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.

Cineforum UER – REPLICAS: Are you your body?

By Claudia Fini

On November 20th, we presented the Cineforum on Replicas, the new film directed by Jeffrey Nachmanoff and starring Keanu Reeves. Replicas tackles the modern concept of artificial intelligence as the translation of human cognitive faculties in an artificial medium. Keanu Reeves plays the role of Will Foster, an employee of the futuristic company Bionyne, whose purpose is, in fact, to transplant the neural network of human consciousness into artificial humanoids. After a car accident that causes the death of his wife and his three children, Foster manages to clone their bodies and transplant their entire consciousness so that none of them has memory of the accident and can continue to live as a replica of the original person. In Replicas, the body thus becomes a chrysalis, a mere item of clothing to change at the time of death, while the mind turns into a set of files to be backed up each time the body medium has to be replaced.

There are many recent film and television productions that deal with the theme of artificial intelligence and mind-body dualism. From The Matrix to the Netflix series Altered Carbon, it’s no wonder how, in the age of technology and information, such parables are at the centre of our most ambitious narrative constructions. And what is more ambitious than immortality? From the practice of mummification of the ancient Egyptians, humanity has always been fascinated by the concept of eternal life. But if once the imagination of men pictured fountains of eternal youth and a body that would never age, now this takes a back seat and leaves room for the myth of the eternal mind and consciousness.

In recent years, the technological revolution and medical and scientific innovations have become deeply intertwined with the ancient human fascination with immortality and have thus given rise to a new cultural movement based on this very premise: trans-humanism. In 1957, biologist Julian Huxley defined transhumanism as “the man who remains human, but who transcends himself, realizing the new potentialities of his human nature, for his human nature”. The romantic theme of Nature and the artificial creation that disturbs the perfect natural balance echoes Mary Shelley’s Frankenstein and the myth of the dangerous knowledge that drives men to cross the boundaries of his existence and dare to “play God”. In modern society, where technology is advancing at a surprisingly fast pace, it is not difficult to imagine how, in the near future, we will be able to exploit novel scientific discoveries to increase human physical and cognitive abilities.

Martin Monti, associate professor at University of California Los Angeles’s Department of Psychology and Director of the MontiLab, has done revolutionary work on the human brain and post-trauma consciousness. According to Dr. Monti, the transcription of the human neural network into a new silicon-based medium is not impossible and that one day it will be possible to obtain results similar to those portrayed in Replicas. According to the integrated information theory, in fact, if we re-create the exact function and the same connections of each neuron in a chip, we could obtain an electrical circuit that is an artificial copy of the original biological system.

Figure 1 Il Professore Martin Monti nel suo ufficio a UCLA, California

Bioethical considerations for policymakers in businesses’ NeuroDI-Warfare.

On November 6th, our research scholar Mariel Kalkach Aparicio will participate in the session entitled “Business and the protection of the general interest and the citizen” part of the The Law, Justice and Development (LJD) Week 2019. 

Abstract

“In this session I will highlight some key components of the bioethical reflections made in research contexts which seem to be less considered in the real-world practices of business. I will focus on the challenges of policymaking within the business-consumer interaction; specifically, in the merging business activities of two types: monitoring of users’ digital trace and research in the form of Neuromarketing. Although there has been progress made in the discussion and regulation, I will argue that it is not enough specially in context of vulnerable populations. If these circumstances remain unchanged, the gap between developed economies and those in development could increase due to the use of technology.” – Mariel Kalkach Aparicio.

PROGRAM OF THE SESSION

 

Timing Speaker Topics addressed
10:00 – 10:04 Anne-Charlotte Gros Introductory remarks
10:04  -10:05 Anne-Charlotte Gros Speaker’s presentation and first question
10:05 – 10:13 Mariel Kalkach Bioethical considerations for policymakers in businesses’ Neuro-Digital-Info Warfare
10:13 – 10:14 Anne-Charlotte Gros Speaker’s presentation and second question
10:14 – 10:18 Louis-Bernard Buchman The protection of personal data : the example of the GDPR
10:18 – 10:19 Anne-Charlotte Gros Speaker’s presentation and third question
10:19 – 10:27 Frédéric Varin The fight against land grabbing in developing countries
10:27 –  10:28 Anne-Charlotte Gros Speaker’s presentation and fourth question
10:28 – 10:36 Jeffrey  Schlagenhauf (To be confirmed) 1) The Work of the OECD Centre for Responsible Business Conduct 2) The Human Centered Business Model
10:36 – 10:37 Anne-Charlotte Gros Fifth question
10:37 – 10:41 Louis-Bernard Buchman The duty of vigilance
10:41 – 10:42 Anne-Charlotte Gros Speaker’s presentation and sixth question
10:42 – 10:50 Stéphane de Navacelle

 

1) The recognition of the social and environmental interest of companies 2) The protection of whistleblowers 3) The fight against corruption
10:50  – 10:51 Anne-Charlotte Gros Speaker’s presentation and seventh question
10:51 – 10:59 Marie-Florence Zampiero-Bouquemont

 

The fight against money laundering
10:59 -11:00 Anne-Charlotte Gros Concluding remarks

XII National Congress SIHTA 2019

From 10 to 11 October, our Chair fellow Fr. Prof. Alberto Carrara, LC, will participate as a speaker in the XII National Congress SIHTA 2019, “the chain of technological innovation in healthcare. The difficult balance between rapid access to the product market, patient safety and sustainability of health systems”.

He will present on “The New Frontiers of the Artificial Intelligence in Medicine from an Ethical Perspective”

The theme of the Congress is linked to the continuous and rapid innovation of technologies in a scenario of important regulatory changes: the business world has been looking for a long time with interest at HTA, or rather at the tools of evaluation and quantitative measurement of the impact that certain technologies they can have on the health of the citizens, on the budget of the Sanitary Companies / Hospitals and, therefore, on the sustainability of the expenditure derived for Institutions and families. This common thread of the event will see the deepening of two major innovations in the health field with which more and more European, national and regional institutions, companies, scientific societies and citizens will have to confront to demonstrate clinical efficacy, patient acceptability and economic sustainability: new gene therapies and artificial intelligence. Two issues that are absolutely transversal to health technologies properly defined internationally (Drugs, Medical Devices, Information Systems, Procedures) will be tackled: the promotion and evaluation of public and private investments in scientific research capable of generating true innovation for the benefit of citizens ; the sustainability and fairness of the new models of healthcare organization within the framework of regional autonomy.

Robotics and Law

On Friday 24 May, our Chair fellow P. Alberto Carrara, L.C. with  Avv. Emanuela Cerasella, coordinator of the GdN subgroup on neurolaw, is organizing a conference entitled Robotics and Law. This event is within the Neurobioethics Masterclass.  Among the participants there will be the Magistrate Dr. Giuseppe Corasaniti, a well-known scholar and expert on issues related to the legal problems in regards of information.