“Man-machine interaction: the application in the disability’s field”  Masterclass in Robo-ethics, 4th lesson  Interdisciplinary Resarch Group on Neurobioethics, 25 January 2019

“Man-machine interaction: the application in the disability’s field” Masterclass in Robo-ethics, 4th lesson Interdisciplinary Resarch Group on Neurobioethics, 25 January 2019

By Giulia Bovassi

Encouraged by the words that the Holy Father, in Humana Communitas, dedicated in memory of the twenty-fifth anniversary of the Pontifical Academy for Life, also accompanied by the operative reality of Dr. Federica Ebau, we are called again in this research session to ask ourselves how to conserve humanity within the context of technical innovation.

Last January 25th, the Interdisciplinary Research Group on Neurobioethics, in cooperation with the UNESCO Chair in Bioethics and Human Rights and the Science and Faith Institute, hosted Federica Ebau, Product Specialist of Progettiamo Autonomia Robotics SRL, in order to reflect on the role of robotics in rehabilitation, a speech – as suggested by Claudio Bonito during his introduction – which could be synthetically defined as a conversation about the responsible use of robotic development. Precisely inasmuch as it is a graft between flesh and artifice, an external habit, robotics cannot disregard proper ethical investigations around the approximation between thinking reality and mechanized reality. An ambivalent combination of euphoria and fear, both settled over the uncomfortable session of the techno-scientific paradox.

Using exactly the term “paradox”, Pope Francis, in the letter mentioned above, presses on the anguish experienced by peoples in the era of scientific excellence. History, indeed the very birth of bioethics, marks the continual warning to tirelessly illuminate the action of the human being, therefore moral action, so that it can act as an indispensable glue between specialized studies and the true good for the “mankind’s care,” where the fundamental rights of every member of the human species, the dignity recognized to them and the responsibility towards the common good are contained. Transversely the commitment of international organizations such as the UNESCO Chair in Bioethics and Human Rights, which has the specific purpose of effectively feeding the solidity of common roots, in order to realize what the Holy Father has also recalled: a “global bioethics”.

Clinical practices, such as the professional experience presented by Ebau, concretize the proposed theorization. Robotics – the preferential research field of the speaker – is not only decisive for national and international territories, but rather a real investment material of the contemporary era, and there are three areas in which robotics will be massively involved: the military one, the hospital one and the industrial one. In the rehabilitation context, the patient – generally a paraplegic person – experiences a complex clinical process compared to able-bodied people, but also because these patients lead a life that is mostly active, domestic, athletic or lively working with an enormous therapeutic and rehabilitative need to combat sedentariness. The previous testimony of Carmine had already made us realize the importance of enormous accomplishments produced by self-esteem, willpower and fighting spirit; in the same way Ebau confirms the positive change in her patients and the centrality, in comparison with the machine, of adopting the existential perspective. “A boy in a wheelchair, with no sensitivity from the chest down, feels nothing. His perception of space is very different from ours; he feels like a tightrope walker hanging in the middle of nowhere”: for this reason the impact with the exoskeleton and therefore the adventure towards a change of dimension, from the bottom to the top, is a delicate point in the relational experience and, in this sense, has been interesting to hear the technique put in place by the doctor, proposing to the patient his own image through a mirror, a method of joining two images of the same person.

Once again we are witnesses that the real conflict between artifice and human being refers to personal identity, to the question about the self.

“Robo-ethics: robotics, rehabilitation, personalization and re-education of body and mind” Masterclass in Robo-ethics, 3rd lesson  Interdisciplinary Research Group on Neurobioethics, 14 December 2018

“Robo-ethics: robotics, rehabilitation, personalization and re-education of body and mind” Masterclass in Robo-ethics, 3rd lesson Interdisciplinary Research Group on Neurobioethics, 14 December 2018

By Giulia Bovassi

Addressing the issue of robotics is now a need that cannot be postponed, particularly in recent times, since a rapid acceleration forced this close face-to-face between robotics and human reality. The technical examination offered by the experts conceptually prepares for the personal testimony of Carmine Consalvi.

