# Social Robots in Hospitals: A Systematic Review
## 4 Discussion
Moreover, as a result of the COVID-19 pandemic, social interaction is restricted, and a minimum distance between robots and humans should be respected. Regarding the appearance of robots or the features of robots intended for use by children or the elderly, pet-like SAR, like dinosaurs or animals (Pleo, Paro, Parrot, Aibo, Huggable, or iCat) are preferred [18; 21; 26; 34; 38]. People can also interpret affective nonverbal behavior in robots [21]. A stress-reducing effect on people who are ill in childhood and old age has been identified [24; 62]. As concerns human-like robots, NAO is one of the most accepted robots in healthcare [65]. In [16] found the main concern with social robots to be their cultural acceptance and skills. Additionally, feminine robots are preferred by users. Another concern found in this study was to understand what the human is doing; however, the robot's appearance depends on its application, the user's age, and several other factors [33; 60; 61]. As a method for designing and implementing AAL facilities, the person-centered process has been found to be the best design methodology, as it allows for conversations between participants and healthcare professionals [78]. However, [19] found that highly developed algorithms were needed to integrate more general cognitive aspects in the robot to enable it to diagnose certain illnesses, such as ASD. Another methodology that is useful in healthcare contexts (children with diabetes) is Socio-Cognitive Engineering (SCE) [25], as it enables the integration of different theories, models, and visions of patients and caregivers. More ingredients can be added to the interaction, such as prediction and feedback. Such is the case when using NAO in heart disease settings, which offers users a new way to understand the meaning of their vital signs through human-robot interaction [79]. Although social robots can promote fundamental values of care (i.e., patient safety, dignity, and wellbeing [22; 32]), some researchers believe that doing experiments to test social robots with child patients is not ethical [80]. Besides, care services are highly regulated, and special legislation is required for care-work robotics [22]. According to the International Federation of Robotics (IFR), there is a framework of components of ethical importance, the CCVSD (Care-Centered Value-Sensitive Design) approach [46]. It consists of a framework of components of ethical importance that provides a list of components to take into consideration when evaluating a care robot: the use context, the care practice, the actors involved, the type of care robot (its capabilities, appearance, etc.) and the list of values involved for the practice in question in the stated context (i.e., the interpretation and prioritization of care values) [46]. We found some ethical principles applied to the design of social robot applications in healthcare, such as autonomy, beneficence, non-maleficence, fidelity, justice, utility, and independence [78]. The same authors noted certain ethical requirements in artificial intelligence algorithms for AAL and social robots, like (1) human agency, (2) robustness, (3) privacy, (4) transparency, (5) non-discrimination, (6) wellbeing, and (7) accountability to account for the negative impacts of the systems. Some social robots must comply with the three fundamental guidelines of the Policy Department for Economic, Scientific, and Quality of Life Policies (IPOL) (i) Hospitality and inclusiveness, (ii) Comprehension of individual needs, and (iii) Non-intrusiveness [65]. The ethical dilemma must reconcile the technical problems with patients' needs and rights, with health care services and hospital facilities, in keeping with the ethics in robotics used in medicine [11]. Ethical concerns in the design and use of social robots have been raised involving privacy, restraint, deception, accountability, and psychological damage [45]. Safety--both physical safety and psychological safety [16; 17; 43]--is another principle considered when designing social robots for healthcare.