The challenges of Artificial Intelligence in healthcare

The challenges of Artificial Intelligence in healthcare

by Claudia Fini

Artificial intelligence (AI) aims to reproduce human intellectual faculties in artificial systems to be employed in a variety of fields, from communication networks and services to medicine and healthcare. The development of AI technologies is well described in its potential to lead to substantial improvements in wellbeing and economic growth however, in order to successfully realize this vision, fundamental questions on AI ethics need to be answered first. One of the most arduous challenges of arriving to a fully functional integration of digital services and human life is to take human rights as a starting point for the formulation of policies and guidelines while also offering a unique environment for innovation. In the medical sector, artificial intelligence (AI) systems have gradually emerged as potentially powerful tools to be employed in disease diagnosis and management, mimicking and perhaps even augmenting the clinical thought and decision-making of human physicians. These innovations could not only lead to improved forms of diagnosis and treatment but also to reduced medical expenses which could play an especially important role in countries were access to healthcare is limited by social and economic factors. For both human physicians and AI systems, patients’ data are the most important starting element.

To formulate a diagnosis, physicians frequently use hypotheticodeductive reasoning, starting with the chief complaint and with appropriately targeted questions related to that complaint. After this initial phase, the physician proceeds to investigate secondary or surrounding areas such as familial history, previous physical exam findings, laboratory testing, and/or imaging studies to rule in or rule out the diagnosis. The entire diagnostic process requires time and extensive data but, if automized with machine learning to extract clinically relevant features, it could be temporally and logistically simplified. A first example is represented by a commonly used technique for drug delivery to cerebral parenchyma. Magnetic particles are injected in the brain tissue and warmed with the use of the magnetic radiation, an operation that allows the burning of specific tumoral areas. The intensity of the magnetic field can be calculated using model-based algorithms, but large volumes of training data needs to be provided in order to determine how these values can be affected by individual variables. Despite their usefulness, operations such as these are not only time expensive but also highly energy intensive. In a recent study, researchers at the University of Massachusetts, Amherst, calculated the time/energy relationship for training several common large AI models. They found that the process can emit more than 626,000 pounds of CO2 which equates approximately to five times the lifetime emissions of the average American car (and that includes manufacture of the car itself). The environmental impact of AI is only one of the many ethical issues associated with the development of intelligent forms of technology: careful evaluation must be designed so that costs for AI do not overshoot its performance, both in terms of energy but most importantly in terms of human identity.

Valuable lessons on the integration between human attributes and technological innovations can be taken from the experience of Da Vinci, an advanced robotic system for minimally invasive surgery, employed in a verity of medical areas, from urology to gynaecology and general surgery. Physical robots similar to those used in industries around the world have been implemented in the medical sector since the early 2000’s. Contrarily to industrial robots however, typically performing single and pre-defined actions like lifting, rotating or cutting objects, medical robots are able to perform more sophisticated and precise tasks that overshoot human precision. They are also becoming more intelligent, as other AI capabilities are being embedded in their operating systems. In Da Vinci, the surgeon is located at a physical distance from the operating field, controlling the robotic arms of the surgical system through monitors and controllers connected to the endoscopic instruments. From a strictly practical analysis, this operation drastically reduces typical “human-errors” due to hand tremors but, from a social perspective, the extensive and ever-perfecting use of these intelligent instruments may lead to (1) a progressive loss of physical and emotional contact between the patient and the doctor and (2) an immediate decline of the creative freedoms of the surgeon.

A first attempt aimed at the restoration of the surgeon’s sensory control over the machine was recently offered by a new generation of robotic arms developed to provide what is known as haptic feedback. A haptic feedback is an advanced pattern of vibration and waveforms conveying tactile information on the instrument’s movements. An everyday common example of haptic feedback is the resistance felt on the steering wheel of new generation cars when immediate danger is identified. When implemented to surgical robots, this sensory information is conveyed as a resistance on the instrument controller as the robotic arms advance inside the operated structure. This feedback is aimed at providing additional guidance to the surgeon’s movements thus preventing unwanted damage to vital tissues. Such novel integrations between human sensory skills and technology’s precision, between mechanical touching and human feeling does not only returns some degree or creative control to the surgeon but it also considerably improves surgical performances compared to those performed without haptic feedback.

