I discuss an influential argument put forward by Hatherley in theJournal of Medical Ethics. Drawing on influential philosophical accounts of interpersonal trust, Hatherley claims that medical artificial intelligence is capable of being reliable, but not trustworthy. Furthermore, Hatherley argues that trust generates moral obligations on behalf of the trustee. For instance, when a patient trusts a clinician, it generates certain moral obligations on behalf of the clinician for her to do what she is entrusted to do. I make (...) three objections to Hatherley’s claims: (1) At least one philosophical account of interagent trust implies that medical AI is capable of being trustworthy. (2) Even if this account should ultimately be rejected, it does not matter much because what we care mostly about is that medical AI is reliable. (3) It is false that trust in itself generates moral obligations on behalf of the trustee. (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)

Artificial intelligence (AI) is expected to revolutionise the practice of medicine. Recent advancements in the field of deep learning have demonstrated success in variety of clinical tasks: detecting diabetic retinopathy from images, predicting hospital readmissions, aiding in the discovery of new drugs, etc. AI’s progress in medicine, however, has led to concerns regarding the potential effects of this technology on relationships of trust in clinical practice. In this paper, I will argue that there is merit to these concerns, since AI (...) systems can be relied on, and are capable of reliability, but cannot be trusted, and are not capable of trustworthiness. Insofar as patients are required to rely on AI systems for their medical decision-making, there is potential for this to produce a deficit of trust in relationships in clinical practice. (shrink)

This paper concerns the double standard debate in the ethics of AI literature. This debate essentially revolves around the question of whether we should subject AI systems to different normative standards than humans. So far, the debate has centered around the desideratum of transparency. That is, the debate has focused on whether AI systems must be more transparent than humans in their decision-making processes in order for it to be morally permissible to use such systems. Some have argued that the (...) same standards of transparency should be applied across the board, for AI systems and humans alike. Others have argued that we should hold AI systems to higher standards than humans in terms of transparency. In this paper, we first point out that there are structurally similar double standard debates to be had about other desiderata besides transparency, such as predictive accuracy. Second, we argue that when we focus on predictive accuracy, there are at least two reasons for holding AI systems to a lower standard than humans. (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)

Without doctors being able to explain medical decisions to patients, I argue their use of black box AIs would erode the effective and respectful care they provide patients. In addition, I argue that physicians should use AI black boxes only for patients in dire straits, or when physicians use AI as a “co-pilot” (analogous to a spellchecker) but can independently confirm its accuracy. I respond to A.J. London’s objection that physicians already prescribe some drugs without knowing why they work.

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)

Mildred Cho and Nicole Martinez-Martin (2023) distinguish between two of the ways in which humans can be represented in medical contexts. One is technical: a digital model of aspects of a person’s...

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)

Advancements in machine learning have fuelled the popularity of using AI decision algorithms in procedures such as bail hearings, medical diagnoses and recruitment. Academic articles, policy texts, and popularizing books alike warn that such algorithms tend to be opaque: they do not provide explanations for their outcomes. Building on a causal account of transparency and opacity as well as recent work on the value of causal explanation, I formulate a moral concern for opaque algorithms that is yet to receive (...) a systematic treatment in the literature: when such algorithms are used in life-changing decisions, they can obstruct us from effectively shaping our lives according to our goals and preferences, thus undermining our autonomy. I argue that this concern deserves closer attention as it furnishes the call for transparency in algorithmic decision-making with both new tools and new challenges. (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)

Definition of the problem The umbrella term “explicability” refers to the reduction of opacity of artificial intelligence (AI) systems. These efforts are challenging for medical AI applications because higher accuracy often comes at the cost of increased opacity. This entails ethical tensions because physicians and patients desire to trace how results are produced without compromising the performance of AI systems. The centrality of explicability within the informed consent process for medical AI systems compels an ethical reflection on the (...) trade-offs. Which levels of explicability are needed to obtain informed consent when utilizing medical AI? Arguments We proceed in five steps: First, we map the terms commonly associated with explicability as described in the ethics and computer science literature, i.e., disclosure, intelligibility, interpretability, and explainability. Second, we conduct a conceptual analysis of the ethical requirements for explicability when it comes to informed consent. Third, we distinguish hurdles for explicability in terms of epistemic and explanatory opacity. Fourth, this then allows to conclude the level of explicability physicians must reach and what patients can expect. In a final step, we show how the identified levels of explicability can technically be met from the perspective of computer science. Throughout our work, we take diagnostic AI systems in radiology as an example. Conclusion We determined four levels of explicability that need to be distinguished for ethically defensible informed consent processes and showed how developers of medical AI can technically meet these requirements. (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)

