On 8th August 2019, Secretary of State for Health and Social Care, Matt Hancock, announced the creation of a £250 million NHS AI Lab. This significant investment is justified on the belief that transforming the UK’s National Health Service (NHS) into a more informationally mature and heterogeneous organisation, reliant on data-based and algorithmically-driven interactions, will offer significant benefit to patients, clinicians, and the overall system. These opportunities are realistic and should not be wasted. However, they may be missed (one may (...) recall the troubled Care.data programme) if the ethical challenges posed by this transformation are not carefully considered from the start, and then addressed thoroughly, systematically, and in a socially participatory way. To deal with this serious risk, the NHS AI Lab should create an Ethics Advisory Board and monitor, analyse, and address the normative and overarching ethical issues that arise at the individual, interpersonal, group, institutional and societal levels in AI for healthcare. (shrink)

Traditional medical practices and relationships are changing given the widespread adoption of AI-driven technologies across the various domains of health and healthcare. In many cases, these new technologies are not specific to the field of healthcare. Still, they are existent, ubiquitous, and commercially available systems upskilled to integrate these novel care practices. Given the widespread adoption, coupled with the dramatic changes in practices, new ethical and social issues emerge due to how these systems nudge users into making decisions (...) and changing behaviours. This article discusses how these AI-driven systems pose particular ethical challenges with regards to nudging. To confront these issues, the value sensitive design approach is adopted as a principled methodology that designers can adopt to design these systems to avoid harming and contribute to the social good. The AI for Social Good factors are adopted as the norms constraining maleficence. In contrast, higher-order values specific to AI, such as those from the EU High-Level Expert Group on AI and the United Nations Sustainable Development Goals, are adopted as the values to be promoted as much as possible in design. The use case of Amazon Alexa's Healthcare Skills is used to illustrate this design approach. It provides an exemplar of how designers and engineers can begin to orientate their design programs of these technologies towards the social good. (shrink)

Forms of Artificial Intelligence (AI) are already being deployed into clinical settings and research into its future healthcare uses is accelerating. Despite this trajectory, more research is needed regarding the impacts on patients of increasing AI decision making. In particular, the impersonal nature of AI means that its deployment in highly sensitive contexts-of-use, such as in healthcare, raises issues associated with patients’ perceptions of (un) dignified treatment. We explore this issue through an experimental vignette study comparing individuals’ perceptions (...) of being treated in a dignified and respectful way in various healthcare decision contexts. Participants were subject to a 2 (human or AI decision maker) x 2 (positive or negative decision outcome) x 2 (diagnostic or resource allocation healthcare scenario) factorial design. We found evidence of a “human bias” (i.e., a preference for human over AI decision makers) and an “outcome bias” (i.e., a preference for positive over negative outcomes). However, we found that for perceptions of respectful and dignified interpersonal treatment, it matters more who makes the decisions in diagnostic cases and it matters more what the outcomes are for resource allocation cases. We also found that humans were consistently viewed as appropriate decision makers and AI was viewed as dehumanizing, and that participants perceived they were treated better when subject to diagnostic as opposed to resource allocation decisions. Thematic coding of open-ended text responses supported these results. We also outline the theoretical and practical implications of these findings. (shrink)

Abstract: Artificial Intelligence (AI) is rapidly becoming a cornerstone of modern healthcare, offering unprecedented capabilities in diagnostics, treatment planning, patient care, and healthcare management. This paper explores the transformative impact of AI on the healthcare sector, examining how it enhances patient outcomes, improves the efficiency of medical practices, and introduces new ethical and operational challenges. By analyzing current applications such as AI-driven diagnostic tools, personalized medicine, and hospital management systems, this paper highlights the significant advancements AI has (...) brought to the field. However, the integration of AI also raises concerns related to data privacy, algorithmic bias, and the displacement of healthcare professionals. This study provides a comprehensive overview of these developments, offering insights into the future potential of AI in revolutionizing healthcare while addressing the ethical considerations that must accompany its adoption. The findings suggest that while AI holds the promise of transforming healthcare delivery, careful consideration of its implications is essential to ensure equitable and effective implementation. (shrink)

Healthcare professionals decide wisely about personalized medicine, treatment plans, and resource allocation by utilizing big data analytics and machine learning. To guarantee that algorithmic recommendations are impartial and fair, however, ethical issues relating to prejudice and data privacy must be taken into account. Big data analytics and machine learning have a great potential to disrupt healthcare, and as these technologies continue to evolve, new opportunities to reform healthcare and enhance patient outcomes may arise. In order to investigate (...) the patient’s outcomes with empirical evidence, this research was conducted using an online survey to incorporate healthcare professionals, patient’s reviews, and clinical staff. The data were analyzed using SmartPLS 4.0 to predict the structural model. The findings revealed a direct impact as positive influence of using machine learning on healthcare performance and patient outcomes through big data analytics. Moreover, it is evident that this can lead to personalized treatment plans, early interventions, and improved patient outcomes. Additionally, big data analytics can help healthcare providers optimize resource allocation, improve operational efficiency, and reduce costs. The impact of big data analytics on patient outcome and healthcare performance is expected to continue to grow, making it an important area for investment and research. (shrink)

