監視科技的雙元本質： 增能？限制？紅外線熱感應影像裝置應用於高齡照顧之經驗初探研究

Dual Nature of Surveillance Technology: Exploratory Study on the Application of an Infrared Thermal Image Sensing Module on Elderly Care

為解決高齡照顧「安全」與「隱私」平衡兩難議題，本研究與財團 法人工業技術研究院合作，以兩個高齡照顧單位為場域，訪談蒐集場域 利害關係人需求與經驗，研發「紅外線熱感應影像裝置（以下簡稱熱感 應裝置）」，並探討三個研究問題：1. 場域利害關係人對熱感應裝置的需 求為何？ 2. 熱感應裝置的使用，可能產生哪些倫理議題？ 3. 熱感應裝 置是否解決了隱私與安全的零和困境（zero-sum）？研究發現：首先， 高齡者表達生理與心理層面的安全保障，並且希望與熱感應裝置能有對 話形式的互動。社工及照服員在強調生理安全保障以及即時通報等共同 需求的同時；基於在照顧現場位置的差異，他們對熱感應裝置，也產生 了不同的需求與隨之而來的矛盾情緒。其次，受訪者對隱私保障呈現分 歧看法，熱感應裝置也產生心理壓力等干擾性倫理議題。科技擁有的主 動性，也改變了高齡者個人隱私空間（後台）的內涵，使之成為類似於 公共空間（前台）般正式互動的區域。最後，雖然高齡者認為感受熱 感應裝置帶來的安全感，但部分高齡者對隱私保障仍有所顧慮。針對 這些發現，本文除了從場域使用經驗，提出熱感應裝置的研發建議，以 朝向隱私與安全的「正和典範（positive sum paradigm）」之外；鑑於保 障失智症高齡者自主權的重要性，本文也提出「預立研究參與書」相關 討論，期許藉由「預立研究參與書」落實與簽署，確保其研究自主參與 權。

This study identified methods of harnessing the power of technology to ensure a balance between safety and privacy in elderly care. On the basis of the experience of using a prototypical infrared thermal image sensing module (hereinafter referred to as thermal sensor), which was developed in collaboration with the Industrial Technology Research Institute, and the collected qualitative data on the needs and experiences of stakeholders from two elderly care institutions, the current study answered the following three research questions: (1) What are stakeholders' demands of thermal sensors? (2) What ethical issues might be involved in the use of thermal sensors? (3) Does the use of thermal sensors solve the zero-sum problem between privacy and safety? This study provided three research findings. First, senior citizens attached considerable value to safety and protection (i.e., physiological and psychological demands). Additionally, while social workers and care assistants emphasized the common needs of physical safety and emergency alarms, they also had different and paradoxical demands of thermal sensors that were dependent on differences in care setting locations. Second, the interviewees had diverse opinions on privacy protection; furthermore, the use of thermal sensors caused perceived obtrusiveness, such as psychological pressure. Furthermore, this technology altered how senior citizens viewed their private (backstage) spaces that were turned into formal interaction areas similar to public (front-stage) spaces. Finally, despite the sense of security gained from thermal sensors, a few senior citizens were still concerned about the possible invasion of their privacy. On the basis of these findings, the study proposed research and development suggestions for using thermal sensors, thereby identifying a means of achieving a positive-sum paradigm that can reconcile privacy and safety. Furthermore, on the basis of the value that elderly adults with dementia attach to autonomy, this paper discusses the content of advance research directives. It is hoped that the right to autonomy and freedom of research participation of the elderly with dementia is protected through the implementation of advance research directives.