This paper sets out an account of trust in AI as a relationship between clinicians, AI applications, and AI practitioners in which AI is given discretionary authority over medical questions by clinicians. Compared to other accounts in recent literature, this account more adequately explains the normative commitments created by practitioners when inviting clinicians’ trust in AI. To avoid committing to an account of trust in AI applications themselves, I sketch a reductive view on which discretionary authority is exercised by (...) AI practitioners through the vehicle of an AI application. I conclude with four critical questions based on the discretionary account to determine if trust in particular AI applications is sound, and a brief discussion of the possibility that the main roles of the physician could be replaced by AI. (shrink)

This chapter focuses on AI-based cognitive and perceptual enhancements. AI-based brain enhancements are already under development, and they may become commonplace over the next 30–50 years. We raise doubts concerning whether radical AI-based enhancements transhumanists advocate will accomplish the transhumanists goals of longevity, human flourishing, and intelligence enhancement. We urge that even if the technologies are medically safe and are not used as tools by surveillance capitalism or an authoritarian dictatorship, these enhancements may still fail to do their job for (...) philosophical reasons. In what follows, we explore one such concern, a problem that involves the nature of the self. We illustrate that the so called transhumanist efforts to “merge oneself with AI” could lead to perverse realizations of AI technology, such as the demise of the person who sought enhancement. And, in a positive vein, we offer ways to avoid this, at least within the context of one theory of the nature of personhood. (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)

Principles of fairness and solidarity in AI ethics regularly overlap, creating obscurity in practice: acting in accordance with one can appear indistinguishable from deciding according to the rules of the other. However, there exist irregular cases where the two concepts split, and so reveal their disparate meanings and uses. This paper explores two cases in AI medical ethics – one that is irregular and the other more conventional – to fully distinguish fairness and solidarity. Then the distinction is applied (...) to the frequently cited COMPAS versus ProPublica dispute in judicial ethics. The application provides a broader model for settling contemporary and topical debates about fairness and solidarity. It also implies a deeper and disorienting truth about AI ethics principles and their justification. (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)

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)

Abstract: As there are no visible ways to create safe self-improving superintelligence, but it is looming, we probably need temporary ways to prevent its creation. The only way to prevent it, is to create special AI, which is able to control and monitor all places in the world. The idea has been suggested by Goertzel in form of AI Nanny, but his Nanny is still superintelligent and not easy to control, as was shown by Bensinger at al. We explore here (...) the ways to create the safest and simplest form of AI, which may work as AI Nanny. Such AI system will be enough to solve most problems, which we expect the AI will solve, including control of robotics, acceleration of the medical research, but will present less risk, as it will be less different from humans. As AI police, it will work as operation system for most computers, producing world surveillance system, which will be able to envision and stop any potential terrorists and bad actors in advance. As uploading technology is lagging, and neuromorphic AI is intrinsically dangerous, the most plausible way to human-based AI Nanny is either functional model of the human mind or a Narrow-AI empowered group of people. (shrink)

The recent progression in AI, nanomedicine and robotics have increased concerns about ethics, policy and law. The increasing complexity and hybrid nature of AI and nanotechnologies impact the functionality of “law in action” which can lead to legal uncertainty and ultimately to a public distrust. There is an immediate need of collaboration between Central Asian biomedical scientists, AI engineers and academic lawyers for the harmonization of AI, nanomedicines and robotics in Central Asian legal system.

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 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)

In this paper I describe a novel application of contemplative techniques to software engineering with the goal of augmenting the intellectual capabilities of knowledge workers within the field in four areas: flexibility, attention, creativity, and trust. The augmentation of software engineers’ intellectual capabilities is proposed as a third complement to the traditional focus of methodologies on the process and environmental factors of the software development endeavor. I argue that these capabilities have been shown to be open to improvement through the (...) practices traditionally used in spiritual traditions, but now used increasingly in other fields of knowledge work, such as in the medical profession and the education field. Historically, the intellectual capabilities of software engineers have been treated as a given within any particular software development effort. This is argued to be an aspect ripe for inclusion within software development methodologies. (shrink)

