There is a moment, often somewhere in our 50s or 60s when the future shifts its angle. The horizon draws closer, the noise recedes, and a quieter question makes itself heard: What do I want to leave behind?

Not the inventory of possessions, but the pattern of our presence. The imprint of our care. The courage of our convictions. The habits of kindness that might keep on happening after we are gone.

This blog is an invitation to linger with that idea of legacy: how the desire to leave something of worth shapes our older age; what the psychology says; and how we can attend to it in ourselves, in our families, and in the craft of social care.

I find myself in this space because this past week I’ve been reflecting on my own late twin brother who died 8 years ago last week. Too soon and too young, with so many left empty by his absence. As is so often the case in someone who knows that they are going to die, we did not spend the time that we could have in reflecting or speaking about what life had been like. We spent the time we had left together in laughter and remembrance, in anecdote and fondness, keeping the uncomfortable away and the fear largely unmentioned.

But this past week both because of his own early death and because of so many others who I know, and the far too frequent conversations I have, I have spent time reflecting on legacy and purpose.

It is perhaps a truism to say that there are days when life’s timetable is torn up. A diagnosis, a sudden decline, and the horizon that once stretched decades ahead now feels alarmingly near.

Psychologists have long observed that, in mid-to-late life, that many of us turn outward with a concern for the generations to follow. My old psychologist inspiration Erik H. Erikson called this generativity, the developmental pivot from “What did I achieve?” to “Whom and what did I grow?” The fruits are not just external. It is the impulse to nurture what will outlast us.

Generativity predicts better well‑being and even stronger cognition in later life, whereas its shadow which is described as stagnation can shrink our world to self-preoccupation, which is often the accusation of those in older age.

What is undeniable is that numerous sources of research show that people who engage in legacy-building, through storytelling, mentoring, or creating tangible gifts, report lower anxiety, greater sense of purpose, and improved emotional well-being, even in palliative contexts.

Legacy work is not about grandeur. It is about continuity: ensuring that something of our values, our love, our wisdom remains in the world when we cannot and perhaps especially in the lives of those whom we have loved and who mean so much to us.

Another favourite, Dan McAdams’ psychological research adds texture to the work of Erikson on legacy, arguing as he does that highly generative people tend to tell redemptive life stories, transforming setbacks into service, threading meaning through adversity; such narrative style correlates with psychological adaptation and prosocial engagement. Legacy is not only what we do; it is how we narrate what we’ve done, which is in and of itself critical because that story mobilises us to keep giving. It is the words we chose to tell the tale of our being in life.

As we grow older and age we also reorganise our motivations. Laura Carstensen’s work on Socioemotional Selectivity Theory shows that as time horizons feel shorter, we prioritise emotionally meaningful goals and relationships. Legacy work naturally fits this shift: we invest in fewer, deeper ties and do things whose meaning can be felt now and remembered later.

We can see this in clinical and care contexts as well. Life review work which was first described by Robert Butler in the 1960s, offers structured reflection that helps older adults integrate memory, resolve regrets, and move towards integrity. It’s a cornerstone in later‑life and palliative practice, and when facilitated well and sensitively, it can reduce distress and enhance a sense of coherence: a psychological soil in which legacy grows.

Then at the end of life, Dignity Therapy takes this further: a brief, guided process that invites people to record what they most want remembered. Research trials report heightened dignity, meaning, and perceived benefit for families with the legacy document becoming a tangible bridge between the living and the soon‑to‑be‑bereaved.

If we want to leave something of worth, psychology suggests two reciprocal movements: doing (generative acts) and meaning-making (stories that redeem and bind).

This past week I have been reflecting on the extent to which in residential care and in homecare in all our palliative care and support of residents and citizens whether we have properly maximised the potential of legacy work. Because even accepting all the understandable constraints of time, resource and capacity I am not sure we have. And at the same time I am equally convinced just how important for the grieving and bereavement of those we leave behind; how critical it is that we do much better at this work which is to aid the art of dying and the gifting of legacy.