In Bulgaria, integrating technology and innovation is crucial for advancing sustainable healthcare disaster management, enhancing disaster response and recovery, and minimizing long-term environmental and social impacts. The purpose of the study is to assess the impact of modern technological innovations on the effectiveness of disaster management in health care in Bulgaria with a focus on Health Information Systems (HIS), Telemedicine, Telehealth, e-Health, Electronic Health Records, Artificial Intelligence (AI), Public Communication Platforms, and Data Security and Privacy. These innovations, when integrated (...) effectively, can significantly strengthen Bulgaria's preparedness and response capabilities, improving efficiency and reducing the environmental footprint of disaster interventions. Collaboration with technology experts, research institutions, and international organizations is essential for successful implementation. The research aims to assess how these technologies can enhance disaster management efficacy, adopting a methodical approach using Systematic Literature Reviews (SLRs). Systematic Literature Reviews (SLRs) utilize precise criteria for research selection and evaluation to reduce bias, systematically compiling and analyzing data from various studies to offer evidence-based insights. They are crucial for uncovering research gaps, indicating areas needing further exploration. Findings highlight the transformative potential of technology integration in streamlining communication, data management, and operational efficiency. The study underscores the urgent need for an integrated approach and a culture of innovation within the healthcare sector, emphasizing ongoing assessment and adaptation of technology-based strategies. While acknowledging limitations and calling for further research, the study provides valuable insights into Bulgaria's healthcare disaster management strategies and sets the stage for future investigations to refine and expand upon these strategies. It advocates for a strategic framework guiding the efficient integration of technology into disaster management, aiming for resilient and patient-centric healthcare systems. (shrink)

Healthcare is becoming increasingly automated with the development and deployment of care robots. There are many benefits to care robots but they also pose many challenging ethical issues. This paper takes care robots for the elderly as the subject of analysis, building on previous literature in the domain of the ethics and design of care robots. Using the value sensitive design approach to technology design, this paper extends its application to care robots by integrating the values of care, values (...) that are specific to AI, and higher-scale values such as the United Nations Sustainable Development Goals. The ethical issues specific to care robots for the elderly are discussed at length alongside examples of specific design requirements that work to ameliorate these ethical concerns. (shrink)

Recent AI ethics has focused on applying abstract principles downward to practice. This paper moves in the other direction. Ethical insights are generated from the lived experiences of AI-designers working on tangible human problems, and then cycled upward to influence theoretical debates surrounding these questions: 1) Should AI as trustworthy be sought through explainability, or accurate performance? 2) Should AI be considered trustworthy at all, or is reliability a preferable aim? 3) Should AI ethics be oriented toward establishing protections for (...) users, or toward catalyzing innovation? Specific answers are less significant than the larger demonstration that AI ethics is currently unbalanced toward theoretical principles, and will benefit from increased exposure to grounded practices and dilemmas. (shrink)

Breast cancer treatment is being transformed by artificial intelligence (AI). Nevertheless, most scientists, engineers, and physicians aren't ready to contribute to the healthcare AI revolution. In this paper, we discuss our experiences teaching a new American student undergraduate course that seeks to train the next generation for cross-cultural design thinking, which we believe is critical for AI to realize its full potential in breast cancer treatment. The main tasks of this course are preparing, performing and translating interviews with (...) class='Hi'>healthcare professionals from both Portugal and the USA. Since the course is offered in Portugal as a short-term faculty-led study abroad program, students can explore the effect of culture on healthcare delivery and the design of healthcare technologies. The learning tests demonstrated student growth for breast cancer treatment in many areas important for the development of AI. In respect to understanding breast cancer care, most students had undervalued the effect of cancer and its treatment on the quality of life of women before taking this course and most were unaware of the importance of multidisciplinary care teams. Regarding AI in medical, students became more mindful of data privacy issues and the need to consider the effect of AI on healthcare professionals. (shrink)

Emotion detection and management have emerged as pivotal areas in humancomputer interaction, offering potential applications in healthcare, entertainment, and customer service. This study explores the use of deep learning (DL) models to enhance emotion recognition accuracy and enable effective emotion regulation mechanisms. By leveraging large datasets of facial expressions, voice tones, and physiological signals, we train deep neural networks to recognize a wide array of emotions with high precision. The proposed system integrates emotion recognition with adaptive management strategies that (...) provide personalized feedback and interventions based on detected emotional states. Our approach surpasses traditional machine learning methods, demonstrating superior performance in real-time applications. We also explore the ethical implications and challenges associated with deploying such systems, particularly regarding privacy concerns and the potential for misuse. Through extensive experiments, our model achieved an average accuracy rate of 92%, highlighting its robustness across different environments and user demographics. This research not only contributes to the growing field of affective computing but also lays the groundwork for future developments in emotionally intelligent systems. (shrink)

What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It’s also highly likely to impact on the organisational and business practices (...) of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare institutions. We will suggest that two questions, in particular, are deserving of further attention from philosophers and bioethicists. What does care look like when one is dealing with data as much as people? And, what weight should we give to the advice of machines in our own deliberations about medical decisions? (shrink)

