Introduction
A new focus on technology in health and care services is part of an international trend. The demographic changes implied by ageing populations, the growing chronicity of illness, together with rising expectations, lack of qualified labour and rising costs of public welfare are expected to pose challenges to public welfare systems. Policy responses to this impending ‘care crisis’ promote technology or ‘telecare’ as a solution that may at the same time reduce care needs and public expenditure and improve the quality of life of older people, by allowing them to receive the necessary support at home and to maintain their independence for as long as possible.
Critical engagements with these discourses note that there seems to be an underlying assumption that technology (for example GPS tracking technology, automatic alarms, detectors and medical monitoring devices) can replace the need for care and human relations and networks, and that this is seen to be desirable (Chaper One in this volume; see also Roberts and Mort, 2009; Mort et al, 2013). This policy is built on the assumption that people prefer to grow old in own their homes rather than living and being taken care of in institutions, and that technology will enable them to do so. These expectations of a ‘technological fix’ relate also to groups not previously considered as candidates for independent living, such as people with dementia.
From a care ethics perspective, the discourses of active ageing and independence and of a technological fix that replaces care needs and substitutes embodied , face-to-face, direct care with electronically mediated care at a distance seem to miss the point of care altogether. They contribute to the on-going individualisation of care (Chapter One in this volume) and also turn care issues into issues of individual risk management and security (Lopez, 2010). A central notion of care ethics, however, is the notion of the relational interdependence of people as caring subjects (Barnes, 2012a). According to Tronto (1993), people exist in and through caring relations with others. Care is constitutive of individual human being as well as of social and public life. People are relational entities, and so are their identities and subjective capacities. What characterises people is interdependence, rather than independence or dependence.