For those of us whose work it is to care and support folks at the end of their lives, I think we need to get better at embedding life review and legacy work in assessments and care planning (especially in hospice, care homes, and community nursing). We need to train staff in dignity‑conserving practices; create quiet rituals for recording and returning a person’s words to their family. We need to measure outcomes beyond symptom control: track family perceptions of meaning, appreciation, and connectedness post‑bereavement.

All that might just start by asking the ‘why’ questions, however provisional they may be. An encouragement to try to write a brief “legacy sentence”: “I want the people and places I love to be more X because I was here.”  It might move on to a guided life review where time is set aside – together or alone – to walk your story: chapters, turning points, the regrets that still disquiet, the gifts you’ve given and received.

And of course, all of this means tackling head on all the barriers that silence people. Those who have spent a life convincing themselves that they have nothing to leave. This is poverty of imagination, not of worth. Those who say, “Talking about death feels morbid.” Completely understandable on the one hand but at the same time we know that shared meaning and esteem buffer anxiety. In community, we can approach finitude not with fear but with craft: rituals, conversation, song. And there is so much more practitioners of endings in care home and community can do.

Legacy is not the marble we carve; it is the meal we keep setting. It is the apprentice we welcome into the workshop; the young carer we notice and support; the foreign‑born neighbour we draw into our circle until this land is also theirs.

Our social care, when at its best, is legacy in motion: the daily transfer of attention from one generation to the next. It is where the values we say we hold are stress‑tested against reality. If we make our services places where people can remember, make meaning, and give one last time, then we will have honoured the dignity of ageing and have given space and place to a legacy that never ends.

Bequeathal

Leave not the stone with your name,
leave the path you wore through the field,
the one that knows your footfall and invites another’s tread.

Leave not the chair at the table,
leave the habit of an extra place,
the cup that finds the hand that trembles.

Leave not the answer, clean and sure,
leave the question, kindly asked,
that opens like a gate and lets the younger through.

Leave not the purse alone,
leave the skill of open hands,
and the craft of making enough into plenty.

Leave not the speech fine‑phrased,
leave the story told in kitchens,
where steam writes blessings on the window glass.

Leave not a claim on land,
leave belonging to a people,
soil in the marrow, duty turned to joy.

And when the light goes thin,
and names begin to loosen from their faces,
let what you have planted be your speaking:
the neighbourly knock; the steady chair;
the path; the cup; the open gate.

 

My late twin had two loves in his life – his family and his roses – after he had died, I took cuttings of some of the roses and to my great surprise managed to get them to grow in my own garden in another country from their original soil. Even after transplanting they lived on – a memory, a legacy of his creativity and so much more. Planting what outlives us in hope and love, dignity and desire, is the work we should all seek to undertake, every day.

If legacy is love with a timetable, then ageing is not the end of that work; it is the season when love gets organised. May we be found busy planting what will outlive us and may Scotland’s people and places be the richer for it.

Donald Macaskill

Photo by Amarbayasgalan Gelegjargal on Unsplash

The third Saturday of January 2026 arrives not with celebration, but with a heavy sense of reckoning. The Scottish Government’s newly announced Budget, for all its rhetoric of renewal, has once again relegated social care to the margins. For those of us who live and breathe social care, this is not just a policy disappointment rather it is a profound moral failing. The question before us is urgent and inescapable: What kind of Scotland do we want to create together, and why does our Government not share that vision?

Every day, in every corner of Scotland, social care is the quiet infrastructure that holds our communities together. It is not a discretionary spend, nor a luxury to be afforded only in times of plenty. It is the scaffolding that allows individuals to thrive, families to stay together, and communities to flourish. Yet once again, this Budget treats care as an afterthought: “a budget that talks about dignity but does not fund it”.

In the wake of this Budget, each of the six pillars which comprise the vision within  the Scottish Care 2026 Election manifesto Care Creates feel more like a distant aspiration than a policy reality. Rights‑based budgeting and ethical commissioning remain words on paper, not principles in practice. The workforce; already stretched to breaking, faces another year of undervaluation and uncertainty. Promises of integration and innovation ring hollow without the resources to make them real. And now, Scottish Care’s own analysis makes the picture starker: the budget “falls dramatically short of what is required to protect essential care and support services, the workforce that delivers them, and… the individuals, families and communities who rely on them.”

