The ethics of using virtual assistants to help people in vulnerable positions access care

Sep 29, 2026

Uploaded by Bulrr

People in vulnerable positions who need daily support often struggle to obtain timely access to care, including due to disabilities and broader individual or situational vulnerabilities. Growing reliance on technology-mediated access has introduced ethical concerns about whether digitalising care requests is appropriate and inclusive. This paper reports empirical focus-group findings on a “sensitive” virtual assistant and links them to five wider ethical issues, highlighting unequal benefits across users despite inclusive design.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Introduction

Methods

Study design

Original research The ethics of using virtual assistants to help people invulnerable positions access care Steven R Kraaijeveld , 1 Hanneke van Heijster,2,3 Nadine Bol,2 Kirsten E Bevelander3 ► Additional supplemental material is published online only. To view, please visit the journal online ([https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.1136/jme-2024-110464](10.1136/jme-2024-110464)) . 1Department of Ethics, Law & Medical Humanities, Amsterdam UMC, Amsterdam, Netherlands 2Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands 3Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands Correspondence to Dr Steven R Kraaijeveld; s. r. kraaijeveld@amsterdamumc. nl Received 20 September 2024 Accepted 6 February 2025 © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group. To cite: Kraaijeveld SR, van Heijster H, Bol N, et al. J Med Ethics Epub ahead of print: [please include Day Month Year] . doi:10 . 1136/ jme-2024-110464 ABSTRACT People in vulnerable positions who need support in their daily lives often face challenges in receiving timely access to care; for instance, due to disabilities or individual and situational vulnerabilities. There has been an increasing turn to technology-mediated ways to improve access to care, which has raised ethical questions about the appropriateness and inclusiveness of digitalising care requests. Specifically, for people in vulnerable positions, digitalisation is meant to facilitate requests for access to healthcare resources and to simplify the process of navigating the healthcare system. In a multidisciplinary research project, we examined the use and value of a ’sensitive’ virtual assistant that can accommodate different needs of target groups through inclusive design, adaptive technology and artificial intelligence. This paper presents empirical findings from focus groups with care recipients and caregivers about the sensitive virtual assistant and relates the findings to five larger ethical issues associated with the use of virtual assistants in healthcare settings and care practices more generally. It highlights the risk that, even with the inclusion of target groups in the design of digitalised care assistants, some people may benefit significantly less than others. INTRODUCTION People in vulnerable positions who need support in their daily lives—for example, due to disabilities or individual and situational vulnerabilities—often face challenges in gaining timely access to care.1 There has been an increasing turn towards technology-mediated ways to provide better and more timely care, particularly given the rising costs of health and social care in many countries around the world.2–4 One approach has been to digitalise different aspects of health and social care; for instance, through artificial intelligence (AI), eHealth or mHealth technologies.5–7 Digitalisation is meant to improve access to care by making it more readily available, especially when in-person interactions are not feasible. Additionally, digitalisation aims to simplify the process of receiving care.8 One example of a digital health tool that can improve access to care and potentially simplify the process of receiving it is a ‘virtual assistant’—a tool that‘accepts natural language as input and generates natural language as output, engaging in a conversation with a user,’9 such as a chatbot or artificial conversational agent.10 Virtual assistants, which can provide automated and standardised responses in a conversational manner to address various informational and motivational needs of care recipients,11 are increasingly implemented across various healthcare settings and for different target groups.12–14 At the same time, the rise of such digital health tools raises important ethical questions about when, how and for whom they ought to be used.15–17 Following

FAQs

Why is ethical scrutiny needed when using virtual assistants for care access?

Because technology-mediated access is intended to improve timeliness and simplify navigation, but it raises questions about appropriateness and inclusiveness for people in vulnerable positions.

What is the “sensitive” virtual assistant studied in the paper?

It is a chatbot designed to accommodate different needs of target groups through inclusive design, adaptive technology, and AI, responding to specific capabilities such as those of people needing long-term care.

What ethical concern does the study highlight regarding benefits to users?

Even when target groups are included in design, some people may benefit significantly less than others, indicating unequal outcomes.

Sep 29, 2026

Uploaded by Bulrr