The Catena aurea entium of Henry of Herford is part of the work of re-elaboration of Aristotle’s natural-philosophical corpus, which characterised the European intellectual environment in the Late Middle Ages. In the central books of his encyclopaedia, Henry comments on the works of natural philosophy of Albert the Great, placing himself in continuity with the cultural project started by Albert in Cologne. The present article aims to compare the 5th book of the Catena aurea entium, which consists of a comment (...) per modum quaestionis on the Meteora of Albert the Great, with some meteorological quaestiones composed between the 13th and 15th centuries. This analysis will lead me to grasp the philosophical orientations and interpretation of Henry and also his reception of Albert the Great’s meteorology. In the 5th book, Henry introduces an extensive medical section taken from the pseudo-Aristotelian Problemata, in which he applies the Galenic medical principles to meteorology. Besides, in the quaestio 105 (V 1 105), he interprets Albert through the theological-poetic explanation of ancient origins on the sacrality of the number three and an excerpt from the Liber proverbiorum. (shrink)

Recent years have witnessed intensive efforts to specify which requirements ethical artificial intelligence (AI) must meet. General guidelines for ethical AI consider a varying number of principles important. A frequent novel element in these guidelines, that we have bundled together under the term explicability, aims to reduce the black-box character of machine learning algorithms. The centrality of this element invites reflection on the conceptual relation between explicability and the four bioethical principles. This is important because the application of general ethical (...) frameworks to clinical decision-making entails conceptual questions: Is explicability a free-standing principle? Is it already covered by the well-established four bioethical principles? Or is it an independent value that needs to be recognized as such in medical practice? We discuss these questions in a conceptual-ethical analysis, which builds upon the findings of an empirical document analysis. On the example of the medical specialty of radiology, we analyze the position of radiological associations on the ethical use of medical AI. We address three questions: Are there references to explicability or a similar concept? What are the reasons for such inclusion? Which ethical concepts are referred to? (shrink)

Vast archives of fragmentary structural brain scans that are routinely acquired in medical clinics for diagnostic purposes have so far been considered to be unusable for neuroscientific research. Yet, recent studies have proposed that by deploying machine learning algorithms to fill in the missing anatomy, clinical scans could, in future, be used by researchers to gain new insights into various brain disorders. This chapter focuses on a study published in2019, whose authors developed a novel unsupervised machine learning algorithm for (...) synthesising missing anatomy in extremely sparse clinical MRI scans of thousands of stroke patients. By approaching the study from a media-theoretical perspective, I analyse how its authors dis-cursively negotiated the anatomical and operative plausibility of the unobserved anatomy that their black-boxed algorithm reconstructed from the existing sparse data. My analysis fore-grounds the processual, relational, context-dependent, and essentially unstable character of the thus established plausibility of the algorithmically synthesised neuroanatomy. (shrink)

Artificial Intelligence (AI) often outperforms human doctors in terms of decisional speed. For some diseases, the expected benefit of a fast but less accurate decision exceeds the benefit of a slow but more accurate one. In such cases, we argue, it is often justified to rely on a medical AI to maximise decision speed – even if the AI is less accurate than human doctors.

Advanced AI systems are rapidly making their way into medical research and practice, and, arguably, it is only a matter of time before they will surpass human practitioners in terms of accuracy, reliability, and knowledge. If this is true, practitioners will have a prima facie epistemic and professional obligation to align their medical verdicts with those of advanced AI systems. However, in light of their complexity, these AI systems will often function as black boxes: the details of their (...) contents, calculations, and procedures cannot be meaningfully understood by human practitioners. When AI systems reach this level of complexity, we can also speak of black-box medicine. In this paper, we want to argue that black-box medicine conflicts with core ideals of patient-centered medicine. In particular, we claim, black-box medicine is not conducive for supporting informed decision-making based on shared information, shared deliberation, and shared mind between practitioner and patient. (shrink)

Fears of black-box algorithms are multiplying. Black-box algorithms are said to prevent accountability, make it harder to detect bias and so on. Some fears concern the epistemology of black-box algorithms in medicine and the ethical implications of that epistemology. In ‘Who is afraid of black box algorithms? On the epistemological and ethical basis of trust in medical AI,' Durán and Jongsma seek to allay such fears. While some of their arguments are compelling, we still see reasons for fear.