We cannot ignore the consequences of this chronic underfunding. Workforce shortages deepen, finances grow ever more fragile, and the scars of austerity persist. Increasingly we are relying on people to pay more and more for their own care and support whilst the Government pays less and less. Increasingly this current Government is creating a two tier social care system in Scotland whether by default or deliberate design. The Government has failed to meet COSLA’s call for an additional £750 million in core funding to stabilise and grow social care support. Instead, providers are left “delivering more with less,” absorbing unsustainable costs and shielding people from the fallout of an under‑resourced system.

“Care Creates” is not just a campaign tagline; it is a summons to action and a framework for transformation. The Scottish Care Manifesto for 2026 sets out a bold, necessary vision: six pillars that, if embraced, could reshape our nation.

1. Rights at the heart of Social Care

Human rights are non‑negotiable. Embedding rights‑based budgeting and ethical commissioning ensures decisions reflect the voices of those who rely on support. Yet, as the Budget analysis makes clear, this Government has again offered “no ring‑fenced protection for social care support, no alignment to the true cost of care”. Human rights cannot flourish in the vacuum left by insufficient investment.

2. Fair Pay, Fair Work, Fair Care

A thriving social care system demands a valued workforce. Fair remuneration, career progression and parity with NHS roles are essential. But “warm words will not pay the bills”. The Real Living Wage uplift, while welcome, remains inadequate without funded differentials or career pathways. With thousands of vacancies, we cannot afford to lose more skilled professionals to sectors offering better pay and lower responsibility.

3. Integration across systems

Care cannot exist in silos. We know that integrated care teams reduce admissions and transform outcomes. But without resources, integration is rhetoric. Today we face “crisis conditions” where unmanaged pressures threaten to further reduce care packages and increase unmet need across health and social care. We are faced with the sad daily reality that people are dying whilst waiting for their care but because they are unseen by everyone except their families, they are the hidden victims of a broken system.

4. Future‑Ready Care

Our sector has proven its capacity for innovation, from digital tools to climate‑conscious planning. Ethical AI and adaptive models offer huge potential- but only if investment matches ambition. Instead, Scotland remains “a decade behind before we even begin,” with key digital infrastructure not expected to be social‑care‑ready until 2029 – an “unacceptable delay” that entrenches inefficiency and stalls innovation.

5. Investing like it matters

Funding care is not charity: it is a strategic, national economic investment. Every pound invested in social care returns more than double in socio‑economic value, strengthening local economies and enabling people to live well in their communities. Yet this Budget once again chooses not to unlock those benefits for Scotland.

6. Care for people and planet

Ethical commissioning, sustainability and community wellbeing must shape every decision. But the absence of robust investment renders environmental and community ambition fragile. As Scottish Care notes, “This Budget does not meet the moment”: a moment demanding bold choices, not incrementalism.

The “Care Creates” campaign exists to shift public and political understanding: social care is not a cost to be contained, but an essential investment in Scotland’s future. It underpins health, drives economic participation, sustains communities and supports family life. Yet at a time when “providers are closing” and “workforce shortages are at crisis levels”, Scotland’s Budget has offered neither boldness nor stability.

It has chosen caution where courage was required.

It has chosen system preservation over human flourishing.

It has chosen short‑termism over Scotland’s long‑term wellbeing.

Disappointment must not become despair. Realistic positivity means acknowledging the constraints while refusing to surrender hope. It means saying: Yes, the road is hard, but it is not impassable. It means recognising that although Government has not led, we will.

As Scottish Care affirms:
“Investing in social care support is not a cost, it is a national dividend. Care creates stability. Care creates opportunity. Care creates Scotland’s future.”

Even as we face disappointment, we are never alone. Together we can influence change, support those who suffer, and celebrate the compassion, expertise and community that define our sector. With courage, creativity and solidarity, we can build the Scotland we know is possible; one where social care is not an afterthought, but the beating heart of national life.

Care creates Scotland’s future.
If our Government will not lead, then we must.

