We define an agency transfer point as the point at which a person is no longer capable of performing an important task or function such that responsibility for that task or function must be transferred to another person. Because many older adults worry that if they experience cognitive decline they might lose their ability to function in ways they value, there’s growing interest in the possibility that AI systems might help older adults maintain their independence. This paper identifies several strategies through which AI systems might help older adults avert agency transfer points caused by cognitive decline. Although safe and effective assistive AI systems for older adults do not yet exist, it is important to proactively identify and address problems likely to result from their development and deployment. Importantly, although AI support might avert agency transfer points, there has been little recognition of the prospect that if individuals experience further declines in cognitive capacity, agency transfer points will reemerge. We therefore examine the ethical implications of alternative governance strategies and social policies for coping with the reemergence of agency transfer points for older adults who rely on AI systems to remain independent. This includes consideration of a requirement for contingency planning on the part of older adults as a condition of using such systems. We also consider the role that conversational AI systems might play in the process of contingency planning and after responsibility for some aspects of an older adult’s care has been transferred to another person.
London et al. (Sun,) studied this question.