The development of artificial intelligence technologies should thus not run isolated and independent from the societal landscape but rather align closely with human needs and intellectual faculties and their limitations. Observations on the role of men and women in the contemporaneity of the digital age should in fact be made in the very first stages of the design of AI services to obtain not only better performing systems but also their ethical advancement in the respect of human rights and values.

19th SUMMER COURSE IN BIOETHICS -Bioethics and Consciousness: an interdisciplinary and interreligious reflection on an essential dimension of the human person

19th SUMMER COURSE IN BIOETHICS -Bioethics and Consciousness: an interdisciplinary and interreligious reflection on an essential dimension of the human person

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INTRODUCTORY COURSE: Current challenges in Bioethics

To propose a global vision of the chief bioethical themes, in light of the fundamental principles that guide practical choices.

How does one choose whether to begin a therapy that might have grave consequences? What can a couple do or not do to have a child? What is the destiny of frozen embryos? How should we educate youth to respect their bodies and not to play with their lives? how should we deal with same-sex tendencies? To what point can the rapid advances in the technology – cloning, neuroscience, nanotechnology enhance man?

Human action also entails ethical questions: we will seek the answer together, through the investigation of a science, as an ally of truth, in the service of life.

REFRESHER COURSE IN BIOETHICS: Bioethics and Consciousness: an interdisciplinary and interreligious reflection on an essential dimension of the human person

The course proposes an interdisciplinary and interreligious study of human consciousness with the aim of understanding the plurality of meanings corresponding to the multi-layered complexity of personal dimensions of which it is composed. The course will offer its participants the chance to acquire the knowledge regarding the following areas: the state of the art of the so-called “science of consciousness” ranging from neuroscience to artificial intelligence and including quantum physics; the medical-clinical and psychiatric-psychological context; the philosophy and anthropology of consciousness; the artistic-aesthetic and theological-spiritual dimension. In this final context, special emphasis will be given to interreligious dialogue.

The course will give its participants the competencies necessary to discern critically the varied contemporary contexts in which consciousness is invoked, in order to evaluate critically clinical protocols, proposed laws, sanitary applications, and the polical, economic and social implications of the theme.

The theme of consciousness is at the center of contemporary bioethics debates. At the beginning stages of human life, the absence of self-consciousness is invoked to justify depriving the human organism of the status of personhood. At the final stages of human life, it is argued that an apparently irreversible loss of the manifestations of human self-consciousness can justify the harvesting of organs as a “donation” from subjects in gravely compromised states of altered consciousness. Moreover, two tensions are widespread in neuroscientific, philosophical and social contexts. On the one hand, there are attempts at reductionism, whether in the merely neurobiological sense or in a functionalist sense. On the other hand, there have emerged many substitutionary approaches that seek to identify personal self-consciousness with mere digitizable information.

AUDIENCES FOR THE COURSES

The summer courses are open to everyone. The introductory course in Bioethics is aimed at all those who intend to approach the world of bioethics, and do not yet know the history, principles, and principle models of the discipline; to all those who are looking for answers regarding questions concerning the meaning of human sexuality, huanity in an embryonic state, criteria and orientations in assisted reproduction, the history, current debate, and scientific data on the so-called gender theory, experimentation, informed consent, neurobioethics, human enhancement, euthanasia, and much more. The bioethics refresher course is of particular interest to social workers; doctors, psychologists and psychiatrists, administrator and managers; educators and professors; priests, religious, catechists and other pastoral agents; lawyers and jurists; politicians; journalists, communicators and sociologists, as well as those who are interested in the cultural and social dynamics of our globalized world and wish to have prudent, informed and critical criteria on global, bioethical and social issues relating to public health issues of international interest.

COURSE STRUCTURE

Both courses consist of lectures, question and answer sessions, seminars, forums, film discussions, and interactive group activities. The professors of the School of Bioethics and other experts will partecipate as speakers and moderators of group dynamics. at the end of each course the students will take an achievement test.

The courses will be given in the Italian and English languages at the Pontifical Athenaeum Regina Apostolorum at via degli Aldobrandeschi 190, Roma, Aula Master, first floor.
Coordinator of the Introductory Course:
Prof. Joseph Tham L.C.
Coordinators of the Refresher Course: Prof. Alberto Carrara L.C. and Prof. Aberto García Gómez

ACADEMIC FEES AND REGISTRATION

The academic fee for attending a single course is 350 euros; for both courses 600 euros. There is the possibility of asking for scholarships. Price recuctions are available for groups.