Donald Macaskill

Photo by Nick Fewings on Unsplash

 

The turning of the year always invites reflection and an opportunity to consider both personal and societal priorities and ambitions. It offers us an opportunity to reflect not only on what lies ahead but on what binds us together as a community and for me the ties that bind us are often seen best and most clearly at times of loss and grief. Bereavement is not a private shadow; it is a communal experience that shapes the health and wellbeing of our society. As we step into January, I am thoughtful of the extent to which as a society and as communities in Scotland we do or do not support every single person who is living with loss and experiencing grief in our midst at this time.

Bereavement is not merely a health service concern; it is a public health issue. Research shows that unresolved grief increases risks of mental illness, physical health decline, and economic strain through lost productivity and higher healthcare costs. I became very well aware of this whilst serving as a Commissioner on the UK Bereavement Commission and listening to the stories of hundreds of individuals whose lives were so damaged by grief. Poor bereavement support both costs lives and cripples our economic wellbeing. A very convincing article in The Lancet some eighteen months ago reminds us that failure to integrate bereavement care into public health systems leaves families vulnerable to illness and isolation, exacerbating the societal toll of loss. It forcefully argues what I believe personally to be truthful and that is that investing in bereavement care and support is a public health priority.

This past week those individuals and organisations involved in Scotland’s National Charter on Bereavement for Adults and Children, which was launched in 2020, published their Manifesto for the upcoming Scottish Parliamentary elections.

The manifesto calls for:

• A National Bereavement Lead within government to coordinate policy and ensure bereavement does not fall between departmental cracks.
• Investment in Bereavement Charter Marks for workplaces, schools, and other locations such as prisons and ordinary businesses thus creating cultures of compassion where grief is acknowledged and supported.
• Community Partnerships that embed bereavement support in local networks, from hospices to voluntary groups.

The Manifesto uses a number of case scenarios to show the sort of success that has been achieved to date, all of which evidence compassion in practice and the positive impact that good bereavement support can bring to communities as well as individuals.

It tells the story of ten Scottish schools who have embraced the Bereavement Charter Mark, integrating grief literacy into education and partnering with local hospices. Teachers report that this work “takes a village” building resilience and empathy among pupils and staff alike. The Manifesto shows how employers adopting bereavement-friendly policies have seen improved staff wellbeing and retention. As one case study notes, “a single act of kindness kept me afloat”—a reminder that organisational culture can transform grief into belonging.

Strong bereavement support is not charity; it is social infrastructure. A 2023 study by Marie Curie and Warwick University found that equitable access to bereavement care reduces health inequalities and fosters community cohesion, particularly for marginalised groups. When grief is met with understanding, people return to work sooner, families avoid crisis, and communities grow stronger.

The Charter Group is making simple asks of our new parliamentarians and whoever it is that will form the next Scottish Government. These practical steps are to:

1. Fund the Vision: Allocate resources for Bereavement Charter initiatives – especially by resourcing the process with £250K over three years which is a modest investment for systemic change.
2. Appoint a National Bereavement Lead: The next Government needs to create a dedicated role within Scottish Government to coordinate bereavement policy and practice across departments.
3. Develop a National Bereavement Strategy: The lack of a national strategy is a real gap in Scottish public policy. We need to co-produce a national strategy for bereavement support, building on the Charter and addressing gaps in the current palliative care strategy
4. Embed Bereavement in Public Health strategies: We need to integrate grief support into mental health and wellbeing plans, ensuring timely, culturally competent care. This can be achieved by more groups adopting the Charter Mark, but that work needs to be resourced.
5. Mobilise Communities: We need to encourage local employers, schools, and voluntary groups to adopt Charter principles and collaborate with bereavement organisations, and lastly
6. Prioritise Succession Rights in the Housing Bill: We need to implement actions to protect the housing rights of terminally ill people and bereaved families.

As someone who has walked alongside countless individuals and families in the aftermath of loss, I know that bereavement is not an event rather it is a landscape. It shapes how we live, work, and belong. Policy matters because it signals what we value as a society. When we invest in bereavement support, we invest in humanity. When we consider bereavement support as a matter of societal and economic priority then we shape our communities into places where all are welcome, where none are excluded even in the rawness of grief and the pain of absence. Bereavement support opens the door to belonging.

