Ethics and Technology (1) – a Prerequisite for European Research: Medical and Health Sciences

In this episode we speak with Nikola Biller-Andorno who directs the Institute of Biomedical Ethics and History of Medicine at the University of Zurich in Switzerland. We look at some of the ethics issues in medical and health sciences and how to best integrate key principles for successful ethics outcomes. 

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Episode Transcript

Intro (00:02):
This is a Technikon podcast.

Peter Balint (00:08):
Humankind has been talking about ethics as long as we
have been talking, but ethics and technology now, that's a
relatively new conversation. After all, when we think of ethics,
technology is probably not the first thing that comes to mind.
I'm Peter Balint from Technikon, and I'm happy to bring
you this special podcast series entitled Ethics and Technology - A

(00:31):
Prerequisite for European Research. We can't tackle the entire and
often fluid topic of ethics, but we can show you
that things are being done to avoid unintended ethical consequences
and inequities. We can explain some of the more common
ethical issues that become apparent in technology projects. And we
can tell you how these issues are abated. And that

(00:55):
is exactly what we will do in this series. We
will look at ethics in the context of technology from
many disciplines, including cyber security, infrastructure and smart mobility, artificial
intelligence in personalized health care and forensic software and hardware engineering,
to name a few. We will talk about attitudes towards ethics,

(01:16):
and we will examine how ELSA is increasingly becoming part
of the framework in EU funded projects. And in case
you don't know, ELSA is ethical, legal and societal aspects.
And if you're running a project without regard to ELSA,
your propensity for complications will grow exponentially. To kick things off,

(01:36):
we delve into the idea of ethics in the world
of personalized medicine, more specifically using artificial intelligence to harmonize
tons of data in order to guide doctors towards prescribing
personalized treatment plans for children with cancer. These data consist
of things like medical publications or large molecular data sets.

(01:58):
As you can imagine, balancing the ethical issues with technological
advancements is quite a task. Today, we are lucky enough to
speak with Nikola Biller-Andorno , who directs the Institute of Biomedical
Ethics and History of Medicine at the University of Zurich
in Switzerland. She's an ethics advisor in the EU funded
iPC project, which stands for Individualized Paediatric Cure. Welcome, Nicola.

(02:24):
Thanks so much for coming on.

Nikola Biller-Andorno (02:26):
You're welcome.

Peter Balint (02:27):
iPC is a project that relies on artificial intelligence to
inform medical decisions. What potential conflicts could arise when introducing
ethics into a project like this and how are these
conflicts dealt with?

Nikola Biller-Andorno (02:41):
In my experience, scientists are quite receptive of ethical thinking
and very willing to comply with ethical standards. They just
at times tend to underestimate the complexity of ethical assessments as
compared to the science they are doing. The High-Level Expert
Group on artificial intelligence of the European Commission has issued
guidance that outlines key requirements for trustworthy A.I. These requirements

(03:05):
include human agency and oversight, technical robustness and safety, privacy
and and adequate data governance, transparency, diversity, non-discrimination and fairness,
societal and environmental well-being and accountability. So that's a lot
of stuff to address. And projects can fall short. For instance,
time pressure might lead to the temptation to make compromises

(03:27):
regarding safety tests or commercial interests may tempt developers to
posteriorise privacy concerns. It's therefore helpful if researchers note that
the ethical standards are part of what they expect to
adhere to and that they are morally accountable for their actions.
And in highly innovative fields such as A.I., scientists have

(03:48):
to even go beyond compliance and in fact help interpret
and operationalise ethical principles in light of the work they
are doing. And for me as an ethicist, this is
where the fun part starts.

Peter Balint (03:59):
And if we look at perhaps in the context of
iPC or... actually any EU funded project for that matter,
what gains can be realized by adhering to these ethical
principles other than achievements on moral grounds?