To register: https:/www.upra.org/modulo-ammissione/
For further information visit the site: www.upra.org and click the section:

Offerta formativa – Bioetica – Corso estivo

For any questions, contact us at: info.bioetica@upra.org

MIUR ACCREDITATION ECTS CREDITS

Both summer courses are part of the courses that the Pontifical Athenaeum Regina Apostulorum, as an accredited body, registers on the S.O.F.I.A. (Operating System for Training and Initiatives for Updating of Teachers) of MIUR (Ministry of Education, the University and Research). At the end of the course the student will be able to apply for the training certificate recognized by MIUR.

The summer course is one of the optional courses of the Licentiate in Bioethics and worth 3 ECTS.

Dialogue in diversity: Cross-cultural challenge of fostering convergence and cooperation in global bioethics

Dialogue in diversity: Cross-cultural challenge of fostering convergence and cooperation in global bioethics

By Alberto García

From 11 to 12 December 2019 Our Director Prof. Alberto Garcia and Chair Fellow Fr. Alberto Carrara, LC, will participate in the international conference: the new anthropological challenges between memory and vision of the future at the Notre Dame Pontifical Institute in Jerusalem organized by Università Europea di Roma.

Prof. Alberto García will discuss Dialogue in diversity: Cross-cultural challenge of fostering convergence and cooperation in global bioethics

Abstract

When we come into contact and communication with people very different from us, we naturally experience a certain feeling of fear. We are afraid of linguistic, political, social, religious, racial or economic diversity. The root of that fear is not the person in front of us, but our ignorance of the other, of his or her world, of his or her cultural and social environment. The knowledge of people helps to overcome fears, prejudices. The encounter with people is the best antidote against intolerance and hate. But I mean a knowledge not of the ideas or ideologies that are learned in the books, but the knowledge and wisdom that flourish from the encounter and dialogue with the diverse.

In my experience of the last 10 years working in the university and in international organizations to promote convergence and cooperation between bioethics experts that come from different cultural traditions, Buddhism, Confucianism, Christianity, Islam,  Judaism and Hinduism, I have been able to make and enjoyable experience that I want to share and I have come to the conviction that this multicultural and intereligious dialogue is not only possible, but that it is a moral imperative that is imposed on me not so much by the force of the rules or laws necessary in political life, but by force of friendship and love I’ve found meeting people. This has convinced me that the experience and the fruit of the dialogue is not only possible and something due, but that it is something particularly beautiful. It helps us to become aware of that universal fraternity that allows us to recognize us as one, that is, part of a common humanity, precisely by appreciating our diversity. It takes us out of our “comfort area” in which I sometimes shield myself to face “face to face” with the treasure of those who do not resemble me, who do not think or believe what I do, who belong to another race or is a citizen of other worlds.

When together we seek to live an existence in peace and harmony, trying to build the common good and social cohesion, we offer to the society a testimony and a credible voice that people who have a religious conviction are not an obstacle to scientific and technological development, nor are we the cause of conflicts and wars – as it is sometimes said. We can and should offer our contribution to the international Community for the sake of an ever more globalized and diverse humanity. Let us not forget that about 83% of the world population has a defined cultural and religious identity (even with varying levels of conviction and observance). Only 17% are atheists and agnostics. So I believe that it is legitimate and fair (it is deeply democratic) that our convergent voices be heard, that is, that of a choir characterized by its religious and philosophical diversity, but that in many respects they have visions not opposed but similar and in great harmony .

7th International Bioethics, Multiculturalism and Religion Workshop

7th International Bioethics, Multiculturalism and Religion Workshop

By Camila Salcedo

On November 11-13, the 7th International Bioethics, Multiculturalism and Religion Workshop was held in Casablanca, Morocco. It was organized by the UNESCO Chair in Bioethics and Human Rights, in partnership with Foundation Cultures du Monde and the Fondation de la Mosquée Hassan II.

This year, the conference was centered on Article 16 of the UNESCO Declaration on Bioethics and Human Rights, “The impact of life sciences on future generations, including on their genetic constitution should be given due regard.” Under this framework, it focused on the ethics of human reproduction, more specifically on pre-natal Testing, pre-implantation genetic diagnosis, and maternal surrogacy. The conference was divided into ten sessions, out of which seven were panels focusing on specific religious or secular traditions. Each of these panels included one main talk by an expert, commentary from an expert from the same tradition, and commentary from an expert from another tradition. These interventions were then followed by hour-long discussions open to all attendees.