Why interdisciplinary research in AI is so important, according to Jurassic Park. -/- “Your scientists were so preoccupied with whether or not they could, they didn’t stop to think if they should.” -/- I think this quote resonates with us now more than ever, especially in the world of technological development. The writers of Jurassic Park were years ahead of their time with this powerful quote. -/- As we build new technology, and we push on to see what can actually (...) be achieved there is an undertone of sales to whatever we build. The end product must be sold somewhere and to someone. This can derail any good intentions, just as building a resort full of dinosaurs was sold as a fun attraction, we see later in the film that it became a resort of terror. -/- In the field of AI we are certainly late to the party with ethics and regulation. Indeed, even existing modelling protocols have been, in many cases, circumvented or potentially ignored. This has led to a widening of the gap in the interdisciplinary field of AI. This is compounded by pop culture representations of AI and the Ethicist’s potential lack of knowledge surrounding technical progression in the field of AI. There are now seemingly two separate branches that ought to be in sync. The first branch is a group of Philosophers led by the Author of Superintelligence, Nick Bostrom, who believe that there is a singularity where AI takes over the world and starts to kill off humans. The second branch is the Technical Cohort who are led by companies such as Google and Deepmind. The remit of these developers is to see what can be developed and produced. Ultimately a separate sales team will determine what products can be sold. -/- We have seen multiple failures of AI due to lack of interdisciplinary discourse. Some cases include misallocated or cut off financial support and healthcare. This indicates the prevalence of issues that can grow and become ever more complex. -/- So, we have to ask ourselves two questions: One, do the Philosophers have a point? Two, does that point refer to humans programming AI in such a way that the destruction of the human race is its optimal aim in order to create a better future world? -/- Is the development of AI that different to an island of genetically engineered Dinosaurs? -/- The only solution, in my view, is interdisciplinary discourse. (shrink)

The increasing application of artificial intelligence (AI) to healthcare raises both hope and ethical concerns. Some advanced machine learning methods provide accurate clinical predictions at the expense of a significant lack of explainability. Alex John London has defended that accuracy is a more important value than explainability in AI medicine. In this article, we locate the trade-off between accurate performance and explainable algorithms in the context of distributive justice. We acknowledge that accuracy is cardinal from outcome-oriented justice because it (...) helps to maximize patients’ benefits and optimizes limited resources. However, we claim that the opaqueness of the algorithmic black box and its absence of explainability threatens core commitments of procedural fairness such as accountability, avoidance of bias, and transparency. To illustrate this, we discuss liver transplantation as a case of critical medical resources in which the lack of explainability in AI-based allocation algorithms is procedurally unfair. Finally, we provide a number of ethical recommendations for when considering the use of unexplainable algorithms in the distribution of health-related resources. (shrink)

The adoption of AI in the health sector has its share of benefits and harms to various stakeholder groups and entities. There are critical risks involved in using AI systems in the health domain; risks that can have severe, irreversible, and life-changing impacts on people’s lives. With the development of innovative AI-based applications in the medical and healthcare sectors, new types of risks emerge. To benefit from novel AI applications in this domain, the risks need to be managed in (...) order to protect the fundamental interests and rights of those affected. This will increase the level to which these systems become ethically acceptable, legally permissible, and socially sustainable. In this paper, we first discuss the necessity of AI risk management in the health domain from the ethical, legal, and societal perspectives. We then present a taxonomy of risks associated with the use of AI systems in the health domain called HART. HART mirrors the risks of a variety of different real-world incidents caused by use of AI in the health sector. Lastly, we discuss the implications of the taxonomy for different stakeholder groups and further research. (shrink)

The Netherlands was the first country to legalize euthanasia and physician-assisted suicide. This paper offers a first legal perspective on the prospects of using AI in the Dutch practice of euthanasia and physician-assisted suicide. It responds to the Regional Euthanasia Review Committees’ interest in exploring technological solutions to improve current procedures. The specific characteristics of AI – the capability to process enormous amounts of data in a short amount of time and generate new insights in individual cases – may for (...) example alleviate the increased workload of review committees due to the continuous increase of euthanasia cases. The paper considers three broad categories for the use of AI in the Dutch euthanasia practice: (1) the physician’s assessment of euthanasia requests, (2) the actual execution of euthanasia, and (3) the retrospective reviews of cases by the Regional Euthanasia Review Committees. Exploring the legal considerations around each avenue, both in the EU AI Act and the Dutch legal framework, this paper aims to facilitate the societal discussion on the role of technology in such deeply human decisions. This debate is equally relevant to other countries that legalized euthanasia (e.g. Belgium and Canada) or physician-assisted suicide (e.g. Switzerland and numerous states in the US). (shrink)

As healthcare technologies rapidly progress, a paramount concern arises: are individuals adequately prepared for the current challenges accompanying these advancements? Despite regulatory measures in place, the persistent issue of privacy demands heightened attention and prioritization. This essay aims to consistently underscore the significance of privacy in the evolving landscape of healthcare technologies, fostering a future where the advantages of these innovations are managed with responsibility. We present an ethical analysis addressing privacy apprehensions in emerging healthcare technologies, accompanied (...) by recommendations for viable solutions to address these pressing concerns. It is concluded that hasty acceptance of new healthcare technology should be resisted, advocating instead for the allocation of resources and time to address privacy issues associated with emerging healthcare innovations. This commitment is indispensable for the well-being of patients, healthcare providers, technology enterprises, policymakers, activists, and the public. (shrink)

