From Moral Will toMoral Skill

Abstract

Healthcare systems increasingly rely on robotic technologies to address workforce shortages, yet asignificant disconnect remains between the technical logic of efficiency and the relational requirementsof care. While standard Value Sensitive Design (VSD) provides a method for value integration, it lacksspecific normative content. Care Centered VSD (CCVSD) resolves this by anchoring design in careethics, yet it remains a theoretical model that lacks the practical tools required for engineering implementation.This thesis posits that this failure stems not from a deficit of moral will (practitioner apathy),but from a deficit of moral skill: the lack of intermediate-level knowledge (operational artifacts thatbridge the divide between high-level theory and concrete implementation) to translate abstract valuesinto concrete technical implementations.Adopting a Research through Design (RtD) approach, this study operationalized the CCVSD frameworkthrough a case study within a commercial robotics company, focusing on the development of a socialnavigation module (interaction-aware motion planning that respects human proximity and social cues)for the PAL Tiago robot. The investigation revealed three structural barriers. First, semi-structured interviewswith 19 stakeholders (comprising robotics engineers and caregivers) identified a semantic gapwhere groups held divergent interpretations of care values; this was bridged by the Prospective ValueHierarchy, which translated care values into technical constraints. Second, the technical implementationof the navigation algorithm revealed a normative void, caused by the original framework structurallyskipping the technical development process. This phase was made explicit and operationalizedby integrating standard engineering workflows, providing the necessary structure to document technicaltrade-offs as ethical decisions rather than implicit defaults. Third, the integration phase of theframework, executed through comparative evaluations with 20 stakeholders (spanning care receivers,caregivers, and management) uncovered contextual instability, demonstrating that identical robotic behaviorselicited divergent value judgments across different care settings.The findings from this case study suggest that the operationalized framework offers practical utility forengineering teams. Feedback from the participating engineers indicated that the translational artifactshelped structure their tacit knowledge into a formalized process. These results indicate that providingengineers with tools to convert ethical mandates into actionable constraints can support a shift frompost-hoc ethical critique to continuous design input within such collaborative environments.