Designing Ethical AI and Healthcare Technologies

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In this thought-provoking and eye-opening episode of Impetus Digital‘s Fireside Chat, I had the pleasure of speaking with Bryn Williams-Jones, Professor & Director of the Bioethics Program at ESPUM and Editor-in-Chief of the Canadian Journal of Bioethics. Among many other things, we discussed the bioethical challenges of innovative healthcare technologies such as AI, digital therapeutics, wearables, and big data & data analytics. Further, we delved into the novel ethical dilemmas brought on by the COVID-19 pandemic and how these can be managed.

Here is a sneak peek of our discussion:

Q: Unfortunately, the concept of mask-wearing has been weaponized and politicized. Can you tell us a little bit about your thoughts around mask-wearing and how this fairs for people’s legal and ethical rights as being free citizens?

A: In the context of a pandemic, we’re immediately forced to confront the limits of our individual liberties, and the recognition that there are lots of things that we can’t do by ourselves, the response has to be collective. That’s the nature of public health and public health is aiming at not the patient but at the population. It’s there to protect us all collectively. The interventions are populational, so it’s groups or entire populations. It’s also operating in the context of uncertainty. At the beginning of the crisis, we didn’t really know about the efficacy of masks. We didn’t know how this virus was circulating. Was it like influenza? Was it super infectious like the common cold? How is it working?

The downside of that is we saw lots of ambivalence on the part of our public health officials and politicians around. “Should we wear masks?”, “Ah, we’re not so sure!”, “It’s not that big of a deal.” The problem with that was it created uncertainty and then when we move towards “Okay, we’ve now got clear recommendations. Everybody should be wearing masks in these contexts and here’s why,” you have to then get over that bubble of uncertainty because that information wasn’t available. Now, you deal with that by actually being a lot more honest and, where I’ve critiqued our health decision-makers is around a lack of transparency on what they know and what they don’t know.

By being more honest to citizens with scientific uncertainty, it enables you to build trust and saying “Here’s what we do know and here’s what we don’t know, but we’re working at it. We’re doing research and as we know more, we’ll change decisions in the light of the best evidence that’s available.” But that best evidence is always a shifting target and that’s normal. That’s science. That’s how health gets done. So in that context, you build trust by being honest.

With the masks, we’re now hitting a stage in Canada where adaption is pretty strong, but we’re also having to ask questions, “Do we now start imposing it and making fines?” because there are some people who are just completely refractory to the standard guidance that’s available right now. We know that the mask is not the only solution, the vaccine will not be the only solution, and physical distancing; it has to be a multi-level approach.

I read an article yesterday that was saying we need the “Swiss cheese approach,” which has multiple holes and the virus doesn’t get through, because it’s hitting multiple layers of protection. Each single layer is insufficient. Together, you now have something that will enable us to get out of this crisis hopefully in the next year or two. But we still have a long way ahead so we’ve got to get over that COVID fatigue of “We really want to get together with our family and friends, and socialize”.

Are we going to really imagine that we’re gonna have a party with 10 people at Christmas and everybody’s going to bring their own dinner and their own cutlery and they’re gonna be wearing a facemask? No, of course not. There’s a calculated risk happening but we also have to be cognizant of that.”

For more of our discussion, you can watch the whole Fireside Chat with Bryn Williams-Jones, or listen to the podcast version, below.

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