In Deep Medicine, Eric Topol argues that the development of artificial intelligence (AI) for healthcare will lead to a dramatic shift in the culture and practice of medicine. Topol claims that, rather than replacing physicians, AI could function alongside of them in order to allow them to devote more of their time to face-to-face patient care. Unfortunately, these high hopes for AI-enhanced medicine fail to appreciate a number of factors that, we believe, suggest a radically different picture for the (...) future of healthcare. Far from facilitating a return to “the golden age of doctoring”, the role of economic and institutional considerations in determining how medical AI will be used mean that it is likely to further erode therapeutic relationships and threaten professional and patient satisfaction. (shrink)

Healthcare systems across the globe are struggling with increasing costs and worsening outcomes. This presents those responsible for overseeing healthcare with a challenge. Increasingly, policymakers, politicians, clinical entrepreneurs and computer and data scientists argue that a key part of the solution will be ‘Artificial Intelligence’ (AI) – particularly Machine Learning (ML). This argument stems not from the belief that all healthcare needs will soon be taken care of by “robot doctors.” Instead, it is an argument that rests (...) on the classic counterfactual definition of AI as an umbrella term for a range of techniques that can be used to make machines complete tasks in a way that would be considered intelligent were they to be completed by a human. Automation of this nature could offer great opportunities for the improvement of healthcare services and ultimately patients’ health by significantly improving human clinical capabilities in diagnosis, drug discovery, epidemiology, personalised medicine, and operational efficiency. However, if these AI solutions are to be embedded in clinical practice, then at least three issues need to be considered: the technical possibilities and limitations; the ethical, regulatory and legal framework; and the governance framework. In this article, we report on the results of a systematic analysis designed to provide a clear overview of the second of these elements: the ethical, regulatory and legal framework. We find that ethical issues arise at six levels of abstraction (individual, interpersonal, group, institutional, sectoral, and societal) and can be categorised as epistemic, normative, or overarching. We conclude by stressing how important it is that the ethical challenges raised by implementing AI in healthcare settings are tackled proactively rather than reactively and map the key considerations for policymakers to each of the ethical concerns highlighted. (shrink)

Artificial intelligence (AI) systems have demonstrated impressive performance across a variety of clinical tasks. However, notoriously, sometimes these systems are “black boxes.” The initial response in the literature was a demand for “explainable AI.” However, recently, several authors have suggested that making AI more explainable or “interpretable” is likely to be at the cost of the accuracy of these systems and that prioritizing interpretability in medical AI may constitute a “lethal prejudice.” In this paper, we defend the value of interpretability (...) in the context of the use of AI in medicine. Clinicians may prefer interpretable systems over more accurate black boxes, which in turn is sufficient to give designers of AI reason to prefer more interpretable systems in order to ensure that AI is adopted and its benefits realized. Moreover, clinicians may be justified in this preference. Achieving the downstream benefits from AI is critically dependent on how the outputs of these systems are interpreted by physicians and patients. A preference for the use of highly accurate black box AI systems, over less accurate but more interpretable systems, may itself constitute a form of lethal prejudice that may diminish the benefits of AI to—and perhaps even harm—patients. (shrink)

We argue that while digital health technologies (e.g. artificial intelligence, smartphones, and virtual reality) present significant opportunities for improving the delivery of healthcare, key concepts that are used to evaluate and understand their impact can obscure significant ethical issues related to patient engagement and experience. Specifically, we focus on the concept of empowerment and ask whether it is adequate for addressing some significant ethical concerns that relate to digital health technologies for mental healthcare. We frame these concerns using (...) five key ethical principles for AI ethics (i.e. autonomy, beneficence, non-maleficence, justice, and explicability), which have their roots in the bioethical literature, in order to critically evaluate the role that digital health technologies will have in the future of digital healthcare. (shrink)

Peer commentary on Char, Abràmoff & Feudtner (2020) target article: "Identifying Ethical Considerations for Machine Learning Healthcare Applications" .

The application of Artificial Intelligence (AI) in healthcare and epidemiology undoubtedly has many benefits for the population. However, due to its environmental impact, the use of AI can produce social inequalities and long-term environmental damages that may not be thoroughly contemplated. In this paper, we propose to consider the impacts of AI applications in medical care from the One Health paradigm and long-term global health. From health and environmental justice, rather than settling for a short and fleeting green honeymoon (...) between health and sustainability caused by AI, it should aim for a lasting marriage. To this end, we conclude by proposing that, in the upcoming years, it could be valuable and necessary to promote more interconnected health, call for environmental cost transparency, and increase green responsibility. (shrink)

Over the past year, technology companies have made headlines claiming that their artificially intelligent (AI) products can outperform clinicians at diagnosing breast cancer, brain tumours, and diabetic retinopathy. Claims such as these have influenced policy makers, and AI now forms a key component of the national health strategies in England, the United States, and China. While it is positive to see healthcare systems embracing data analytics and machine learning, concerns remain about the efficacy, ethics, and safety of some commercial, (...) AI health solutions. This paper argues that improved regulation and guidance is urgently required to mitigate risks, ensure transparency and best practice, Without this, patients, clinicians, and other stakeholders cannot be assured of an app’s efficacy, and safety. (shrink)

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and (...) Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)

