The “CICERONE” Consensus conference on rehabilitation assisted by robots and electromechanical devices for people with neurological disabilities, promoted by SIMFER and SIRN, is about to reach its crucial stage. The final document produced by the jury of the conference will be presented tomorrow, September 15, during an online event. Among the members of the Jury also the FAIP (the Federation of the Italian Associations of Persons with Spinal Cord Injury), whose major contribution was, in particular, the sphere of the implications of the social, ethical and legal entities, Called CICERO, is about to reach its crucial stage of the Consensus Conference on the rehabilitation robotic-assisted and electromechanical devices for people with neurological disability, which is promoted by SIMFER (Italian Society of Physical Medicine and Rehabilitation) and the SIRN (Italian Society of Neurological Rehabilitation). In fact, the final document produced by the jury of the conference was approved, which will be presented tomorrow, September 15, during a videoconference organized by the Istituto Superiore di Sanità and SIMFER and SIRN themselves (details can be read in the box at the bottom).
“CICERO – explain the promoters of the initiative, is the world’s first experience of this kind dedicated to the topic of robotics in rehabilitation and has the purpose to clarify various aspects useful to employ these technologies in the field of rehabilitation in a way that is more effective, stable, safe, and acceptable by all the different actors involved, as well as to indicate the objectives and modalities of the development of research in the field, with the aim of consolidating the various data so far emerged. The preparatory work of the collection of documents, analysis, and discussion lasted more than two and a half years, having to overcome the difficulties related to the pandemic, and has seen the involvement of about two hundred people, including clinicians, researchers, developers, administrators, users and their families, experts in the field of technology, law, and bioethics, as well as representatives of the world of production”.
The directions which will be explained in the course of the meeting tomorrow, therefore, made by the Jury of the Conference on the basis of the evidence made available by the nine working groups, and the comparison between the Jurors and will cover: definitions and classification criteria of the devices; the theoretical models of reference for the development and clinical use; however, their clinical use in the most frequent conditions disabling of neurological origin; the organisational contexts that are appropriate for their application; the regulatory aspects, the social implications, ethical and legal; indications for the development of research.
Immediately after the presentation event, the initiatives to disseminate the jury’s document and the material produced during the work will begin, in order to make available the results and the large amount of information collected to anyone involved and interested in these issues.
To participate in the jury of the conference, there was also the FAIP (Federation of Italian associations of people with Spinal Cord Injury), represented in the jury itself by Giampiero Griffo. And it is in particular in the context of the social, ethical and legal implications that this organization has made a substantial contribution to the elaboration of the final document. As Griffo himself explains, “We focused above all on emphasizing that the treatment of patients with robotic applications should never deprive them of a significant human relationship of care with the doctor and with the health personnel responsible for each treatment, otherwise the risk of dehumanization of the person”.
“In addition-he adds-We believe that the treatment with robotic applications should avoid inducing, as far as possible, a feeling of psychological or emotional discomfort in the person, making him feel isolated and not worthy of care and attention by a human being. This therefore requires an adequate training of the operators, whose presence, on the other hand, must be guaranteed in a proportional way to the needs of the person during the entire time of the rehabilitation session”.
Finally, a risk highlighted by Griffo is that “the prolonged exposure of man to the machine, if you are not mediated and assisted by the participation of a human being, could induce the person, in particular if in the conditions of particular vulnerability (child or elder), to develop an improper attachment to the same”.
All issues, therefore, of particular complexity and delicacy, which together with that of the necessary safety of the equipment, the FAIP has contributed to have included with all evidence within the document produced by the jury of the conference. (S. B.)