This third afternoon, dedicated to the interaction between different forms of specialized knowledge, brought the theory into praxis, not only through the interventions of Giovanni Morone and his colleague, Marco Iosa, but also through the autobiographical note of the young Carmine Consalvi, 31 years, whose history is linked to the exoskeleton application in rehabilitation. As a patient, Carmine brought an important fact back to the heart of the research so far conducted, easily to get lost when you enter conceptually into the bioethical issues, namely the human being. Claudio Bonito, member of the GdN and coordinator of the research subgroup on “Posthumanism”, introducing this last intervention as the conclusion of the afternoon session, contrasted the “to do” with the “to act”: the action framework is working on new moving realities. That Vitruvian man, from whom humanism took inspiration for years, is challenged by the external act, a product of man, the artifice of the creative mind, which runs the risk of reductively exhausting himself in himself, concealing the ultimate destination of a “to do” that makes itself “to act.” Empathy takes over. Carmine shared the following: the invention rushed in my aid by physically, psychologically and humanly giving me new forces, driven by the determination arose in succeeding ex novo to relate myself with someone looking into his eyes, which, backward, the view of the wheelchair, from the bottom towards the other, failed. Six years ago, the road accident: a trauma that drastically influenced his life and his habits causing him the lack of voluntary residual movements, removing the complete control of the trunk; aspects to which Carmine felt called in a physical and existential rehabilitative response. After learning about the exoskeleton, he decided to try it, firstly to test whether innovation was ready for him. The patient’s feedback lies on the adaptability of the robot to its psychological, as well as physical, predisposition. The device is applied when you let it; in this sense, Carmine spoke of a subjective, non-standardized reaction to this type of technology, where a non-marginal role in his case was played by constancy and willpower.

A closure which is in line with the opening of the seminar conducted by Morone, “The right robot for the right person at the right time: state of the art, future perspectives on the use of robots in neuro-rehabilitation,” which accompanied the reflection through the work done at the IRCCS Santa Lucia, where they deal with new technologies used in neuro-rehabilitation. Complex applications under multiple points of view, from the costs to the much longer rehabilitation times, up to the same effectiveness; factors assumed by a part of experts and researchers with extreme skepticism and, by the other part, with excessive optimism, two ways which made the relationship between therapy and technology not always linear – as explained by the professor. Then the fundamental question reiterated by. Morone, pervasive in all the neuro-rehabilitative practice, is: “in the moment when we have to push the neuro-plastic capacity to its maximum for recovery, functionality and ability, during the hospitalization (especially in patients suffering from stroke), did it provide a sufficient stimulus for the patients to their recover?” Here then returns the example embodied by Carmine himself, although with different clinical situations: to know which patients can benefit from therapeutic robotics, so from a generic question “is this robot generally effective?” to “for whom this robot is effective?” We need to change the question because the focus has changed. Within their research group, a team of specialists during about ten years of observation, noted how the resistance was massively sedimented in people psychologically proven by states of anxiety or stress, emotionally disturbed by the robotic element. By looking for a propulsive force in brain plasticity we learn first that there cannot be “any patient” for “any robot,” so that the neuro-rehabilitation principles can be facilitated or increased thanks to the robotic supplement.

Marco Iosa spoke on “The ethics of rehabilitation robots. The three laws of neuro-robotics”, with clear reference to I. Asimov, as the Three Laws of Robotics and to its explanatory filmography, such as “I, Robot.” Robots are designed for three types of work: the dirty one, the boring one and the dangerous one. In the case of rehabilitation or, generically, in medicine, there is a need for adaptability with what the patient wants to do or feels he can do, following a procedure that is very different from what is normally followed by pharmacovigilance. Thus, we could outline three modern laws of robotics in the health field: 

1) a robot for neuro-rehabilitation may not injure a patient or allow a patient to come to harm;

2) a robot must obey the orders given it by the therapists, provided that such orders do not contravene the First Law;

3) a robot must adapt its functioning to the patient’s abilities in a transparent way as long as this does not conflict with the First or Second Laws.

This structure is affected by the difficulty of the “Paradox of efficacy”, i.e. how to benefit from a proven effectiveness-risk criterion. The resolution is obtained changing the request, that is asking for whom it is effective (as already said, the anxious subject, if called to choose between robot and physiotherapist, opts for the latter). The professor noted, “the robot is like the invention of the machine; it answers the question: “what can you not do for the patient?” We thus tread on the limit not only between effectiveness and risk, but between therapeutic and enhancement, highlighted by the performance accomplished with cerebral, electrical or magnetic stimulation. What purpose and what distinction is made between what is therapeutically beneficial and what an enhancement? What is the distinction between treatments to provide for learning or athletic difficulties, emotional or traumatic management in the military field, etc.? Countless examples for a single ethical macro-question: is all that is technically possible also morally licit?