Purpose: The method of diagnosing diabetic retinopathy (DR) through artificial intelligence (AI)-based systems has been commercially available since 2018. This introduces new ethical challenges with regard to obtaining informed consent from patients. The purpose of this work is to develop a checklist of items to be disclosed when diagnosing DR with AI systems in a primary care setting. -/- Methods: Two systematic literature searches were conducted in PubMed and Web of Science databases: a narrow search focusing on DR and a (...) broad search on general issues of AI-based diagnosis. An ethics content analysis was conducted inductively to extract two features of included publications: (1) novel information content for AI-aided diagnosis and (2) the ethical justification for its disclosure. -/- Results: The narrow search yielded n = 537 records of which n = 4 met the inclusion criteria. The information process was scarcely addressed for primary care setting. The broad search yielded n = 60 records of which n = 11 were included. In total, eight novel elements were identified to be included in the information process for ethical reasons, all of which stem from the technical specifics of medical AI. -/- Conclusions: Implications for the general practitioner are two-fold: First, doctors need to be better informed about the ethical implications of novel technologies and must understand them to properly inform patients. Second, patient's overconfidence or fears can be countered by communicating the risks, limitations, and potential benefits of diagnostic AI systems. If patients accept and are aware of the limitations of AI-aided diagnosis, they increase their chances of being diagnosed and treated in time. (shrink)

In this paper, we focus on the most efficacious AI applications for life extension and anti-aging at three expected stages of AI development: narrow AI, AGI and superintelligence. First, we overview the existing research and commercial work performed by a select number of startups and academic projects. We find that at the current stage of “narrow” AI, the most promising areas for life extension are geroprotector-combination discovery, detection of aging biomarkers, and personalized anti-aging therapy. These advances could help currently living (...) people reach longevity escape velocity and survive until more advanced AI appears. When AI comes close to human level, the main contribution to life extension will come from AI integration with humans through brain-computer interfaces, integrated AI assistants capable of autonomously diagnosing and treating health issues, and cyber systems embedded into human bodies. Lastly, we speculate about the more remote future, when AI reaches the level of superintelligence and such life-extension methods as uploading human minds and creating nanotechnological bodies may become possible, thus lowering the probability of human death close to zero. We suggest that medical AI based superintelligence could be safer than, say, military AI, as it may help humans to evolve into part of the future superintelligence via brain augmentation, uploading, and a network of self-improving humans. Medical AI’s value system is focused on human benefit. (shrink)

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)

There is considerable enthusiasm about the prospect that artificial intelligence (AI) will help to improve the safety and efficacy of health services and the efficiency of health systems. To realize this potential, however, AI systems will have to overcome structural problems in the culture and practice of medicine and the organization of health systems that impact the data from which AI models are built, the environments into which they will be deployed, and the practices and incentives that structure their development. (...) This perspective elaborates on some of these structural challenges and provides recommendations to address potential shortcomings. (shrink)

This is a model of consciousness. The hard problem of consciousness, what it feels like, is answered. The work builds on medical research analyzing the source and mechanisms associated with our feelings. It goes further by describing a generic model with wide applicability. The model is fully consistent with medical pathways in humans, but easily extends to animals and AI. The essence of the model is the interplay between associative memory and physiology. The model is a clear and (...) concrete counterexample to the famous philosophical objections to a scientific explanation. (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)

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)

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)

We begin at the beginning, with an outline of Aristotle’s views on ontology and with a discussion of the influence of these views on Linnaeus. We move from there to consider the data standardization initiatives launched in the 19th century, and then turn to investigate how the idea of computational ontologies developed in the AI and knowledge representation communities in the closing decades of the 20th century. We show how aspects of this idea, particularly those relating to the use of (...) the term 'concept' in ontology development, influenced SNOMED CT and other medical terminologies. Against this background we then show how the Foundational Model of Anatomy, the Gene Ontology, Basic Formal Ontology and other OBO Foundry ontologies came into existence and discuss their role in the development of contemporary biomedical informatics. (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)

In the year 2020, during the global race to combat the coronavirus, the scientific community experienced a seismic shock when a research paper in the medical science journal The Lancet was retracted [1]. Since then, retractions of research papers in The Lancet have become more frequent. This not only raises concerns about the quality of research within the academic community but also has the potential to erode public trust in science. As transparent retraction notice will help alleviate the negative (...) impacts of retractions on the academia and general public, I used AI (Google Bard) to check whether important information related to the retractions had been provided. (shrink)

