To analyze which ethically relevant biases have been identified by academic literature in artificial intelligence algorithms developed either for patient risk prediction and triage, or for contact tracing to deal with the COVID-19 pandemic. Additionally, to specifically investigate whether the role of social determinants of health have been considered in these AI developments or not. We conducted a scoping review of the literature, which covered publications from March 2020 to April 2021. ​Studies mentioning biases on AI algorithms developed for contact (...) tracing and medical triage or risk prediction regarding COVID-19 were included. From 1054 identified articles, 20 studies were finally included. We propose a typology of biases identified in the literature based on bias, limitations and other ethical issues in both areas of analysis. Results on health disparities and SDOH were classified into five categories: racial disparities, biased data, socio-economic disparities, unequal accessibility and workforce, and information communication. SDOH needs to be considered in the clinical context, where they still seem underestimated. Epidemiological conditions depend on geographic location, so the use of local data in studies to develop international solutions may increase some biases. Gender bias was not specifically addressed in the articles included. The main biases are related to data collection and management. Ethical problems related to privacy, consent, and lack of regulation have been identified in contact tracing while some bias-related health inequalities have been highlighted. There is a need for further research focusing on SDOH and these specific AI apps. (shrink)

The main aim of this article is to reflect on the impact of biases related to artificial intelligence (AI) systems developed to tackle issues arising from the COVID-19 pandemic, with special focus on those developed for triage and risk prediction. A secondary aim is to review assessment tools that have been developed to prevent biases in AI systems. In addition, we provide a conceptual clarification for some terms related to biases in this particular context. We focus mainly on nonracial biases (...) that may be less considered when addressing biases in AI systems in the existing literature. In the manuscript, we found that the existence of bias in AI systems used for COVID-19 can result in algorithmic justice and that the legal frameworks and strategies developed to prevent the apparition of bias have failed to adequately consider social determinants of health. Finally, we make some recommendations on how to include more diverse professional profiles in order to develop AI systems that increase the epistemic diversity needed to tackle AI biases during the COVID-19 pandemic and beyond. (shrink)

This interdisciplinary volume gathers selected, refereed contributions on various aspects of public health from several disciplines and research fields, including the philosophy of science, epidemiology, statistics and ethics. The contributions were originally presented at the 1st Barcelona conference of “Philosophy of Public Health”. This book is intended for researchers interested in public health and the contemporary debates surrounding it.

El objetivo de este artículo es mostrar la necesidad de abordar de forma coherente los tres temas que se deben analizar en el campo de la justicia en salud. El primero remite al ámbito ético-jurídico de un supuesto derecho a la salud. El segundo es el tema de las desigualdades injustas en salud que se derivan de las desigualdades sociales y económicas. Y el tercero es el tema de la priorización o racionamiento sanitario en un contexto de recursos limitados. En (...) el artículo, describo las principales preguntas y problemas que se suscitan en dichos ámbitos y esbozo algunas conclusiones en cada uno de ellos. También advierto de la necesidad de construir una teoría de la justicia en salud que proporcione una respuesta coherente e integradora de los tres temas. (shrink)

La pobreza extrema y la enorme desigualdad global son un mal de nuestro tiempo, pero ¿son una injusticia? Se indican diferentes tipos de obligaciones morales globales y se critican los enfoques que 1) niegan las obligaciones de justicia en un contexto global, 2) priorizan sistemáticamente las obliga..

Rare diseases generally receive less funding for their medical research and treatments than other diseases. Apart from well-known scientific and economic explanations, there are two major ethical positions regarding this fact, the one that approves it for reasons of utilitarian ethics, and the one that condemns it by insisting on egalitarian and individual rights reasons. In this article, I analyse the problems of both types of moral justification, and propose an ethical alternative based on the idea of political fraternity that, (...) applied to rare diseases, avoids the worst consequences of both utilitarianism and the language of individual rights to health and mere egalitarianism. (shrink)

Una de las cuestiones que debería preocupar más a la teoría de la justicia global es la enorme desigualdad de salud que hay en el mundo. En este artículo, se repasan las causas de la desigualdad global de salud y los argumentos éticos a favor y en contra de la necesidad de tratar dicha desigualdad desde la perspectiva de la justicia global. Tras rechazar los argumentos en contra tanto del libertarismo de derechas como del estatalismo, y tras exponer las críticas (...) tanto al lenguaje de los derechos humanos como a la propuesta poggeana de reducir los deberes de la justicia global a deberes morales negativos, defiendo la necesidad de partir de un criterio de justicia global suficientista y basado en los deberes morales positivos para afrontar la gravedad y la urgencia moral que suponen las desigualdades globales de salud. (shrink)

Extreme poverty and tremendous inequality are an evil of our times, but do they constitute injustice? The article discusses different types of global moral obligations and criticizes those that 1) reject obligations of justice in a global context, 2)systematically prioritize special obligations, and 3) reduce the main obligations ofglobal justice to negative duties. Without necessarily defending global egalitarianism, it is possible to justify the redistribution of wealth in the world on the basis of a wide interpretation of the duty to (...) help and the right to survival. (shrink)