promote more informed health policy decisions, enshrined in legislation. As health policy expert Bruce Jennings44 opines: "Caring and caregiving, after all, are not only about meeting an individual's needs or making him comfortable; they are about the recognition of the person being cared for and the recognition of the caregiver's own personhood therein"45 .
What is more, now is a principally opportune time to carefully consider the impact of new technologies on the most at risk amongst the vulnerable – the elderly suffering from some degree of mental incapacity, most commonly Alzheimer's patients. Not only do we, as a population, live longer46, but advocates for the elderly have voiced an urgent call for a national strategy on Alzheimer's disease and related dementias47. Plainly put, the issue cries out for resolution.
As the law (or, in this case lack, thereof) does not exist in a cultural vacuum, it appears edifying to contrast our48 almost mechanical acceptance of assistive technologies with the sceptical UK approach to the same devices. Indeed, while both the American and Canadian Alzheimer's society have embraced and promoted the surveillance programmes, their UK counterpart has, for its part, suspended the implementation of such monitoring techniques in light of the ethical concerns and whilst those are being thoroughly explored49.
Finally, since the matter of dementia rights is to a certain degree inseparable from health care rights generally50, caregiver concerns must not be neglected. If carers are tempted to routinely resort to such technologies – now in their infancy – it is perhaps due to the onerous burden they face, characterized by lack of resources and (the more costly human rather than more economically convenient technological) assistance. Our health policy must strive to remedy these intrinsic shortcomings as a means to ensure that such technologies – whatever their merits – if at all used, are deployed as a last and regulated resort. Sober reflection on the long-term implications of routinizing technological surveillance leaves little doubt as to the costs of too easily succumbing to the temptation of technology in this context – both financial (one could think of malpractice insurance) and in terms of liberties. #p#分页标题#e#
In view of that, following a succinct overview of GPS technology and its use in the context of anti-stalking legislation and privacy rights, Part I of this article will raise a number of issues potentially responsible for the "legal limbo" relating to the electronic monitoring of dementia patients. Namely, the identity and intentions of the watchers; paternalism, intersection of interests and the inappropriateness of traditional legal remedies, aggravated by definitional difficulties regarding what actually constitutes "restraints". Part II will then proceed to engage in a comparative exercise, contrasting the "culture of care" and how it impinges on the willingness to rubber stamp GPS monitoring of the elderly suffering from dementia. Part III (or "a Final Word) explores prospective recommendations, offered for the purpose of promoting further discussion.