Presentation of the XXI edition 2019 of the Carta Artistica Universale (Universal Artistic Paper) – Marianna Foundation

Presentation of the XXI edition 2019 of the Carta Artistica Universale (Universal Artistic Paper) – Marianna Foundation

On February 19th, UNESCO Chair Director, Prof. Alberto Garcia, as a member of Honorary Committee of the Marianna Foundation, participated in the presentation of the XXI edition 2019 of the Carta Artistica Universale (Universal Artistic Paper).

What Marianna Foundation is?

Pinuccia Pitti

Pinuccia Pitti, the founder, is a painter and poetess who is aware of the painful humanity and of the sacredness and beauty of every human being,. She felt the duty to create the Marianna Foundation to disseminate and promote respect for the fundamental rights of women and of man, using the Universal Declaration of Human Rights (1948) as a reference point. Cultura dell’ amore dall’Europa a Tutti i Popoli della Terra: (Culture of Love from Europe to All the People of the Earth), which  is the central program of the foundation. From this project comes “The Universal Artistic Paper”, an editorial tool that brings Human Rights to the attention of the world. Published each year, every edition deals with a different topic. To disseminate the idea of Human Rights, the “Carta Artistica Universale” uses a pictorial work, a poem by Pinuccia Pitti and a commentary by an authoritative personality, this year, Stefania Giannini, Assistant Director – General for Education, UNESCO, related to the topic of the year and is officially presented during a prestigious evening with important speakers. In the same context, the Foundation gives out different awards which include: The “Intercultura” prize awarded to two students of different nationalities for a paper on the theme of the year; The “A Life for Love” award to a person who has distinguished himself for dedication and humanity.

the XXI edition 2019 of the Carta Artistica Universale (Universal Artistic Paper)

Stefania Giannini, Assistant Director – General for Education, UNESCO, wrote the main massage of the Carta Artistica Universale emphasizing the importance of the UNESCO role in promoting “values of solidarity, social justice, global citizenship and environmental awareness” through art education. Moreover, she added that “advancing these values through the arts is a powerful way to build more inclusive and just societies and to strengthen peace.”

UNESCO Chair in Bioethics and Human Rights is committed to raise awareness of human rights through Global Art and the International Research Group & International Network of Bioethics and Aesthetics that is part of the Bioethics Art Group of Study. Through this project, the chair wants to study the relation and interaction between bioethics, art, and the impact of art in human behavior; evaluate the impact of the transformative power of arts in research and medical ethics as well as in environmental ethics; and to bridge the gap between academics involved working in bioethics and the art world by carrying research activities and publications.

Roboethics: Humans, Machines and Health – Pontifical Academy for Life

Roboethics: Humans, Machines and Health – Pontifical Academy for Life

On February 25th and 26th, the Pontifical Academy for Life organized a workshop on Roboethics: Humans, Machines and Health. The goal of the Workshop was to provide updates on the characteristics of the technologies in the field of robotics. One of the primary goals was to shape and identify the questions rising in the field from the anthropological and ethical point of view through those who work on the ground. Another goal was to propose some ethical criteria and possibly some recommendations in order to reintroduce a global dimension of the theme.

At the workshop, UNESCO Chair Director, Prof. Alberto Garcia had the chance to meet Pope Francis. In their meeting, he presented the Chair and spoke about the that the Chair has carried out through these years in disseminating principles of Human Rights and Bioethics. Through a constantly working towards organizing workshops, national and international conferences, UNESCO Chair in Bioethics and Human Rights is committed to continuing the establishment of forums of discussion on Multiculturalism and Interreligious dialogue, Neurobioethics, and Human Rights.

Participation in the 14th World Congress of Bioethics in Bangalore, India

Participation in the 14th World Congress of Bioethics in Bangalore, India

From December 5 to 7, 2018, the World Congress of Bioethics was held at St. John’s Medical Centre in Bangalore, India.  The theme this year was “Health for All in an Unequal World: Obligations of Global Bioethics.” 

Several fellows and collaborators of the UNESCO Chair participated in this encounter of around 400 bioethicists all over the world.  They presented a symposium on “Social Responsibility and Health according to Western and Hindu Traditions” based on the 4th International Bioethics, Multiculturalism and Religion workshop held in Mexico, 2014 on this topic.

