Solitary death and new lifestyles during and after COVID-19: wearable devices and public health ethics

• Published in: BMC medical ethics Vol. 22; no. 1; pp. 1 - 89
• Main Authors: Nakazawa, Eisuke, Yamamoto, Keiichiro, London, Alex John, Akabayashi, Akira
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 10.07.2021; BioMed Central; BMC
• Subjects: Aged; Autonomy; Bioethics; Collaboration; Community; Coronaviruses; COVID-19; COVID-19 vaccines; Death of; Debate; Demographic aspects; Ethical aspects; Ethics; Health surveillance; Life style; Lifestyles; Medical ethics; Monitoring systems; Older people; Pandemics; Public health; Social aspects; Social distancing; Social isolation; Solitary death; Urban areas; Wearable computers; Wearable device; Japan
• ISSN: 1472-6939; 1472-6939
• DOI: 10.1186/s12910-021-00657-9

Solitary death (kodokushi) has recently become recognized as a social issue in Japan. The social isolation of older people leads to death without dignity. With the outbreak of COVID-19, efforts to eliminate solitary death need to be adjusted in line with changes in lifestyle and accompanying changes in social structure. Health monitoring services that utilize wearable devices may contribute to this end. Our goals are to outline how wearable devices might be used to (1) detect emergency situations involving solitary older people and swiftly connect them with medical treatment, to (2) reduce the frequency of deaths that remain undiscovered and (3) to reduce social isolation by promoting social interaction. Theoretical and philosophical approaches were adopted to examine ethical issues surrounding the application of wearable devices and cloud-based information processing systems to prevent solitary death in the world with/after COVID-19. If thoughtfully deployed under proper policy constraints, wearable devices offer a way to connect solitary older people to health services and could reduce cases of solitary death while respecting the personhood of the user.