Belonging is not a feeling we manufacture; it is a practice we share. It looks like a school that teaches grief literacy and a workplace that keeps the door open when someone returns. It looks like a local café that knows how to hold a silence, and a parish that lights a candle with a name. It looks like government appointing a Bereavement Lead and resourcing Charter Marks so compassion becomes ordinary and everywhere. It looks like the neighbour who brings bread, the nurse who calls back, the friend who sits and says nothing at all. If we want a Scotland where everyone has a place, then we must keep making places where grief is met, supported, and held. When we invest in bereavement support, we invest in community. When we stand with the grieving, we stand with ourselves.

The UK Commission on Bereavement captured this truth with clarity:

“Bereavement is everyone’s business. It is not a niche concern but a universal experience that demands a collective response.”

Starting the year with compassion means making this more than a slogan. It means embedding bereavement care and support into the architecture of our communities and the heart of our governance. As we’ve set out in the Charter and its Manifesto, these are simple, fundable acts that make compassion part of the everyday. Let us make 2026 the year we turn manifesto into movement.

I am mindful of one of my favourite poems from a favourite poet, Jackie Kay, who offers us a tender, communal vision of how those who have died  “are still here holding our hands,”

Darling

You might forget the exact sound of her voice
or how her face looked when sleeping.
You might forget the sound of her quiet weeping
curled into the shape of a half moon,

when smaller than her self, she seemed already to be leaving
before she left, when the blossom was on the trees
and the sun was out, and all seemed good in the world.
I held her hand and sang a song from when I was a girl –

Heel y’ho boys, let her go boys –
and when I stopped singing she had slipped away,
already a slip of a girl again, skipping off,
her heart light, her face almost smiling.

And what I didn’t know or couldn’t say then
was that she hadn’t really gone.
The dead don’t go till you do, loved ones.
The dead are still here holding our hands.

Darling by Jackie Kay – Scottish Poetry Library

 

Donald Macaskill

Photo by Priscilla Du Preez 🇨🇦 on Unsplash.

As the calendar turns and we stand at the threshold of a new year, I find myself drawn to reflection not least on what I consider to have been the significant changes and developments in social care in the last year, and what this new one might bring. That for me has undoubtedly been in the arena of Ai in social care. I am reflective of the journey so far, the companions who have shaped my thinking, and the ethical crossroads that lie ahead for social care in Scotland.

The rapid advance of artificial intelligence in our sector is not just a technical story; it is, at its heart, a human one. And as we look forward, I believe it is essential to ground our ambitions in the enduring values of dignity, autonomy, and justice. I offer this extended thought piece as a contribution to that ambition.

My first instinct is gratitude. The conversations and collaborations of the past year, especially with the Institute for Ethics in Ai at Oxford, the Digital Care Hub, and Casson Consulting, have given our sector a shared language for what ‘responsible’ Ai should mean in social care. Their Summit and White paper gave us a shared language for dignity, autonomy and equality in the age of automation. I am equally grateful for the practical clarity offered by the AI & Digital Regulations Service (AIDRS), which brings together NICE, MHRA, CQC and HRA in England to help health and social care organisations navigate regulation. And I acknowledge UN human‑rights experts who have insisted, I think quite rightly, that the procurement and deployment of AI must be grounded in robust human‑rights due diligence.

All this work has served to remind me that human rights and ethics is not an afterthought, but the very foundation of innovation.

Why a human‑rights approach to AI in social care is non‑negotiable

Ai is already here in adult social care. We see systems that transcribe and draft notes and care assessments, support language translation, monitor movement to reduce falls, and triage requests for support. These tools hold promise, but they also reach into the most intimate spaces of life, our homes, our relationships, our routines. That depth of reach demands a depth of ethics. Oxford’s work in our field is clear: responsible use means Ai must support and never undermine human rights, independence, choice and control, dignity, equality and wellbeing. UN guidance adds the necessary governance spine: carry out human‑rights due diligence across the Ai lifecycle, engage those most affected, and ensure access to remedy.

Regulatory currents are shifting underneath us. The EU’s Artificial Intelligence Act is now law, with staged obligations and a risk‑based structure that bans certain “unacceptable‑risk” practices (for example, systems that exploit vulnerabilities or enable unlawful mass surveillance), sets transparency duties for limited‑risk systems, and imposes stringent requirements on high‑risk uses. Even for Scottish providers, this matters: EU rules apply whenever AIisystems or their outputs are placed on the EU market or used in the EU which is an extraterritorial pull that many supply chains and software subscriptions already trigger.

