Human, machine, environment: Restructuring care ethics in the AI-empowered smart home

Abstract Introduction: As global population aging accelerates, the integration of Artificial Intelligence (AI) into smart home environments is profoundly reshaping eldercare practices. While these technologies promise enhanced safety and efficiency, they also generate novel ethical challenges that exceed the explanatory capacity of traditional ethics rooted in human-to-human care relationships. This article presents a theory-driven ethical analysis of AI-empowered age-friendly smart living environments, arguing that ethical dilemmas in this context are not isolated technical failures or individual moral lapses, but emergent properties of Human–Machine–Environment (HME) interactions. Methods: To examine this interactional complexity, the article develops the HME framework through an integrative synthesis of existing literature. The framework synthesizes three complementary perspectives: the Four Principles of Biomedical Ethics to identify normative tensions, Value Sensitive Design to analyze how ethical values are embedded in technological architectures, and Embodied Ethics to illuminate how intelligent systems transform older adults’ lived experiences of care. Results: Through this integrated analysis—illustrated by an applied case study of intelligent fall detection—it is demonstrated that ethical challenges such as technological paternalism, simulated empathy, and stigmatization are systematically produced through the configuration of bodies, algorithms, and domestic environments. Conclusions: Building on these findings, the article advances a set of actionable ethical strategies, including elder-centered governance mechanisms, embodied and value-sensitive design practices, and interdisciplinary ethical literacy development. By reframing ethics as a dynamic, interaction-generated process, this work contributes a coherent analytical framework capable of guiding ethical reflection, design decision-making, and governance in rapidly evolving smart eldercare ecosystems. Ultimately, it advocates for a shift from a technology-driven paradigm toward an ethics-by-design, human-centered model of aging in place.