Much of the discussion of the role of emerging technologies associated with AI, machine learning, digital simulacra, and relevant ethical considerations such as those discussed in the target article, take a relatively narrow and episodic view of a person’s healthcare needs. There is much speculation about diagnostic, treatment, and predictive applications but relatively little consideration of how such technologies might be used to address a person’s lived experience of illness and ongoing care needs. This is likely due to the (...) greater weight or priority given to acute care needs and the role of medical treatment in care provision, but it may also reflect the limitations of current technologies and our limited vision of their potential application. Such limitations are not surprising given that we are still grappling with the complexities and nuances of achieving the ethical and humanistic ideals of care, namely, care that addresses the hermeneutical, relational, contextual, temporal, and agential dimensions of a person’s health and wellbeing. (shrink)

Artificial intelligence (AI) systems have demonstrated impressive performance across a variety of clinical tasks. However, notoriously, sometimes these systems are 'black boxes'. The initial response in the literature was a demand for 'explainable AI'. However, recently, several authors have suggested that making AI more explainable or 'interpretable' is likely to be at the cost of the accuracy of these systems and that prioritising interpretability in medical AI may constitute a 'lethal prejudice'. In this paper, we defend the value of interpretability (...) in the context of the use of AI in medicine. Clinicians may prefer interpretable systems over more accurate black boxes, which in turn is sufficient to give designers of AI reason to prefer more interpretable systems in order to ensure that AI is adopted and its benefits realised. Moreover, clinicians may be justified in this preference. Achieving the downstream benefits from AI is critically dependent on how the outputs of these systems are interpreted by physicians and patients. A preference for the use of highly accurate black box AI systems, over less accurate but more interpretable systems , may itself constitute a form of lethal prejudice that may diminish the benefits of AI to - and perhaps even harm - patients. (shrink)

Artificial intelligence systems have been widely applied to various contexts, including high-stake decision processes in healthcare, banking, and judicial systems. Some developed AI models fail to offer a fair output for specific minority groups, sparking comprehensive discussions about AI fairness. We argue that the development of AI systems is marked by a central paradox: the less participation one stakeholder has within the AI system’s life cycle, the more influence they have over the way the system will function. This means (...) that the impact on the fairness of the system is in the hands of those who are less impacted by it. However, most of the existing works ignore how different aspects of AI fairness are dynamically and adaptively affected by different stages of AI system development. To this end, we present a use case to discuss fairness in the development of corporate wellness programs using smart wearables and AI algorithms to analyze data. The four key stakeholders throughout this type of AI system development process are presented. These stakeholders are called service designer, algorithm designer, system deployer, and end-user. We identify three core aspects of AI fairness, namely, contextual fairness, model fairness, and device fairness. We propose a relative contribution of the four stakeholders to the three aspects of fairness. Furthermore, we propose the boundaries and interactions between the four roles, from which we make our conclusion about the possible unfairness in such an AI developing process. (shrink)

Objectives: Machine learning (ML) has the potential to facilitate “continual learning” in medicine, in which an ML system continues to evolve in response to exposure to new data over time, even after being deployed in a clinical setting. In this article, we provide a tutorial on the range of ethical issues raised by the use of such “adaptive” ML systems in medicine that have, thus far, been neglected in the literature. -/- Target audience: The target audiences for this tutorial are (...) the developers of ML AI systems, healthcare regulators, the broader medical informatics community, and practicing clinicians. -/- Scope: Discussions of adaptive ML systems to date have overlooked the distinction between 2 sorts of variance that such systems may exhibit—diachronic evolution (change over time) and synchronic variation (difference between cotemporaneous instantiations of the algorithm at different sites)—and underestimated the significance of the latter. We highlight the challenges that diachronic evolution and synchronic variation present for the quality of patient care, informed consent, and equity, and discuss the complex ethical trade-offs involved in the design of such systems. (shrink)

Technologies to rapidly alert people when they have been in contact with someone carrying the coronavirus SARS-CoV-2 are part of a strategy to bring the pandemic under control. Currently, at least 47 contact-tracing apps are available globally. They are already in use in Australia, South Korea and Singapore, for instance. And many other governments are testing or considering them. Here we set out 16 questions to assess whether — and to what extent — a contact-tracing app is ethically justifiable.

Artificial Intelligence (AI) technologies are now widely used in a variety of fields to aid with knowledge acquisition and decision-making. Health information systems, in particular, can gain the most from AI advantages. Recently, symptoms-based illness prediction research and manufacturing have grown in popularity in the healthcare business. Several scholars and organisations have expressed an interest in applying contemporary computational tools to analyse and create novel approaches for rapidly and accurately predicting illnesses. In this study, we present a paradigm for (...) assessing the efficacy of combining Machine Learning (ML) and Natural Language Processing (NLP) technologies in a disease prediction system. We scraped a disease-symptom dataset with NLP characteristics from one of the UK's most trusted National Health Service (NHS) websites as an example. In addition, we will thoroughly examine our data using symptom frequency, similarity, and clustering analysis. As a consequence, we can observe that the forecast has a high efficiency rate, but there are still some challenges to work out. (shrink)

In the past months, there has been a lively debate about so-called COVID-19 apps developed to deal with the pandemic (Morley et al. 2020b). Some of the best solutions use the Bluetooth connection of mobile phones to determine contacts between people and therefore the probability of contagion, and then suggested related measures. In theory, it may seem simple. In practice, there are several ethical problems (Morley et al. 2020a), not only legal and technical ones. To understand them, it is useful (...) to distinguish between the validation and the verification of a system, remembering that these words are used here only in the design/engineering sense, and certainly not philosophically. The validation of a system answers the following question:“are we building the right system?”. (shrink)