In the UK, there is as yet no single Ai Act. Instead, a regulator‑led approach asks sector regulators to enforce five core principles (safety, transparency, fairness, accountability, redress) under existing law. For health and social care, AIDRS and NHS information‑governance guidance have become the de facto playbooks: proportionate assurance, safe evidence, clear data rights, and ethical oversight. In short: the EU sets a high, codified floor; the UK expects context‑based governance through existing duties. Scotland must live comfortably with both. I would particularly commend here the blog written by John Warchus which unpacks some of this hinterland.

PANEL: how I turn “rights” into decisions

In a previous article I argued that this is an ethical and rights space that benefits from the implementation of the well-recognised PANEL human rights framework. Nothing that is happening now has changed that perspective and personally I would commend the continued use of the PANEL principles: Participation, Accountability, Non‑discrimination, Empowerment, Legality, to move from slogans to practice. Let me illustrate some of this:

Participation

People who draw on care, unpaid carers and frontline staff should shape Ai before it arrives. Participation is not a survey at the end; it is co‑design at the start and dialogue throughout. The Oxford collaboration modelled this: bringing people with lived experience into the room, defining “responsible” in the language of care, not merely in the grammar of compliance. In my view, participation must include real choices about trade‑offs, say, between night‑time safety and the sanctity of the home, because these are moral choices, not merely technical settings.

Mrs M lives with frailty and prefers to sleep with her door ajar. Her care home trials a thermal‑imaging night monitor to reduce falls. In a participation session, residents and families ask: Can we disable the device in private moments? Where is the data processed? Who can review it? The home agrees to local (on‑premise) processing, automatic masking of faces, visible “privacy on” indicators, and a resident‑controlled off‑switch. The result is not the absence of technology; it is what Jenna Joseph calls consented technology.

Accountability

We need an accountability map for every deployment: who is the provider/deployer and who is the vendor/importer; who signs off risks; who investigates incidents; how can residents and staff escalate concerns; what goes into the public learning log? The EU AI Act gives practical scaffolding, namely roles, risk management, post‑market monitoring, all of which I would contend Scottish providers can adopt to make accountability legible even in a UK regime that leans on existing law.

A local authority pilots an LLM that drafts care assessments from worker dictation. After several weeks, managers notice the model confidently inserts “no risk of self neglect” where the worker had simply paused. An incident is logged; the authority’s accountability map lets a resident, a worker and the vendor meet to replay the transcript and model output. The authority introduces a “yellow banner” policy: any AI generated statement about risk must be explicitly confirmed by the social worker, or it is struck out. This example builds on some of the excellent ethical considerations espoused by Rees and Edmonson.

Non‑discrimination

Bias audits must be routine. Predictive models trained on skewed data can channel more surveillance toward some groups than others, or depress service offers without anyone intending harm. NHS ethics work emphasises countering inequalities; UN guidance insists on HRDD with those most at risk. In social care, we should publish fairness metrics, not hide them in procurement files.

A homecare provider uses an Ai scheduler. Complaints rise from women working school‑hours who get fewer paid visits. A fairness audit shows the model equates “availability” with a 12‑hour window and penalises constrained patterns. The provider resets the objective function to value continuity of relationship and paid breaks, not only distance and minutes. Complaints fall; retention rises.

Empowerment

Human rights require capability. We must make explanations understandable, options visible, and opting‑out feasible. Generative tools should lower barriers for those who do not speak English as a first language, or who want draft letters in accessible formats, without locking people into systems they cannot question. UK information‑governance guidance is clear: professionals remain decision‑makers, and individuals retain rights over their data.

Amira, recently arrived in Scotland, struggles to draft a support request. A co‑produced LLM assistant helps her write in Arabic and produces a plain‑English summary for her key worker. The service’s policy, shaped with users, states that the assistant never submits letters; Amira reads, edits and approves every word. Empowerment is the difference between a tool that writes for me and one that lets me say what I want to say.

