Beyond the Surface: Identifying Ethical Blind Spots in the Development of Locator Devices for Dementia Care

Locator devices, also known as electronic tracking, monitoring, or surveillance devices, are increasingly being adopted in various care settings to help manage dementia-related wandering and bolster the safety and autonomy of persons with dementia. Their use in dementia-care has raised ethical concerns. While the primary focus of this concern has centered on the use of locator devices, there is a steadily growing call to better integrate ethical reflection into the development phase of these technologies. Many ethical tensions are present during the development of a locator device, and stakeholder inclusion, inclusive of persons with dementia, is a key method to navigating them. However, due to current limitations in dementia inclusive development, stakeholder inclusion alone is insufficient to fully engage with the ethical dimensions of locator device development. In this article, we aim to support more effective stakeholder inclusion by identifying underrepresented elements of the current normative debate and translating them into ethical considerations that can be used throughout the development process. We do this by applying the Leuven Ethical Question Framework for the evaluation of health technology innovations. Using the Framework as a tool for reflection, we identify six ethical considerations present at the individual-relational, organizational, societal, and global socio-historical contexts. These considerations can help integrate ethical reflection into the development process by providing developers with an initial scaffold for dialogue, both with stakeholders and within their own teams, and also serve as starting points for future research.