In the article ‘Represent Me: Please! Towards an Ethics of Digital Twins in Medicine’, I analysed and tried to better understand the main ethical challenges associated with Digital Twins. For those who are just entering the debate with this article: DT is a metaphor for a bundle of artificial intelligence driven simulation technologies that constantly, in real time and ad personam simulate single or multiple parts of the body and make predictions about future health states based on these simulations. My (...) argument addresses the need to look at the breadth of challenges through a perspective of representation. From such a take, key consequences can be drawn for the further development of such technologies, the required means of control and not least the way to think about the interaction between humans and ‘their’ simulations. I am very grateful for the subsequent suggestions, criticisms and further arguments, which have helped me to elaborate my arguments more clearly and have led to a substantial advancement of the debate and the discussion about ethical questions in dealing with DT. Jenny Blumenthal-Barby,1 Deborah Lupton,2 Jenny Krutzinna,3 Janina Loh,4 Brent Mittelstadt,5 Sven Nyholm,6 Daniel Tigard7 and Max Tretter8 have made excellent points, which, in the following, I will not be able to reply to individually and in detail. In this response, I will try to bundle the open points and questions along the comments and considerations mentioned above and attempt to outline their significance for an ethics of DT. Four challenges seem to be central. A first point addresses anthropological issues. It is concerned …. (shrink)

Critics currently argue that applied ethics approaches to artificial intelligence (AI) are too principles-oriented and entail a theory–practice gap. Several applied ethical approaches try to prevent such a gap by conceptually translating ethical theory into practice. In this article, we explore how the currently most prominent approaches of AI ethics translate ethics into practice. Therefore, we examine three approaches to applied AI ethics: the embedded ethics approach, the ethically aligned approach, and the Value Sensitive Design (VSD) approach. We analyze each (...) of these three approaches by asking how they understand and conceptualize theory and practice. We outline the conceptual strengths as well as their shortcomings: an embedded ethics approach is context-oriented but risks being biased by it; ethically aligned approaches are principles-oriented but lack justification theories to deal with trade-offs between competing principles; and the interdisciplinary Value Sensitive Design approach is based on stakeholder values but needs linkage to political, legal, or social governance aspects. Against this background, we develop a meta-framework for applied AI ethics conceptions with three dimensions. Based on critical theory, we suggest these dimensions as starting points to critically reflect on the conceptualization of theory and practice. We claim, first, that the inclusion of the dimension of affects and emotions in the ethical decision-making process stimulates reflections on vulnerabilities, experiences of disregard, and marginalization already within the AI development process. Second, we derive from our analysis that considering the dimension of justifying normative background theories provides both standards and criteria as well as guidance for prioritizing or evaluating competing principles in cases of conflict. Third, we argue that reflecting the governance dimension in ethical decision-making is an important factor to reveal power structures as well as to realize ethical AI and its application because this dimension seeks to combine social, legal, technical, and political concerns. This meta-framework can thus serve as a reflective tool for understanding, mapping, and assessing the theory–practice conceptualizations within AI ethics approaches to address and overcome their blind spots. (shrink)

The global landscape in which we wrote this essay has fundamentally changed. Given how these changes have altered the rhythm of life, particularly the added responsibilities that many of you have a...