Legality

We must separate lawful bases for direct care from those for training or improving systems. We need Data Protection Impact Assessments (DPIAs), contracts that say what data can (or cannot) be used for, and documentation that shows how we manage risk. For high‑risk uses, the EU AI Act expects a full risk‑management system and technical documentation; UK guidance expects the same good governance, anchored in GDPR and equality law.

A supplier proposes to “improve accuracy” by training on de‑identified care plans. The provider’s DPIA flags re‑identification risk for small island communities. The contract is amended: no secondary use without explicit, revocable permission from the individual; only synthetic or federated approaches may be used for model refinement; independent re‑identification testing is required before release.

 The human rights we must actively protect (and how AI touches each)

When I talk about a human‑rights approach, I mean specific rights not vague goodwill.

• Dignity: The first test is always whether the person’s sense of self is enhanced or eroded. Ambient sensors and “smart” cameras risk reducing people to data points, especially older adults. Dignity is preserved when surveillance is not the default; when there are off‑switches; when people choose how technology shows up in their home.
• Privacy: Home should remain a sanctuary. Data minimisation, local processing, strict retention limits and audit trails are the ethics that make sanctuary possible. The EU AI Act’s bans and transparency duties give guardrails, but we must reach for the higher standard of trustworthiness experienced by the person.
• Autonomy and Informed Consent: Consent for direct care is not consent for model training. People should be able to say “yes” to one and “no” to the other. Explanations must be understandable, and meaningful alternatives must exist. UK IG guidance is explicit about these distinctions in care contexts.
• Equality and Non‑discrimination: Age, disability, race, language and socio‑economic status can interact with AI in harmful ways. UN experts call for HRDD with at‑risk groups; NHS programmes focus on countering inequalities. Make fairness testing public and fix disparities quickly.
• Participation and Voice: People affected by Ai must have a say. Co‑production is a right, not a courtesy. Oxford’s co‑produced guidance shows how to do this well in social care.
• Accountability and Remedy: Grievance routes should be accessible and non‑retaliatory, with independent escalation. Document AI incidents (privacy breach, discriminatory output, harm to autonomy/dignity) and publish learning. AIDRS provides pathways for when regulatory notification is required.
• Workforce right and professional judgement: AI must augment care and support work, not deskill workers or micro‑surveil them. Scheduling and productivity analytics need limits and worker voice. Oxford’s governance work and sector commentary both underline this.

Scotland’s digital and policy context: making rights operational

Scotland’s Data Strategy for Health and Social Care emphasises data ethics, interoperability and “better use of data” in preventative care, with work underway toward an Ai policy framework. This is precisely where PANEL and HRDD must be baked in, not as an afterthought, but as the organising principle for design, procurement and evaluation. The Scottish AI Alliance has moved the public sector toward greater AI transparency, and that same ambition should explicitly extend to adult social care.

Scotland’s continuing debate on social care reform and international human rights incorporation is a reminder that law matters when resources are thin and systems are stressed. As the Health and Social Care Alliance have  clearly articulated Ai  must never become a technical shortcut for structural under‑investment. Efficiency that erodes relationships or displaces human judgement is not progress; it is a re‑statement of the very problems we claim to solve.

On a Hebridean island, a care provider is offered a “smart home” package: video monitoring, voice analysis, predictive alerts. The team ask residents to join a design circle. The answer that emerges is: “No, unless it is privacy‑first, entirely local, and unless our crofts feel like crofts, not clinics.” The vendor re‑engineers the solution: devices process on‑device; cameras are replaced by door sensors and pressure mats; and a human call‑back is guaranteed within 10 minutes of any alert. Rights shape the technology, not the other way round.

 

How EU and UK legislation will impact social care in Scotland

Let me put this plainly and practically.

EU AI Act: what Scottish providers must understand accepting the comment above about best practice and legal requirement given our non-membership of the EU at present.