The first two sessions set the framework for the workshop. The first session included welcoming remarks by the directors of the three organizing institutions; the director of the Médiathèque de la Fondation de la Mosquée Hassan II, Driss Alaui of the Foundation Cultures du Monde and Come to My Home, and Alberto García and Fr. Joseph Tham, LC, of the UNESCO Chair in Bioethics and Human Rights. The second session held the keynote talks, including an introduction on the latest radical innovations on assisted reproductive technologies (ART) by Prof. John Appleby, an introduction to the use of ART in Israel and Jewish views on these technologies by Dr. Jonathan Halevy, and gynecologist Dr. Paul Lee’s introduction to NaProTechnology, a possible treatment that addresses the underlying causes of infertility.

The third session–and first religious panel–was on Islamic views on ART. The main talk was given by Dr. Aasim Padela, who explained a Sunni Islam position, which rejects most forms of ART. Prof. Padela described several theological arguments and shared polls on the views of American Muslim women on these technologies. Katherine Klima, DNP, co-author of the paper presented by Padela, also joined the panel and later–in the discussion–called for a greater emphasis on the perspectives of ordinary Muslims and on the concept of human flourishing. This paper was commented upon by Prof. Mohammed Ghaly who explained the most prevalent Muslim views of ART by focusing on their understanding of parenthood. Finally, Prof. Mirko Garasic, in his comments, shared a few reflections on ectogenesis (artificial womb) from a secular Jewish perspective. The subsequent discussion centered on the topics of sterility, ectogenesis, parenthood, and the concept of the family.

The fourth session was on Christian views on ART. The main talk was given by Prof. Laura Palazzani, who explained the Catholic views on ART by explaining its emphasis on human dignity and the sanctity of human life, and the Catholic understanding of sex and procreation. Her talk was commented upon by Prof. Chris Durante, who, after an introduction to virtue ethics framework, explained the central role of individual discernment in Orthodoxy for these issues, and shared that the Greek Orthodox Church strongly discourages these practices but does not officially prohibit them. The second commenter was Prof. Paul MacNeill, who spoke from a secular position, calling the audience to try to approach common conclusions and called for the taking of a less legalistic-normative approach to ethics. The discussion that followed included several interventions from the audience who said that dogmatic and legalistic views were misunderstandings of the Catholic approach to ethics as a whole. Another key idea discussed among the experts was the possibility of a religion to reject any given action in its entirety versus only in certain instances.

The fifth session discussed Jewish positions on the current generation’s responsibilities to future generations. The main talk was given by Prof. David Heyd, who explored a section of the Babylonian Talmud that discussed whether it is better to be born or not. While he argued that this debate is meaningless because of the questions that matter are those related to what to do when existence is assumed. He then argued that unconceived people have no moral standing. This was commented upon by Prof. Jonathan Crane, who explored the Scriptural story of Leah and Rachel, on which there was divine intervention to change the children’s sex–or the children were swapped before birth–to prevent a family problem. From this, Prof. Crane deduced the permissibility of embryonic or fetal selection for gender and therapeutic purposes. The second comment was made by Fr. Joseph Tham, LC, who explored the Catholic understanding of existence and the soul, and then analyzed the story of Abraham impregnating Hagar. Fr. Tham interpreted this action as the result of Sarah and Abraham becoming impatient because God had not yet given him descendants and then trying to take destiny into their own hands. Fr. Tham spoke on the question of control in the use of ART and maternal surrogacy. The discussion that followed covered points raised by all three speakers, and it had a special focus on Heyd’s argument for non-responsibility.

The sixth session explored secular perspectives on ART. The first talk was given by Prof. Peter Mills, who discussed the intentions of couples, socio-technical contexts, and current international conventions. Prof. Mills then delved on questions of prenatal testing and human dignity, its possible impact on interpersonal relationships and the freedom of the future person, as well as some discussion on the ethics of the development of new ART techniques. The next intervention was made by Prof. Vardit Ravitsky, who called for a greater focus on the justice principle in bioethics, raising questions about inequity issues with couples who cannot afford ART, the morality of investing in ART given the number of existing children, the complexity of the concept of “healthy” children, and the subject of children who look for their genetic parents. These two interventions were commented upon by Fr. Gonzalo Miranda, LC, who talked from a Christian point of view, focusing on the concepts of human dignity and exploring the importance of metaphysical foundations in bioethics. The discussion covered topics on transhumanism, the concept of ethical boundaries, Catholic views on IVF and assistance versus substitution, interpretations of human rights and dignity, and the concept of the family.