Nikola Biller-Andorno (04:15):
Well, I may be biased, but let me say the
gains are tremendous. Having a clear process for involving ethics
early on can pave the way towards public trust and acceptance,
which is what you need if you want to sell
a product based on your research later on. And even
more so, involving ethics can lead to tools that are
indeed trustworthy, which is, I guess, what we all want
on the user side of things. This, however, requires a

(04:38):
close collaboration between ethicists and scientists, which presumes a willingness
to dedicate resources to ethical inquiry that goes beyond a
token contribution. I think such a serious investment in ethics
is more than worthwhile.

Peter Balint (04:52):
Yes, and it seems this willingness to dedicate resources is
overtly shared by the EU as they start to build
in ethics awareness and reporting into technology projects. Some say
the technology is moving exponentially faster than ethics. This means
that ethics can never catch up. How should we deal

(05:13):
with this in the future?

Nikola Biller-Andorno (05:14):
Yeah, the issue of ethics lagging behind scientific innovation has
been discussed in bioethics for decades, at least since the
human genome project, when people were impressed by the speed
with which the genome was eventually deciphered. We since learned
that ethics can contribute both from outside and from within
such big projects. Such embedded ethics components are certainly helpful

(05:38):
to ensure an almost simultaneous transfer between scientific discovery to
ethical deliberation and discussing ethical issues together when they emerge,
or even trying to anticipate them, is intellectually appealing and
provide scientists with an opportunity to grapple with their social responsibility.
Once you've understood and accepted the ethical dimension of the

(06:00):
work you're doing, it's much easier to communicate with the
public and venture into debates about your own work.

Peter Balint (06:06):
So it sounds like ethics definitely has a place in
research and technology kind of projects, but generally researchers and
engineers tend to believe what they see; and how do
we position ethics principles among formulas and data and complex functions?

Nikola Biller-Andorno (06:24):
Well, scientists typically have no problem at all to understand
and use ethical principles. Oftentimes, they are the ones who
see most clearly where questions might be ahead or what
consequences the practical implementation of a tool may have. It's
important to encourage such open discussions that are uncensured by roles,
hierarchies of conflicts of interest. Excellent scientists are reflective about

(06:45):
their own work, can be an inspiration to younger colleagues,
and can help them see that excellence should not be
limited to technical skills, but also extends to ethical deliberation
and foresight.

Peter Balint (06:57):
OK, let's go back to this concept of artificial intelligence,
which is something that is being explored in your project iPC,
Stephen Hawking once said that artificial intelligence would be either
the best thing humans ever created or the last. So
what do you make of that?

Nikola Biller-Andorno (07:17):
I think that's what's so fascinating about ethics. We can
use technologies in many different ways and it's up to
us to figure out in what direction to take them
or where the limits, you know, where we want to set
limits to ourselves. One example for this malleability is the
so-called death algorithm. AI is getting quite good at predicting

(07:38):
a person's remaining lifetime. This information can obviously be used
against people, but it could also be helpful, for instance,
by making sure they receive palliative care when the time
has come. If we opt to generate this information, how
we use it, who gets access, how it is communicated,
all of that is up to us humans. So I

(08:00):
think Immanuel Kant was spot on when he said in
his critique of practical reason
with ever new and increasing admiration and awe
above me and the moral law within me." Ethics is
hot stuff. And I think it will remain so as
long as humans continue to develop and innovate

Peter Balint (08:21):
And we will be forever innovating, which means ethics will
always have a place in technology. Thank you, Nikola, for
coming on today and sharing your knowledge with us.

Nikola Biller-Andorno (08:30):
You're very welcome. Thanks.

Peter Balint (08:32):
Next time around, we look at ethics in the realm
of infrastructure and technology. Efforts are currently underway to utilize
your phone's built in security features to allow you to
access existing data infrastructures to safely enable electronic voting and
smart mobility. Naturally, a project of this magnitude requires a vigilant

(08:54):
adherence to ethics standards. But we dig deeper to see
why this project goes beyond just data protection. See you
next time.

Outro (09:07):
The iPC project has received funding from the European Union's
Horizon 2020 Research and Innovation Program under grant agreement number
826121