The growing global population of older adults has intensified the need for technological approaches to address caregiver shortages and support independent living. Smart home health technologies (SHHTs) are increasingly promoted as practical and cost-efficient solutions. Alongside these benefits, the ethical implications of SHHTs demand careful examination. Following PRISMA guidelines, we performed a systematic review to explore the extent and manner in which ethical issues are considered in SHHTs for elder care. We analyzed 156 peer-reviewed articles in English, German, and French, retrieved from 10 electronic databases. Narrative synthesis revealed seven key ethical themes: privacy, autonomy, responsibility, human versus artificial interaction, trust, ageism and stigma, and other relevant concerns. Our findings reveal limited ethical attention in the development and deployment of SHHTs for older adults. This review emphasizes the importance of incorporating ethical considerations into the design, research, and application of smart home health technologies to improve elder care responsibly. This review is registered with PROSPERO (CRD42021248543).
