A Novel Pathway for Integrating Ethics into Digital Technology Design: A Person-Centred Co-Design Approach Developed in the Context of Assistive Technologies for Older Adults

How can we effectively incorporate ethical considerations into technology design? Several frameworks and evaluation methods focused on ethical aspects of new and emerging technologies have been proposed over the past two decades. Despite this, we still lack a robust pathway for integrating ethical considerations into the design process. We examine three existing methods: ethical technology assessment, value-sensitive design, and embedded ethics. Drawing on their strengths and limitations, we propose a novel pathway for integrating ethics (PIE) that is flexible, multi-disciplinary, and person-centred. It consists of four stages: (1) bringing ethicists and designers together; (2) identifying ethical tensions; (3) exploring solutions to ethical tensions through stakeholder engagement; (4) integrating identified solutions into technology design. This pathway has been developed in the context of digital assistive technology for older adults’ care, building on the principles of person-centred care and co-design, and embeds four fundamental values: inclusivity, collaboration, flexibility, and practicality. This novel approach could also be expanded into other areas of digital health technology design and development. The global aging population faces significant health and well-being challenges. Many older adults prefer to age in their own homes and community. Digital assistive technologies, such as sensors, wearables, and smart devices, offer promising solutions to support independent living while reducing burdens on caregivers and healthcare professionals. However, ethical concerns—including privacy, trust, ageism, loss of self-determination, and equitable access—limit the uptake and sustained use of digital assistive technologies. To address these challenges, we propose an integrated ethics approach grounded in two fundamental principles: person-centred care and co-design. These principles foster inclusivity, flexibility, collaboration, and practicality, forming a robust ethical foundation for the use of assistive technology solutions. Our ‘pathway to integrating ethics’ approach enables structured engagement between ethicists and technology developers, ensuring ethical considerations are embedded throughout the design process rather than treated as they occur after release. Key components include (1) a close collaboration between the design team and ethicists throughout the project, within clearly defined terms and conditions, (2) a strong emphasis on stakeholder involvement across diverse user groups, and (3) proactive identification and resolution of ethical tensions that arise in practice.