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Ursin F, Müller R, Funer F, Liedtke W, Renz D, Wiertz S, Ranisch R. Non-empirical methods for ethics research on digital technologies in medicine, health care and public health: a systematic journal review. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2024:10.1007/s11019-024-10222-x. [PMID: 39120780 DOI: 10.1007/s11019-024-10222-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/27/2024] [Indexed: 08/10/2024]
Abstract
Bioethics has developed approaches to address ethical issues in health care, similar to how technology ethics provides guidelines for ethical research on artificial intelligence, big data, and robotic applications. As these digital technologies are increasingly used in medicine, health care and public health, thus, it is plausible that the approaches of technology ethics have influenced bioethical research. Similar to the "empirical turn" in bioethics, which led to intense debates about appropriate moral theories, ethical frameworks and meta-ethics due to the increased use of empirical methodologies from social sciences, the proliferation of health-related subtypes of technology ethics might have a comparable impact on current bioethical research. This systematic journal review analyses the reporting of ethical frameworks and non-empirical methods in argument-based research articles on digital technologies in medicine, health care and public health that have been published in high-impact bioethics journals. We focus on articles reporting non-empirical research in original contributions. Our aim is to describe currently used methods for the ethical analysis of ethical issues regarding the application of digital technologies in medicine, health care and public health. We confine our analysis to non-empirical methods because empirical methods have been well-researched elsewhere. Finally, we discuss our findings against the background of established methods for health technology assessment, the lack of a typology for non-empirical methods as well as conceptual and methodical change in bioethics. Our descriptive results may serve as a starting point for reflecting on whether current ethical frameworks and non-empirical methods are appropriate to research ethical issues deriving from the application of digital technologies in medicine, health care and public health.
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Affiliation(s)
- Frank Ursin
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
| | - Regina Müller
- Institute of Philosophy, University of Bremen, Enrique-Schmidt-Straße 7, 28359, Bremen, Germany
| | - Florian Funer
- Institute for Ethics and History of Medicine, Eberhard Karls University, Gartenstrasse 47, 72074, Tübingen, Tübingen, Germany
| | - Wenke Liedtke
- Faculty of Theology, University of Greifswald, Am Rubenowplatz 2-3, 17489, Greifswald, Germany
| | - David Renz
- Faculty of Protestant Theology, University of Bonn, Am Hofgarten 8, 53113, Bonn, Germany
| | - Svenja Wiertz
- Department of Medical Ethics and the History of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg, Germany
| | - Robert Ranisch
- Junior Professorship for Medical Ethics with a Focus on Digitization, Faculty of Health Sciences Brandenburg, University of Potsdam, Am Mühlenberg 9, 14476, Potsdam, Golm, Germany
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Newett L, McWhirter R, Eckstein L, Warren V, Nicol D. Australian Attitudes Towards Waivers of Consent Within the Context of Genomic Data Sharing. J Empir Res Hum Res Ethics 2024; 19:113-123. [PMID: 39096208 PMCID: PMC11298119 DOI: 10.1177/15562646241261848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 08/05/2024]
Abstract
This research identifies the circumstances in which Human Research Ethics Committees (HRECs) are trusted by Australians to approve the use of genomic data - without express consent - and considers the impact of genomic data sharing settings, and respondent attributes, on public trust. Survey results (N = 3013) show some circumstances are more conducive to public trust than others, with waivers endorsed when future research is beneficial and when privacy is protected, but receiving less support in other instances. Still, results imply attitudes are influenced by more than these specific circumstances, with different data sharing settings, and participant attributes, affecting views. Ultimately, this research raises questions and concerns in relation to the criteria HRECs use when authorising waivers of consent in Australia.
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Affiliation(s)
- Lyndsay Newett
- University of Tasmania, Hobart, TAS, Australia
- Australian National University, Canberra, ACT, Australia
| | - Rebekah McWhirter
- University of Tasmania, Hobart, TAS, Australia
- Australian National University, Canberra, ACT, Australia
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Polevikov S. Advancing AI in healthcare: A comprehensive review of best practices. Clin Chim Acta 2023; 548:117519. [PMID: 37595864 DOI: 10.1016/j.cca.2023.117519] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/20/2023]
Abstract
Artificial Intelligence (AI) and Machine Learning (ML) are powerful tools shaping the healthcare sector. This review considers twelve key aspects of AI in clinical practice: 1) Ethical AI; 2) Explainable AI; 3) Health Equity and Bias in AI; 4) Sponsorship Bias; 5) Data Privacy; 6) Genomics and Privacy; 7) Insufficient Sample Size and Self-Serving Bias; 8) Bridging the Gap Between Training Datasets and Real-World Scenarios; 9) Open Source and Collaborative Development; 10) Dataset Bias and Synthetic Data; 11) Measurement Bias; 12) Reproducibility in AI Research. These categories represent both the challenges and opportunities of AI implementation in healthcare. While AI holds significant potential for improving patient care, it also presents risks and challenges, such as ensuring privacy, combating bias, and maintaining transparency and ethics. The review underscores the necessity of developing comprehensive best practices for healthcare organizations and fostering a diverse dialogue involving data scientists, clinicians, patient advocates, ethicists, economists, and policymakers. We are at the precipice of significant transformation in healthcare powered by AI. By continuing to reassess and refine our approach, we can ensure that AI is implemented responsibly and ethically, maximizing its benefit to patient care and public health.
