What the Aging Field Got Wrong About AI Ethics — And How to Fix It

At the GSA 2025 Annual Conference in Boston, one conversation kept surfacing in every session, every hallway, every networking dinner:

And yet, despite all the urgency in the room, the field of gerontology has been largely silent on the governance side of this issue. A landmark paper published in The Gerontologist (October 2025) put it plainly: “The field of gerontology has not seriously engaged Al governance, even as technologies described as Al impact older adults in numerous and diverse ways.”

That needs to change. And it needs to change now.

The Problem Is Not the Technology

Let me be clear: Al has enormous potential for aging populations. We are talking about 83% accuracy in fall prediction. Early detection of UTIs before hospitalization. Smart home systems that give older adults genuine independence. These are not hypothetical benefits they are happening.

The problem is not that Al exists. The problem is “how” we are deploying it, and “whose values” are shaping that deployment.

Right now, most age-tech is designed by engineers who have never spent time in a memory care unit. By startups whose investors want scale, not dignity. By companies who mistake surveillance for safety.

And the people who “should” be at the table – gerontologists, clinicians, older adults themselves are rarely in the room.

The 4D Risk We Are Not Talking About Enough

The research literature has given us a powerful framework to name what can go wrong. Al-based gerontechnology carries what researchers call “4D risks”

Depersonalization– when algorithm-based standardization replaces individualized care

Discrimination – when Al systems trained on biased data perform poorly for minority older adults, those with limited English, or those with complex comorbidities

Dehumanization – when the care relationship is automated away and human presence disappears

Disciplination – when continuous monitoring and surveillance erodes autonomy under the guise of keeping someone “safe”

I have seen all four of these play out in real facilities, with real people. A fall sensor that triggers a family panic call every time someone gets up at night. A medication reminder system so intrusive it makes a person feel like a prisoner in their own home. A companionship robot marketed as a solution for loneliness that no one actually wants to talk to.

We can do better. But only if we insist on it.

What Dignity-Centered Al Actually Looks Like

At The Gerontechnology Group, I evaluate Al products through what I call the Dignity-Centered Al Evaluation Framework (DCAEF) a five-pillar methodology that asks the questions engineers don’t always know to ask:

1. Autonomy & Control – Can the older adult turn it off? Override it? Own their data? Or are they passive subjects of a system designed by someone else?

2. Dignity & Respect – Does the interface treat users as competent adults? Does it infantilize through tone, design, or assumption?

3. Safety & Effectiveness – Does the evidence actually support the health claims? What are the failure modes?

4. Usability & Adoption – Was it designed with older adults, or just “for*them? Because those are not the same thing.

5. Transparency & Accountability– Can the AI explain its decisions in plain language? Is there a human accountable when something goes wrong?

When a product scores well across all five pillars, something interesting happens: older adults actually “use* it. They trust it. It becomes part of their life rather than something imposed on their life.

That is the difference between technology that serves people and technology that surveils them.

Why Gerontologists Must Lead This Conversation

Here is what I know after 15 years in eldercare, a PhD in Gerontology & Leadership, and years of building my own Al product for fall prevention:

The ethics of aging technology is not a technical problem. It is a human problem.

And gerontologists are the only people in this ecosystem who are trained to hold the full human picture – the clinical complexity, the psychosocial context, the dignity imperative, the caregiver dynamics, the financial realities – all at once.

We cannot outsource this conversation to Silicon Valley. We cannot wait for regulators to catch up. We cannot let the loudest voices in the room be the ones with the least experience sitting with a person in the last decade of their life.

The GSA community knows aging. It is time we claim our seat at the Al governance table-not as critics, but as architects.

A Call to Action

If you are a gerontologist, a clinician, a researcher, or a family caregiver navigating these decisions, here is what I am asking:

Demand ethics. Ask the companies selling you technology: How was this designed? Who was in the room? What happens to my loved one’s data? What is your dignity policy?

Lead the conversation. If you have expertise in aging, you have something the tech world desperately needs. Offer it. Publish it. Say it out loud.

Hold the standard. Every product that gets deployed without ethical scrutiny makes it harder for the good ones to be heard. Be the person in the room who asks the hard questions.

The aging field has always been about dignity. It is time our relationship with technology reflects that same commitment.