The abundance of literature on ethical concerns regarding artificial intelligence (AI) highlights the need to systematize, integrate, and categorize existing efforts through a systematic literature review. The article aims to investigate prevalent concerns, proposed solutions, and prominent ethical approaches within the field. Considering 309 articles from the beginning of the publications in this field up until December 2021, this systematic literature review clarifies what the ethical concerns regarding AI are, and it charts them into two groups: (i) ethical concerns that (...) arise from the design of AI and (ii) ethical concerns that arise from human–AI interactions. The analysis of the obtained sample highlights the most recurrent ethical concerns. Finally, it exposes the main proposals of the literature to handle the ethical concerns according to the main ethical approaches. It interprets the findings to lay the foundations for future research on the ethics of AI. (shrink)

Words we use to characterize mental states matter; they affect, for better or worse, the individual whose mental states are in question. For example, referring to a child whose behavior seems a bit...

Conversational artificial intelligence (CAI) presents many opportunities in the psychotherapeutic landscape—such as therapeutic support for people with mental health problems and without access to care. The adoption of CAI poses many risks that need in-depth ethical scrutiny. The objective of this paper is to complement current research on the ethics of AI for mental health by proposing a holistic, ethical, and epistemic analysis of CAI adoption. First, we focus on the question of whether CAI is rather a tool or an (...) agent. This question serves as a framework for the subsequent ethical analysis of CAI focusing on topics of (self-) knowledge, (self-)understanding, and relationships. Second, we propose further conceptual and ethical analysis regarding human-AI interaction and argue that CAI cannot be considered as an equal partner in a conversation as is the case with a human therapist. Instead, CAI’s role in a conversation should be restricted to specific functions. (shrink)

Well before the COVID-19 pandemic, proponents of digital psychiatry were touting the promise of various digital tools and techniques to revolutionize mental healthcare. As social distancing and its knock-on effects have strained existing mental health infrastructures, calls have grown louder for implementing various digital mental health solutions at scale. Decisions made today will shape the future of mental healthcare for the foreseeable future. We argue that bioethicists are uniquely positioned to cut through the hype surrounding digital mental health, which can (...) obscure crucial ethical and epistemic gaps that ought to be considered by policymakers before committing to a digital psychiatric future. Here, we describe four such gaps: The evidence gap, the inequality gap, the prediction-intervention gap, and the safety gap. (shrink)

As COVID-19 spread, clinicians warned of mental illness epidemics within the coronavirus pandemic. Funding for digital mental health is surging and researchers are calling for widespread adoption to address the mental health sequalae of COVID-19. -/- We consider whether these technologies improve mental health outcomes and whether they exacerbate existing health inequalities laid bare by the pandemic. We argue the evidence for efficacy is weak and the likelihood of increasing inequalities is high. -/- First, we review recent trends in digital (...) mental health. Next, we turn to the clinical literature to show that many technologies proposed as a response to COVID-19 are unlikely to improve outcomes. Then, we argue that even evidence-based technologies run the risk of increasing health disparities. We conclude by suggesting that policymakers should not allocate limited resources to the development of many digital mental health tools and should focus instead on evidence-based solutions to address mental health inequalities. (shrink)

Smartphone apps might offer a low-threshold approach to the detection of mental health conditions, such as depression. Based on the gathering of ‘passive data,’ some apps generate a user’s ‘digital phenotype,’ compare it to those of users with clinically confirmed depression and issue a warning if a depressive episode is likely. These apps can, thus, serve as epistemic tools for affected users. From an ethical perspective, it is crucial to consider epistemic injustice to promote socially responsible innovations within digital mental (...) healthcare. In cases of epistemic injustice, people are wronged specifically as epistemic agents, i.e., agents of the production and distribution of knowledge. We suggest that epistemic agency relies on different resource- and uptake-related preconditions which can be impacted by the functionality of passive self-tracking apps. We consider how this can lead to different forms of epistemic injustice (testimonial, hermeneutical, and contributory injustice) and analyze the influence of the apps’ use on epistemic practices on an individual level, in mental healthcare settings, and on the structural level. (shrink)