Integrating medical imaging with computing technologies, such as Artificial Intelligence (AI) and its subsets: Machine learning (ML) and Deep Learning (DL) has advanced into an essential facet of present-day medicine, signaling a pivotal role in diagnostic decision-making and treatment plans (Huang et al., 2023). The significance of medical imaging is escalated by its sustained growth within the realm of modern healthcare (Varoquaux and Cheplygina, 2022). Nevertheless, the ever-increasing volume of medical images compared to the availability of imaging experts. Biomedical (...) experts and radiologists have resulted in a widening disparity, causing an excess and overwhelming workload on these healthcare professionals (Chen et al., 2021). Several studies indicate that the present-day biomedical radiologist is now saddled with the daunting task of interpreting an image almost every 10 seconds to keep pace with the burgeoning clinical demands (McDonald et al., 2015; Hosny et al., 2018; Lantsman et al., 2022). This cognitive drain has invariably led to inevitable consequences such as delays in diagnosis and an amplified risk of diagnostic errors – thus, the biomedical imaging aspect is in dire need of methods that would aid accurate diagnostics and analytics for improved decision making. In this review, the importance of AI-related technologies such as ML and/or DL methods are reviewed in relation to the processing of medical or biomedical images along with their potentials, challenges, and possible suggestions for future studies in the health landscape. The focus will be on machine learning methods associated with the medical field of image classification. (shrink)

The application of machine-learning technologies to medical practice promises to enhance the capabilities of healthcare professionals in the assessment, diagnosis, and treatment, of medical conditions. However, there is growing concern that algorithmic bias may perpetuate or exacerbate existing health inequalities. Hence, it matters that we make precise the different respects in which algorithmic bias can arise in medicine, and also make clear the normative relevance of these different kinds of algorithmic bias for broader questions about justice and fairness in (...) healthcare. In this paper, we provide the building blocks for an account of algorithmic bias and its normative relevance in medicine. (shrink)

Western, secularized capitalism appraises the “worth” of a worker through a wage, a numerical value assumed to reflect the value of one’s time (in the case of hourly jobs) or contribution (in the case of salary or commision-based work). Computers and AI models are capable of matching and even exceeding human performance on a variety of tasks such as mathematical computation, handwritten digit recognition, and even complex tasks such as playing the game Go. Furthermore, they can work around the clock (...) with no need for sleep, healthcare, or even a salary. As a result, computers are more “valuable” than humans under capitalism because they are more productive (in terms of quantity and, in many cases, quality of work). Combined with an erosion of the religious idea of explicit human worth or dignity, other humans are seen as mere means to the ends of those powerful enough to exploit them. Any hope of reducing inequality or promoting justice must come from an explicit belief in the “value” of human life independent of his or her ability to produce. (shrink)

Vertigo is a common symptom that can result from various underlying diseases and conditions, ranging from benign to severe. Accurate and timely diagnosis of the cause of vertigo is crucial for appropriate management and treatment. In this research, we propose the development of an expert system for vertigo diseases diagnosis, utilizing artificial intelligence (AI) and the proposed Expert System which was produced to help assist healthcare professionals in diagnosing the cause of vertigo based on a patient's symptoms, medical history, (...) and other relevant clinical information. The proposed expert system presents an overview about vertigo diseases are given, the cause of disease is outlined and the treatment or recommendation of disease whenever possible is given out. CLIPS language was used for designing and implementing the proposed expert system. The potential of the proposed expert system lies in its ability to enhance the accuracy and efficiency of vertigo diagnosis, as well as assist in the proper referral and management of patients. (shrink)

COVID-19 began in China in December 2019. As of January 2021, over a hundred million instances had been reported worldwide, leaving a deep socio-economic impact globally. Current investigation studies determined that artificial intelligence (AI) can play a key role in reducing the effect of the virus spread. The prediction of COVID-19 incidence in different countries and territories is important because it serves as a guide for governments, healthcare providers, and the general public in developing management strategies to battle the (...) disease. The prediction proved beneficial in the early months of 2020 to alert nations and territories in danger of an outbreak, allowing them to take preventative measures. Despite the fact that the COVID-19 outbreak has expanded to practically every location on the planet, the prediction has value in terms of monitoring the intensity of the spread and recovery, as well as determining the likelihood of a sequel or tertiary epidemic. COVID-19, like influenza, could become a seasonal or recurring epidemic in the future. COVID-19 activity must so be predicted and monitored now and in the future. (shrink)

With the progress of artificial intelligence, the digitalization of the lifeworld, and the reduction of the mind to neuronal processes, the human being appears more and more as a product of data and algorithms. Thus, we conceive ourselves “in the image of our machines,” and conversely, we elevate our machines and our brains to new subjects. At the same time, demands for an enhancement of human nature culminate in transhumanist visions of taking human evolution to a new stage. Against this (...) self-reification of the human being, the present book defends a humanism of embodiment: our corporeality, vitality, and embodied freedom are the foundations of a self-determined existence, which uses the new technologies only as means instead of submitting to them. The book offers an array of interventions directed against a reductionist naturalism in various areas of science and society. As an alternative, it offers an embodied and enactive account of the human person: we are neither pure minds nor brains, but primarily embodied, living beings in relation with others. This general concept is applied to issues such as artificial intelligence (AI), transhumanism and enhancement, virtual reality, neuroscience, embodied freedom, psychiatry, and finally to the accelerating dynamics of current society which lead to an increasing disembodiment of our everyday life. The book thus applies cutting-edge concepts of embodiment and enactivism to current scientific, technological, and cultural tendencies that will crucially influence our society’s development in the twenty-first century. (shrink)