UNESCO Chair fellow Fr. Joseph Tham chaired the session. The symposium hoped to stimulate dialogue among the different presenters, discussants and the audience through the moderation of the chair. This format allowed greater engagement between the audience and experts in the fields of religious ethics and human rights.  At each of the three presentations, the main presenter explained his or her paper, followed by the response of the discussants and eventually fielding questions from the audience. After the three presentations, the chair summarized the findings and opened up the discussion to the audience for further clarifications and debates.

Fr. Tham noticed that in the globalized reality, religions could play an essential role in health promotion. Article 14 of the UNESCO Declaration on Bioethics and Human Rights on Social Responsibility and Health states that “The promotion of health and social development for their people is a central purpose of governments that all sectors of society share… the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being…” The symposium focused on how this article is understood in the West, especially Christianity, and the East, represented by the “Hindu” tradition. The contrast and dialogue between these two time-honored traditions can shed light on the differences and convergence of theories, methodologies, and actions regarding social responsibility and health. In the West, this duty originated from the Good Samaritan question in the Gospel, “Who is thy neighbor?” This idea of supererogation—to act beyond the call of duty—is closest to the ideal of treating every stranger with equality and universality in the current milieu of global ethics and human rights. “Hindu” conceptions on social responsibility are based on the balance between the demands of karma and dharma found in Bhagavad Gita. Karma proposes a somewhat resigned acceptance on individual social status, condition, and fate.  In order to achieve the dharma in the social stages of life, individuals are inspired to serve and alleviate the social needs of the less fortunate. Ultimately, these social responsibilities arise from the spiritual discipline of self-perfection and virtuous living to attain liberation or moksha. Some of the concerns raised in these two traditions are 1) respective responsibilities of organized religion and state in healthcare provision. 2) the relationship between health-salvation at the physical and spiritual level. 3) the feasibility of egalitarian distribution of resources. 4) the language of duty vs. rights.

Fr. Sameer Advani, Research Scholar of the UNESCO Chair in Bioethics and Human Rights and professor at the Regina Apostolorum Pontifical Athenaeum presented his paper on “Christianity and the Asiatic religious worldview in the thought of Benedict XVI.” As one of the most recognized intellectuals in the West and as leader of the Catholic Church, Joseph Ratzinger/ Pope Benedict XVI was instrumental in shaping the debate on a wide array of public issues in the late 20th and early 21st century. Key to his approach was the conviction that humankind discovers truth through dialogue, and he was thus a staunch and tireless defender of the need for secular society to talk with religious traditions and for religions to converse among themselves. This paper introduces the symposium by examining Ratzinger’s proposal, highlighting his notion of religion as the ‘cumulative memory of mankind,’ its role in contributing to public debate, and the particular importance that the Christian and Hindu worldviews play in this process.

Colleen Gallagher, Chief of the Section of Integrated Ethics at Houston’s MD Anderson Cancer Center, spoke on the “Christian conception of Social Responsibility in Health.” Christianity interprets the parable of the Good Samaritan as Jesus’ command to see and care for the stranger in need as our neighbors, even beyond the call of duty. These are works of supererogation that overcome the Old Law of duty with the New Law of love. This understanding further develops into a comprehensive understanding of justice, responsibility, and rights to provide individual and community health needs as reflected in the substantial Catholic healthcare provisions globally. It coincides with the vision of Global health and social responsibility expressed in the UNESCO Declaration of Bioethics and Human Rights.

Dr. Vasantha Muthuswamy, President of FERCI and former Senior Deputy Director General of the Indian Council of Medical Research, explained to us “Hinduism and Social Responsibility.” Vedanta provides the code of conduct and spiritual values which fully anticipate socio-economic problems. It prescribes Dharma, the moral duty of each, and Karma, the line of selfless action to be undertaken without expecting any return. It provides the moral compass by cultivating family and social values to fulfill the social responsibilities towards the needy. Hindu ethics leads to self-realization or liberation from the cycle of birth and death, moksha, through service. The presentation will analyze the UNESCO Declaration through the lens of Hindu tenets that eventually form the guiding principles of the Indian Constitution of India which protects the fundamental rights of its citizens.

The Symposium was very engaging for the 30 or so persons who attended, and there are many interchanges regarding this fascinating intersection of religion, human rights, and social responsibility.