• Risk‑based duties: The Act bans certain uses outright (e.g., systems exploiting vulnerabilities, certain emotion‑inference and untargeted biometric scraping), requires transparency for limited‑risk tools (like chatbots), and imposes heavy governance on high‑risk systems (risk management, data governance, technical documentation, post‑market monitoring). In social care, high‑risk categories often include systems that materially influence access to services or safety, or that manage workers in consequential ways.
• Who is on the hook? The Act distinguishes providers (those who develop or place a system on the market) from deployers (those who use it), as well as importers and distributors. A Scottish care organisation using a vendor’s tool is typically a deployer but may inherit provider‑like obligations when customising or substantially modifying a system. Contracts must make these roles explicit.
• Extraterritorial pull: If your system or its outputs are used in the EU – perhaps because you serve people funded from an EU jurisdiction, or your vendor markets the same configured product into the EU- you can be brought under the Act’s scope. Care technology is global; procurement must assume cross‑border obligations.

A Scottish care home adopts a falls‑prediction platform from a vendor whose product is also sold in the Netherlands. The vendor classifies the system as high‑risk under the EU Act and asks the home to contribute to real‑world performance monitoring. The home agrees on conditions: the vendor provides the conformity assessment and post‑market monitoring plan; the home captures outcome data only with resident consent and publishes a lay summary locally. The result: the home benefits from better safety while remaining on the right side of both EU and UK expectations.

UK approach: what anchors apply in Scotland

• Principles via existing law: The UK expects regulators to apply five core principles through current frameworks rather than creating a single AI statute. For social care, this means leaning on UK GDPR, equality law, and sector IG rules, plus clear, proportionate assurance. AIDRS acts as the navigational aid across NICE, MHRA, CQC and HRA.
• Health/social care specifics: NHS information‑governance guidance clarifies consent, data minimisation, and the continuing role of professionals as decision‑makers. The NHS AI Ethics initiatives and MHRA’s “AI Airlock” are developing practical safety and evidence expectations, useful anchors even when tools are used in social care rather than the NHS.
• So what for Scotland? Health and social care are as we know devolved, but UK regulators and guidance still shape market behaviour. Scottish providers should adopt the highest applicable standard: use EU AI Act role definitions and documentation discipline, follow UK IG rules on data and consent, and align with Scotland’s Data Strategy commitments on ethics and transparency. This “belt and braces” approach reduces risk, builds public trust, and future‑proofs practice.

Practice patterns I commend:

• Co‑produce from the outset: Assemble standing forums of people who draw on care, unpaid carers and staff to review proposals, test interfaces, and agree consent flows. Treat this as governance, not engagement.
• Publish an Ai register: What systems do we use? Why? What data do they process? What is the lawful basis? Who is accountable? How can people complain? (If you only have a procurement file, you do not have accountability.)
• Bias and equity routines: Run fairness tests at go‑live and on a schedule; commission independent audits for consequential systems; correct disparities and publish fixes.
• Privacy‑by‑default architecture: Prefer local processing; minimise retention; create human‑readable logs so that residents and families can see what happened and why.
• Explainability for humans: Build short, accessible explanations; train staff to challenge the model and to document overrides; avoid any fully automated adverse decision.
• Contracts that protect rights: Require vendors to disclose training data sources, known limitations, bias mitigations, and incident response plans; prohibit secondary use without explicit permission; align role allocations with EU AI Act definitions.
• Remedy pathways: Offer simple reporting for residents and staff; classify incidents (privacy, bias, harm to dignity/autonomy); share learning in public. Use AIDRS to judge when to notify regulators.
• Worker voice and wellbeing: Set boundaries on algorithmic monitoring; involve staff and unions in tool selection; invest in digital and ethical literacy; design for augmentation, not substitution.

Closing reflection: the humanness of care

I hope you have found the above useful as we start to navigate Ai in social care in 2026 from a human rights and ethical perspective. There is a lot more to say in this conversation. But essentially social care is a human practice and art before it is a service. Ai will be judged not by how clever it seems, but by whether it helps people live the lives they choose, surrounded by relationships that dignify and sustain them. The frameworks are now at hand, the Oxford values‑led guidance, the UN’s HRDD expectations, the EU Act’s structure, and the UK’s principle‑based oversight. Our task in Scotland is to make them lived reality: to ensure that, in our homes and communities, technology becomes a tool for care, not a technique of control.

Donald Macaskill

Photo by Luke Jones on Unsplash