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Pyrrho M, Cambraia L, de Vasconcelos VF. Response to Open Peer Commentaries on "Privacy and Health Practices in the Digital Age". THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:W5-W8. [PMID: 36200929 DOI: 10.1080/15265161.2022.2127972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Schönau A, Goering S, Versalovic E, Montes N, Brown T, Dasgupta I, Klein E. Asking questions that matter – Question prompt lists as tools for improving the consent process for neurotechnology clinical trials. Front Hum Neurosci 2022; 16:983226. [PMID: 35966997 PMCID: PMC9372354 DOI: 10.3389/fnhum.2022.983226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/15/2022] [Indexed: 11/25/2022] Open
Abstract
Implantable neurotechnology devices such as Brain Computer Interfaces (BCIs) and Deep Brain Stimulators (DBS) are an increasing part of treating or exploring potential treatments for neurological and psychiatric disorders. While only a few devices are approved, many promising prospects for future devices are under investigation. The decision to participate in a clinical trial can be challenging, given a variety of risks to be taken into consideration. During the consent process, prospective participants might lack the language to consider those risks, feel unprepared, or simply not know what questions to ask. One tool to help empower participants to play a more active role during the consent process is a Question Prompt List (QPL). QPLs are communication tools that can prompt participants and patients to articulate potential concerns. They offer a structured list of disease, treatment, or research intervention-specific questions that research participants can use as support for question asking. While QPLs have been studied as tools for improving the consent process during cancer treatment, in this paper, we suggest they would be helpful in neurotechnology research, and offer an example of a QPL as a template for an informed consent tool in neurotechnology device trials.
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Affiliation(s)
- Andreas Schönau
- Department of Philosophy, University of Washington, Seattle, WA, United States
- *Correspondence: Andreas Schönau,
| | - Sara Goering
- Department of Philosophy, University of Washington, Seattle, WA, United States
| | - Erika Versalovic
- Department of Philosophy, University of Washington, Seattle, WA, United States
| | - Natalia Montes
- Department of Philosophy, University of Washington, Seattle, WA, United States
| | - Tim Brown
- Department of Philosophy, University of Washington, Seattle, WA, United States
| | | | - Eran Klein
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
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Rahimzadeh V. Regulatory Angels and Technology Demons? Making Sense of Evolving Realities in Health Data Privacy for the Digital Age. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:68-70. [PMID: 35737504 PMCID: PMC9748849 DOI: 10.1080/15265161.2022.2075981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Smit JAR, Mostert M, van Delden JJM. Protecting Privacy While Optimizing the Use of (Health)Data: The Importance of Measures and Safeguards. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:79-81. [PMID: 35737494 DOI: 10.1080/15265161.2022.2075973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Berkowitz KA. Healthcare Organizations Should Be Accountable Stewards of Patient Data. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:73-75. [PMID: 35737482 DOI: 10.1080/15265161.2022.2075974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Kenneth A Berkowitz
- VHA National Center for Ethics in Health Care
- New York University Grossman School of Medicine
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Versalovic E, Goering S, Klein E. Data, Privacy, and Agency: Beyond Transparency to Empowerment. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:63-65. [PMID: 35737483 PMCID: PMC9521182 DOI: 10.1080/15265161.2022.2075975] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Leib-Neri MA, Prince AER. Privacy and the Genetic Community. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:70-72. [PMID: 35737492 DOI: 10.1080/15265161.2022.2075972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Mittelstadt B. Protecting Health Privacy through Reasonable Inferences. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:65-68. [PMID: 35737503 DOI: 10.1080/15265161.2022.2075980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Malinowska JK, Chomański B. Health Privacy, Racialization, and the Causal Potential of Legal Regulations. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:76-78. [PMID: 35737499 DOI: 10.1080/15265161.2022.2075966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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