A chatbot could help Hero Images/Getty

Could chatbots lend a non-judgemental ear to people making decisions about the end of their life? A virtual agent that helps people have conversations about their funeral plans, wills and spiritual matters is set to be trialled in Boston over the next two years with people who are terminally ill.

People near the end of their lives sometimes don’t get the chance to have these important conversations before it’s too late, says Timothy Bickmore at Northeastern University in Boston, Massachusetts. So Bickmore and his team – which included doctors and hospital chaplains – built a tablet-based chatbot to offer spiritual and emotional guidance to people that need it. “We see a need for technology to intervene at an earlier point,” he says.

And it has already seen some success. Bickmore’s team initially tested the chatbot with 44 people aged 55 and over in Boston. Just under half those adults had some kind of chronic illness, and nearly all had spent time with someone who was dying. After spending time talking to the chatbot, most of the participants reported that they felt less anxious about death and were more ready to complete their last will and testament.


Next steps

For the next stage of the trial, Bickmore plans to give tablets loaded with the chatbot to 364 people who have been told they have less than a year to live. The slightly more souped-up version can also take users through guided meditation sessions and talk to them about their health and medication, as well as conversing on a wide range of religious topics.

The earlier people start considering how they want to die and what they want to happen afterwards, the easier it is for those around them to act on those decisions – for example, ensuring they don’t die in hospice if they would prefer to be at home.

The chatbot, does not, however, formalise any of these plans. Rather, if a person tells it that they’re getting ready to make decisions about their end-of-life plans, it will alert a family member or nominated caregiver to follow up on that conversation in real life.

Chatbots have come under fire recently for veering into inappropriate behaviour, so Bickmore kept things simple with his bot. Unlike voice assistants such as Alexa and Siri, it isn’t fully autonomous but sticks to a fairly rigid script, only asking people to choose options from a pre-written list of responses. An unscripted system, he says, might very easily “get into situations where the agent recommends things that are dangerous”.

Providing comfort

Bickmore says the chatbot could be particularly helpful for people that are socially isolated and otherwise wouldn’t be having difficult end-of-life conversations at all.

“It’s hard for humans to be non-judgemental when they’re having these kinds of conversations,” says Rosemary Lloyd from The Conversation Project, a charity that encourages people to have conversations about their end of life care. “So some people might find it easier to talk to a chatbot about their thoughts.”

Harriet Warshaw at The Conversation Project says a chatbot would be a good first step towards talking about end-of-life decisions with a loved one.

We’ve also long known that talking about difficult topics with automated agents is oddly comforting, whereas talking about your end-of-life decisions with people who will be most affected by them is particularly emotionally fraught.

Writer and film-maker Avril Furness agrees that technology can be a useful way to help people start having difficult conversations about death.

Furness, who has explored the subject of assisted suicide, says Bickmore’s chatbot system is another good way to get people thinking about the end of their life, helping them work through their feelings without worrying what someone else thinks. “This chatbot isn’t going to judge you.”