Contemporary and emerging chatbots can be fine-tuned to imitate the style, tenor, and knowledge of a corpus, including the corpus of a particular individual. This makes it possible to build chatbots that imitate people who are no longer alive — deathbots. Such deathbots can be used in many ways, but one prominent way is to facilitate the process of grieving. In this paper, we present a framework that helps make sense of this process. In particular, we argue that deathbots can (...) serve as affective scaffolds, modulating and shaping the emotions of the bereaved. We contextualize this affective scaffolding by comparing it to earlier technologies that have also been used to scaffold the process of grieving, arguing that deathbots offer some interesting novelties that may transform the continuing bonds of intimacy that the bereaved can have with the dead. We conclude with some ethical reflections on the promises and perils of this new technology. (shrink)

Some claim that digital phenotyping will revolutionize understanding of human psychology and experience and significantly promote human wellbeing. This paper investigates the nature of digital phenotyping in relation to its alleged promise. Unlike most of the literature to date on philosophy and digital phenotyping, which has focused on its ethical aspects, this paper focuses on its epistemic and methodological aspects. The paper advances a tetra-taxonomy involving four scenario types in which knowledge may be acquired from human “digitypes” by digital phenotyping. (...) These scenarios comprise two causal relations and a correlative and constitutive relation that can exist between information generated by digital systems/devices on the one hand and psychological or behavioral phenomena on the other. The paper describes several modes of inference involved in deriving knowledge within these scenarios. After this epistemic mapping, the paper analyzes the possible knowledge potential and limitations of digital phenotyping. It finds that digital phenotyping holds promise of delivering insight into conditions and states as well producing potentially new psychological categories. It also argues that care must be taken that digital phenotyping does not make unwarranted conclusions and is aware of potentially distorting effects in digital sensing and measurement. If digital phenotyping is to truly revolutionize knowledge of human life, it must deliver on a range of fronts, including making accurate forecasts and diagnoses of states and behaviors, providing causal explanations of these phenomena, and revealing important constituents of human conditions, psychology, and experience. (shrink)

Sedlakova and Trachsel (2023) identify a major benefit of conversational artificial intelligence (CAI) in psychotherapy as its ability to expand access to mental healthcare for vulnerable populatio...

Sedlakova and Traschel argue that conversational artificial intelligence (CAI) is more than a mere tool, but not quite an agent, as it “simulates having a therapeutic conversation [but] does not re...

The practice of self-diagnosing, amplified by the spread of psychiatric knowledge through social media, has grown rapidly. Yet, the motivations behind this trend, and, critically, its psychological repercussions remain poorly understood. Self-ascribing a psychiatric label always occurs within a broader narrative context, with narratives serving as essential interpretive tools for understanding oneself and others.In this paper, we identify four principal motivators for people pursuing self-diagnosis, pertaining to 1. waiting time and cost of mental health resources, 2. recognition, 3. identity formation, (...) and 4. destigmatization. We compare these motivators against the backdrops of psychiatric narratives, including DSM-based (operationalism), bio-medical, and Neurodiversity narratives, to evaluate the psychological implications of self-ascriptions. We show that while self-ascription aligns with many motivations, it also carries the risk of essentialism across all analyzed narratives, which can over-simplify and sometimes misrepresent people’s attempts to find meaning through psychiatric labels. Essentialism makes narratives less comprehensive, responsive, and resourceful.We contend that self-ascriptions are not inherently problematic; instead, they show the need for greater focus and understanding in psychiatric practices and the importance of incorporating people’s experiences and perspectives in clinical settings. However, both the narratives and the social climate from which they emerge may need adjustments to make self-ascriptions meaningful, comprehensive, and resourceful tools. (shrink)