| Summary: | The article critically examines the ethical implications of wearable tracking devices used in dementia care, focusing on a case where a resident, Mr. Jenkins, is fitted with a location-tracking bracelet relocated from wrist to ankle to reduce his distress. This relocation conceals the device from his awareness, effectively silencing his nonverbal refusal and transforming his autonomy into compliance through what the author terms "dissent-proofing"—design strategies that minimize opportunities for residents to express refusal. The article advocates for a "dissent-by-design" approach that preserves and respects the capacity to refuse by making removal a protected, communicative act, ensuring responsive channels for resident-initiated signals, and maintaining perceptibility of devices to uphold spatial liberty. It also highlights the need for ethical safeguards, including strict data-use limitations and adequate staffing to respond to dissent, emphasizing that true ethical surveillance must allow residents not only to be seen but also to refuse and be heard.
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