Artificial intelligence is one of the most rapidly evolving fields today. It is used in the majority of computer science applications nowadays. Expert systems are one of the most valuable types of AI; they are used to deliver predictions and decisions in order to make scientific, medical, and even architectural challenges easier to address; they will eventually take the place of a human expert. Without having to meet with a genuine human specialist, the user will be able to get (...) a precise solution or diagnose to his problem. This study provides an illustration of how computer systems can be used in agriculture. In order to construct an expert system that can forecast a disease based on its symptoms, we chose a Coriander plant and five of its recognized ailments. CLIPS was used to develop the system. This article contains a full summary of the work that has been done. (shrink)

Dear Colleagues, -/- In this editorial, we would like to share with you important developments in the European Journal of Therapeutics (Eur J Ther). -/- First of all, as the editorial team, we would like you to know that we hold frequent meetings to benefit our esteemed colleagues and continue to work with great devotion in line with our goal of taking the journal further. We have previously shared with you that we have applied to many indexes. It is with (...) great pleasure that we would like to inform you that in the last few months, more of our index applications have been approved. -/- Index Copernicus, as a result of this application, the ICV 2022 value of our journal was determined to be 100 (approved 2023-10-31) [1] BASE (Bielefeld Academic Search Engine) (approved 2023-11-30) [2] Sherpa Romeo (approved 2023-09-27) [3] MIAR (approved 2023-10-16) [4] -/- All indexes in our journal are currently included on the journal web page [5]. -/- As the editorial team, we would like to inform you that we have determined a policy on this issue for our journal [6], taking into account the recommendations of important international ethics committees such as the Committee on Publication Ethics (COPE) [7] and the World Association of Medical Editors (WAME) [8], which have recently become a trendy topic of discussion about AI chatbots and academic studies prepared with the support of such tools. -/- As you know, when our journal was founded in 1990 [9], it was published in two yearly issues. It is an essential responsibility for us to carry our journal, which continued its publication life with three issues a year in 2009 [10] and four issues a year in 2014 [11]. With your valuable support, we would like to announce that we will increase our journal to 6 issues a year as of 2024 (February, April, June, August, October and December) with the rapidly growing progress of our journal. -/- Unfortunately, we cannot share the names of the referees who made significant contributions to our journal in 2023 due to the changes in the article submission interface during the year and the inaccessibility of some data in the previous interface. However, we would like to emphasize again that we are grateful to all of them for their valuable contributions. Moreover, to expand our journal's referee list, we would like to remind you that competent academics who volunteer in this regard can fill out the “Become a Reviewer for the European Journal of Therapeutics” form [12]. -/- Finally, we would like to point out that we have strengthened our editorial team with an academician competent in dentistry, Fatih Sari, DDS, PhD. -/- Fatih Sari, DDS, PhD, is a new Editorial Board Member of the Eur J Ther. Dr. Sari is an Associate Professor in the Department of Prosthodontics at the Gaziantep University Faculty of Dentistry. He is a Vice Dean of the Faculty of Dentistry and Head of Clinical Departments. Dr. Sari is a prosthodontist and a member of the Turkish Dental Association. He has experience in implant-supported fixed prostheses, Cad/Cam applications and dental materials. -/- We look forward to being able to offer you a large number of high-quality and valuable articles over the coming year. In addition, we would like to thank the readers, authors and reviewers of the Eur J Ther for their continuous support. -/- Sincerely yours,. (shrink)

It is easier to talk frankly to a person whom one trusts. It is also easier to agree with a scientist whom one trusts. Even though in both cases the psychological state that underlies the behavior is called ‘trust’, it is controversial whether it is a token of the same psychological type. Trust can serve an affective, epistemic, or other social function, and comes to interact with other psychological states in a variety of ways. The way that the functional role (...) of trust changes across contexts and objects is further complicated when communities and individuals mediate it through technologies, and even more so when that mediation involves artificial intelligence (AI) and machine learning (ML). In this chapter I look at the ways in which trust in institutions, and specifically the medical profession, is affected by the use of AI and ML. There are two key elements of this analysis. The first is a disanalogy between institutional trust in medicine and institutional trust in science (Irzik and Kurtulmus 2021, 2019; Kitcher 2001). I note that as AI and ML become a more prominent part of medicine, trust in a medical institution becomes more like trust in a scientific institution. This is problematic for institutional trust in medicine and the practice of medicine, since institutional trust in science has been undermined by, among other things, the spread of misinformation online and the replication crisis (Romero 2019). There is also a strong analogy between the psychological state of the person who trusts a scientific report or testimony and the psychological state of a patient who trusts individual recommendations made by a medical professional in a clinical setting. In both cases, institutional trust makes it less likely that a mistake or malfeasance will result in reactive attitudes, such as blame or anger, directed at other individual members of that institution. However, it also renders people vulnerable enough to blame the institution itself. This, with time, can erode trust in the institution and naturally leads to policy recommendations that aim to preserve institutional trust. I survey two ways in which that can be done with institutional trust in medicine in the age of AI and ML. (shrink)