The seventh session explored Buddhist perspectives on ART. The main talk was given by Prof. Ellen Zhang, who explained how hard it is to analyze this topic from Buddhism for lack of applicable content on ancient Buddhist texts. Zhang discussed the use of ARTs and sex selection, which is often condemned by Buddhists, but the gender preference is possibly supported by an ancient text. Prof. Zhang also talked about considerations on the qi energy of wasted sperm and a possible distinction between surrogate motherhood out of compassion and due to commodification. The first commentary was made by Prof. Soraj Hongladarom, who also insisted on the lack of sources and argued on the possible permissibility of surrogacy–even paid surrogacy–out of compassion for both the gestating mother and the couple. These points were responded to by Prof. Nouzha Gessous, who spoke from a Muslim women’s rights perspective, and expressed concerns for how ART could impact women by increasing pressures on child-rearing and through objectification and exploitation in surrogacy. Prof. Gessous also invited the panel to focus more on the children themselves and expressed concern for the idea of the right to have a child, especially a child that fits a set of desired characteristics. The subsequent discussion focused on topics related to the meaning of karma, self-cultivation and ART, international regulations on ART, and how ART impacts cultural expectations for women.

The eighth session–and last panel–was on Hinduism and ART . The first talk was given by Dr. RR Kishore, who explained some basic concepts of Hindu thought, and, using deduction from stories of Indian gods, expressed support for ART due to the interests of the couple, concerns for the possible exploitation of underprivileged women, and concerns for commodification of the embryo–for whom Kishore recognizes a sanctity of life. The first commentary was made by Prof. John Lunstroth, who questioned Kishore’s conclusions by examining his method; especially his deduction from mythical stories and his use of texts not meant for those who are not in the householder stage of life. The second comment was made by Fr. Saamer Advani, LC, who offered a Christian Catholic perspective, and raised questions about Kishore’s definition of the sanctity of life and of how Kishore argued, from ancient stories of self-sacrifice, that embryos (third parties) can be sacrificed for the interests of the couple. The discussion of this panel focused on Kishore and Lunstroth’s understandings of Indian philosophies, especially on moksha, the four stages of life, the soul, the role of women according to the ancient Vedas, and commodification in ART.

The ninth session–and last panel–was on Confucianism and ART. The main talk was given by Prof. Wenquin Zhao, who started by explaining the importance of reproduction in Confucianism and then reflected on the ethical considerations of ART as a possible way of reproduction. Prof. Zhao insisted that these methods must be taken seriously, offering surrogacy as an option (suggesting rituals like to those of adoption to mitigate alienation from the parents), and reflecting on the ambiguities related to PNT and PGD for therapeutic purposes. The first commentator was Prof. Ruiping Fan, who explained further the concept of the Qi’s–which, in Confucianism, is passed on from ancestors–and talked about Confucian hexagrams as a primary source of guidance. The second commentator was Prof. Martha Tarasco, who offered a Catholic perspective, expressing concerns for exploitation in surrogacy and the prioritization of the parental desire to have a biological child over the embryo’s right to life. The session’s discussion centered on the moral status of the unborn–with Fan disagreeing with Zhao–on the value of hexagrams in Confucianism, the value of sperm in Confucianism and Chinese society and discussion on whether loyalty to parents or children should come first.

The last session included final remarks by the organizers and speakers, as well as space for all participants to share thoughts, recommendations, and comments. Several experts said that the event surpassed their expectations–even those who said they were really looking forward to it. An expert also expressed gratitude to the partners for the venue and the cultural events. Many discussed the possible inclusion of speakers from Africa and more speakers from Latin America and suggested a greater diversity in the religious perspectives of discussants. Several also insisted on greater engagement with the local community and with younger scholars and students. Finally, the topics and locations for the next conference were discussed, but no definite topic or location was settled.

Follow this link to see more pictures of the event.