We are sometimes unsure of the moral status of our relationships with other entities. Recent case studies in this uncertainty include our relationships with artificial agents (robots, assistant AI, etc.), animals, and patients with “locked-in” syndrome. Do these entities have basic moral standing? Could they count as true friends or lovers? What should we do when we do not know the answer to these questions? An influential line of reasoning suggests that, in such cases of moral uncertainty, we need meta-moral (...) decision rules that allow us to either minimize the risks of moral wrongdoing or improve the choice-worthiness of our actions. One particular argument adopted in this literature is the “risk asymmetry argument,” which claims that the risks associated with accepting or rejecting some moral facts may be sufficiently asymmetrical as to warrant favoring a particular practical resolution of this uncertainty. Focusing on the case study of artificial beings, this article argues that this is best understood as an ethical-epistemic challenge. The article argues that taking potential risk asymmetries seriously can help resolve disputes about the status of human–AI relationships, at least in practical terms (philosophical debates will, no doubt, continue); however, the resolution depends on a proper, empirically grounded assessment of the risks involved. Being skeptical about basic moral status, but more open to the possibility of meaningful relationships with such entities, may be the most sensible approach to take. (shrink)

Henry Shevlin’s paper—“How could we know when a robot was a moral patient?” – argues that we should recognize robots and artificial intelligence (AI) as psychological moral patients if they are cognitively equivalent to other beings that we already recognize as psychological moral patients (i.e., humans and, at least some, animals). In defending this cognitive equivalence strategy, Shevlin draws inspiration from the “behavioral equivalence” strategy that I have defended in previous work but argues that it is flawed in crucial respects. (...) Unfortunately—and I guess this is hardly surprising—I cannot bring myself to agree that the cognitive equivalence strategy is the superior one. In this article, I try to explain why in three steps. First, I clarify the nature of the question that I take both myself and Shevlin to be answering. Second, I clear up some potential confusions about the behavioral equivalence strategy, addressing some other recent criticisms of it. Third, I will explain why I still favor the behavioral equivalence strategy over the cognitive equivalence one. (shrink)

Technological developments involving robotics and artificial intelligence devices are being employed evermore in elderly care and the healthcare sector more generally, raising ethical issues and practical questions warranting closer considerations of what we mean by “care” and, subsequently, how to design such software coherently with the chosen definition. This paper starts by critically examining the existing approaches to the ethical design of care robots provided by Aimee van Wynsberghe, who relies on the work on the ethics of care by (...) Joan Tronto. In doing so, it suggests an alternative to their non-principled approach, an alternative suited to tackling some of the issues raised by Tronto and van Wynsberghe, while allowing for the inclusion of two orientative principles. Our proposal centres on the principles of autonomy and vulnerability, whose joint adoption we deem able to constitute an original revision of a bottom-up approach in care ethics. Conclusively, the ethical framework introduced here integrates more traditional approaches in care ethics in view of enhancing the debate regarding the ethical design of care robots under a new lens. (shrink)

Algorithms are used across a wide range of societal sectors such as banking, administration, and healthcare to make predictions that impact on our lives. While the predictions can be incredibly accurate about our present and future behavior, there is an important question about how these algorithms in fact represent human identity. In this paper, we explore this question and argue that machine learning algorithms represent human identity in terms of what we shall call the statistical individual. This statisticalized representation (...) of individuals, we shall argue, differs significantly from our ordinary conception of human identity, which is tightly intertwined with considerations about biological, psychological, and narrative continuity—as witnessed by our most well-established philosophical views on personal identity. Indeed, algorithmic representations of individuals give no special attention to biological, psychological, and narrative continuity and instead rely on predictive properties that significantly exceed and diverge from those that we would ordinarily take to be relevant for questions about how we are. (shrink)

The Salivaomics Knowledge Base (SKB) is designed to serve as a computational infrastructure that can permit global exploration and utilization of data and information relevant to salivaomics. SKB is created by aligning (1) the saliva biomarker discovery and validation resources at UCLA with (2) the ontology resources developed by the OBO (Open Biomedical Ontologies) Foundry, including a new Saliva Ontology (SALO). We define the Saliva Ontology (SALO; http://www.skb.ucla.edu/SALO/) as a consensus-based controlled vocabulary of terms and relations dedicated to the salivaomics (...) domain and to saliva-related diagnostics following the principles of the OBO (Open Biomedical Ontologies) Foundry. The Saliva Ontology is an ongoing exploratory initiative. The ontology will be used to facilitate salivaomics data retrieval and integration across multiple fields of research together with data analysis and data mining. The ontology will be tested through its ability to serve the annotation ('tagging') of a representative corpus of salivaomics research literature that is to be incorporated into the SKB. Background Saliva (oral fluid) is an emerging biofluid for non-invasive diagnostics used in the detection of human diseases. The need to advance saliva research is strongly emphasized by the National Institute of Dental and Craniofacial Research (NIDCR), and is included in the NIDCR's 2004- 2009 expert panel long-term research agenda [1]. The ability to monitor health status, disease onset, progression, recurrence and treatment outcome through noninvasive means is highly important to advancing health care management. Saliva is a perfect medium to be explored for personalized individual medicine including diagnostics, offering a non-invasive, easy to obtain means for detecting and monitoring diseases. Saliva testing potentially allows the patient to collect their own saliva samples at home, yielding convenience for the patient and savings in health costs, and facilitating multiple sampling. Specimen collection is less objectionable to patients and easier in children and elderly individuals. Due to these advantages. (shrink)