Breast cancer is the leading cause of death among women with cancer. Computer-aided diagnosis is an efficient method for assisting medical experts in early diagnosis, improving the chance of recovery. Employing artificial intelligence (AI) in the medical area is very crucial due to the sensitivity of this field. This means that the low accuracy of the classification methods used for cancer detection is a critical issue. This problem is accentuated when it comes to blurry mammogram images. In this (...) paper, convolutional neural networks (CNNs) are employed to present the traditional convolutional neural network (TCNN) and supported convolutional neural network (SCNN) approaches. The TCNN and SCNN approaches contribute by overcoming the shift and scaling problems included in blurry mammogram images. In addition, the flipped rotation-based approach (FRbA) is proposed to enhance the accuracy of the prediction process (classification of the type of cancerous mass) by taking into account the different directions of the cancerous mass to extract effective features to form the map of the tumour. The proposed approaches are implemented on the MIAS medical dataset using 200 mammogram breast images. Compared to similar approaches based on KNN and RF, the proposed approaches show better performance in terms of accuracy, sensitivity, spasticity, precision, recall, time of performance, and quality of image metrics. (shrink)

A properly programmed artificially intelligent agent may eventually have one duty, the duty to satisfice expected welfare. We explain this claim and defend it against objections.

Background: As part of a consistent effort to examine and provide integrative medical approaches to the therapeutic offering for psychophysical health, this study investigates the utilization of Olfactory Virtual Reality (OVR) in an inpatient psychiatry unit, more specifically in the Shepardson 3 Inpatient Psychiatry Unit at the University of Vermont Medical Center, in Burlington, VT, USA. Objectives: The purpose of this protocol is to explore the therapeutic value of olfactory virtual reality (OVR) in the above described population, and (...) to collect statistically significant data to determine the feasibility of potential future OVR studies. Method: Direct subject observation and monitoring in the context of Olfactory Virtual Reality (OVR) sessions and Qualitative data collection via the administration of subject surveys, subdivided in: a) Pre-OVR experience, b) Immediate post-OVR experience, and c) 1-to-3-hour post-OVR experience questionnaires. Results: The research yielded positive outcomes in all areas investigated, despite challenges related to the utilization of the device itself, issues in individual olfactory threshold, and COVID-19 restrictions and limitations. Conclusion: The outcome of this study indicates that the utilization of olfactory virtual reality technologies is a safe and effective integrative approach to target several aspects of psychological and physical health such as anxiety, stress, and pain, in combination with the psychotherapeutic and pharmacological standards of care in inpatient psychiatry. (shrink)

Olfactory Virtual Reality (OVR) for Wellbeing and Reduction of Stress, Anxiety and Pain - Journal of Medical Research and Health Sciences.

Data-driven predictive algorithms are widely used to automate and guide high-stake decision making such as bail and parole recommendation, medical resource distribution, and mortgage allocation. Nevertheless, harmful outcomes biased against vulnerable groups have been reported. The growing research field known as 'algorithmic fairness' aims to mitigate these harmful biases. Its primary methodology consists in proposing mathematical metrics to address the social harms resulting from an algorithm's biased outputs. The metrics are typically motivated by -- or substantively rooted in -- (...) ideals of distributive justice, as formulated by political and legal philosophers. The perspectives of feminist political philosophers on social justice, by contrast, have been largely neglected. Some feminist philosophers have criticized the local scope of the paradigm of distributive justice and have proposed corrective amendments to surmount its limitations. The present paper brings some key insights of feminist political philosophy to algorithmic fairness. The paper has three goals. First, I show that algorithmic fairness does not accommodate structural injustices in its current scope. Second, I defend the relevance of structural injustices -- as pioneered in the contemporary philosophical literature by Iris Marion Young -- to algorithmic fairness. Third, I take some steps in developing the paradigm of 'responsible algorithmic fairness' to correct for errors in the current scope and implementation of algorithmic fairness. I close by some reflections of directions for future research. (shrink)