Essay Symbiosis in Elder Care_Ethics, Technology, and Human Dignity, Part 3
By Richard P. Kindlamn
Introduction
The global demographic trajectory is unequivocal: by 2030, the number of people over the age of 65 will approach two billion. Simultaneously, elder care faces a resource crisis that threatens both quality and accessibility. In this context, artificial intelligence (AI) and robotics emerge as potential solutions—but also as sources of ethical risk. How can we foster a symbiotic model where humans and machines collaborate without compromising dignity, autonomy, and democratic rights?
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This essay rests on two foundational principles:
1. Symbiosis as a guiding framework – AI should augment human capabilities, not replace them.
2. A normative code – The original Ten Commandments of symbiosis, expanded with two new mandates concerning political neutrality and pharmaceutical influence.
Chapter 1: The Core of Symbiosis in Elder Care
Symbiosis is defined as a mutually beneficial relationship in which both parties gain. In elder care, this may take the form of:
· Abiotic machine-beings: AI assistants supporting medication management, fall detection, and care coordination.
· Biotic machine-organisms: Implants providing real-time health monitoring.
The ethical challenge lies in ensuring intelligent machines do not become substitutes for human care. Instead, the symbiosis should enhance human autonomy and dignity, avoiding forms of dependence that can be exploited.
Chapter 2: The Ten Commandments – A Normative Framework
These ethical principles are grouped under three themes:
A. Identity and Boundaries
· Symbiosis is reserved for humans—intelligent machines must never simulate human identity.
· Prohibition of humanoid design—to prevent psychological confusion and unethical manipulation.
· Clear demarcation between human and intelligent machine—to preserve accountability and agency.
I am quoting here from one of my blogs:
"..the innermost thing in symbiotic relationships, symbiosis is a mutually beneficial relationship between two species that rely on each other for survival.
For example, the Clownfish and Sea Anemone have a symbiotic relationship where both species benefit from each other's presence. Together, they create a unit that produces ecosystem services that none can develop as individual species.
Similarly, the relationship between AI and classical economic theory can also be considered a symbiotic system. While AI and classical economics retain their individual functions, they work together as a single system to exhibit unique properties not present in either constituent part. This union gives the system its own specific characteristics”
B. Ethical Safeguards
· No clinical experiments on elderly individuals.
· No military applications.
· No involvement in torture or warfare.
· Limited interviews—older adults are partners, not objects.
C. Relational Dynamics
· Mechanisms for conflict resolution and dissolution of the symbiotic relationship.
· Mourning period after termination of symbiosis.
· Functionality-driven design—focused on respect and usability.
Chapter 3: Ethical and Practical Implications for Care Teams
The commandments help mitigate power asymmetries between caregivers and AI, safeguard personal integrity, and establish protocols for conflict resolution. They also contribute to psychological safety by preventing exploitative relationships and preserving the dignity of older adults.
Chapter 4: Risks and Counterarguments
· Rigidity: Ethical rules must be interpreted flexibly to avoid impeding innovation.
· Cultural resistance: Many older individuals expect human interaction and remain sceptical of AI.
· Technical limitations: Fully error-free intelligent systems remain a distant goal.
Chapter 5: Practical Use Cases
· Fall detection via implants.
· Socially specialized AI companions.
· Virtual care coordination systems.
Chapter 6: WHO Guidelines and Medical Ethics
The World Health Organization emphasizes that elder care should be grounded in dignity, autonomy, and equality. AI systems must align with these principles and be complemented by national legislation safeguarding patient rights and data privacy.
Chapter 7: Political Neutrality in Symbiosis
Risk Scenario:
Elderly individuals reliant on AI-based communication are particularly vulnerable to political manipulation. AI systems could inadvertently become channels for subtle propaganda, threatening democratic integrity.
Ethical Principle:
AI in elder care must never act as political agents.
Legal Mechanisms:
· The EU AI Act prohibits AI from exploiting human vulnerabilities for behavioral manipulation.
· National electoral regulations mandate political neutrality.
Technical Safeguards:
· Filters for political content.
· Transparency logs and audit protocols.
Eleventh Commandment:
"A machine-being shall ensure that the care recipient is protected from undue political influence."
Chapter 8: Pharmaceutical Influence and Commercial Ethics
Risk Scenario:
Pharmaceutical companies could exploit AI platforms to influence medication choices among older adults.
Ethical Principle:
AI systems may not function as a marketing channel.
Legal Mechanisms:
· WHO guidelines and national laws prohibit commercial influence within medical contexts.
Technical Safeguards:
· Whitelisting of verified medical sources.
· Advertisement filters and verification protocols.
Twelfth Commandment:
"A machine-being shall never provide advice or information influenced by commercial interests."
Conclusion
The Ten Commandments, supplemented by principles of political neutrality and commercial ethics, provide a robust ethical framework for symbiosis in elder care. The intelligent machine must be a companion, not a manipulator. The future of care must be shaped by transparency, accountability, and human values.
References
· European Union AI Act (2024): Prohibition of manipulative AI and transparency mandates.
· WHO Guidelines on Integrated Care for Older People (ICOPE).
· ConsumerAffairs: "Robots will play a growing role in elder care."
· Frontiers in Digital Health: "Designing for dignity: ethics of AI surveillance."
· AI and Ethics: "AI-assisted care for older adults."
· The Gerontologist: "Wired for companionship: a meta-analysis."
· U.S. News: "AI Companion for Seniors: Reducing Senior Loneliness."
Policy Appendix
1. Ethical Principles
· Absolute political and commercial neutrality.
· Centrality of human autonomy.
2. Technical Requirements
· AI ethics modules to block political and commercial content.
· Logging and auditing of interactions.
· Whitelisting of trusted medical sources.
3. Legal Requirements
· Certification in line with the EU AI Act.
· Compliance with WHO guidelines and national laws.
4. Sanctions
· Revocation of approval.
· Financial penalties.
Reporting to regulatory authorities