This paper provides an analysis of the way in which two foundational principles of medical ethics–the trusted doctor and patient autonomy–can be undermined by the use of machine learning (ML) algorithms and addresses its legal significance. This paper can be a guide to both health care providers and other stakeholders about how to anticipate and in some cases mitigate ethical conflicts caused by the use of ML in healthcare. It can also be read as a road map as to (...) what needs to be done to achieve an acceptable level of explainability in an ML algorithm when it is used in a healthcare context. (shrink)

We describe the rationale for an application ontology covering the domain of human body fluids that is designed to facilitate representation, reuse, sharing and integration of diagnostic, physiological, and biochemical data, We briefly review the Blood Ontology (BLO), Saliva Ontology (SALO) and Kidney and Urinary Pathway Ontology (KUPO) initiatives. We discuss the methods employed in each, and address the project of using them as starting point for a unified body fluids ontology resource. We conclude with a description of how the (...) body fluids ontology initiative may provide support to basic and translational science. (shrink)

Hiện nay, chế độ sở hữu ở Việt Nam đã có những đổi mới cơ bản, nhưng vẫn còn những khác biệt rất lớn so với chế độ sở hữu ở các nền kinh tế thị trường hiện đại. Trong cơ cấu của chế độ sở hữu ở Việt Nam, tỷ trọng của sở hữu nhà nước còn quá lớn; kinh tế nhà nước giữ vai trò chủ đạo… Chính những khác biệt này đã làm cho nền kinh tế thị (...) trường Việt Nam bị méo mó và giảm lợi thế cạnh tranh quốc gia. Do vậy, công cuộc đổi mới và hoàn thiện chế độ sở hữu ở Việt Nam phải hướng tới việc khắc phục những hạn chế trên và đạt tới sức cạnh tranh ngang hàng với các nền kinh tế thị trường hiện đại khác. (shrink)

There is a need recognized by the National Institute of Dental & Craniofacial Research and the National Cancer Institute to advance basic, translational and clinical saliva research. The goal of the Salivaomics Knowledge Base (SKB) is to create a data management system and web resource constructed to support human salivaomics research. To maximize the utility of the SKB for retrieval, integration and analysis of data, we have developed the Saliva Ontology and SDxMart. This article reviews the informatics advances in saliva (...) diagnostics made possible by the Saliva Ontology and SDxMart. (shrink)

ĐỀ CƯƠNG HỌC PHẦN VĂN HÓA KINH DOANH 1. Tên học phần: VĂN HÓA KINH DOANH (BUSINESS CULTURE) 2. Mã học phần: BMGM1221 3. Số tín chỉ: 2 (24,6) (để học được học phần này, người học phải dành ít nhất 60 giờ chuẩn bị cá nhân).

(Mặt trận) - Chế độ sở hữu trong nền kinh tế thị trường định hướng xã hội chủ nghĩa Việt Nam trước hết phải tuân theo các nguyên tắc của nền kinh tế thị trường hiện đại. Trong các nguyên tắc của nền kinh tế thị trường hiện đại, nguyên tắc sở hữu tư nhân là nền tảng của nền kinh tế thị trường - là nguyên tắc quan trọng. Xa rời nguyên tắc này, dù chúng ta cố gắng xây (...) dựng nền kinh tế thị trường thì đó vẫn là một nền kinh tế thị trường khó được quốc tế công nhận. Sở hữu tư nhân hiện đại là chế độ sở hữu được cổ phần hóa, được xã hội hóa rất cao, công khai, minh bạch trên các thị trường chứng khoán. Tính xã hội cao của chế độ cổ phần hóa đã được C.Mác đánh giá, xem như là chế độ sở hữu quá độ sang hình thái kinh tế - xã hội mới. (shrink)

Xây dựng nền kinh tế xanh tiến đến mục tiêu phát triển bền vững đang từng bước trở thành xu thế của thời đại và là xu hướng ngày càng rõ nét trên toàn cầu. Hành vi xanh của doanh nghiệp có vốn đầu tư trực tiếp nước ngoài (doanh nghiệp FDI) có mối quan hệ chặt chẽ và tác động tích cực đáng kể đến sự phát triển bền vững của địa phương/quốc gia, bao gồm cả các nước phát (...) triển và đang phát triển, trong đó có Việt Nam. Bài viết tập trung phân tích những tác động của các doanh nghiệp FDI đến phát triển bền vững của Việt Nam thông qua các hành vi xanh, cụ thể là các hành vi đầu tư gắn với phát triển bền vững của quốc gia, từ đó đề xuất các nhóm giải pháp thúc đẩy hành vi xanh của doanh nghiệp FDI tại Việt Nam. (shrink)