Diagnostics 11 (3):440 (2021)
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Abstract |
Biomarker-based predictive tests for subjectively asymptomatic Alzheimer’s disease (AD) are utilized in research today. Novel applications of artificial intelligence (AI) promise to predict the onset of AD several years in advance without determining biomarker thresholds. Until now, little attention has been paid to the new ethical challenges that AI brings to the early diagnosis in asymptomatic individuals, beyond contributing to research purposes, when we still lack adequate treatment. The aim of this paper is to explore the ethical arguments put forward for AI aided AD prediction in subjectively asymptomatic individuals and their ethical implications. The ethical assessment is based on a systematic literature search. Thematic analysis was conducted inductively of 18 included publications. The ethical framework includes the principles of autonomy, beneficence, non-maleficence, and justice. Reasons for offering predictive tests to asymptomatic individuals are the right to know, a positive balance of the risk-benefit assessment, and the opportunity for future planning. Reasons against are the lack of disease modifying treatment, the accuracy and explicability of AI aided prediction, the right not to know, and threats to social rights. We conclude that there are serious ethical concerns in offering early diagnosis to asymptomatic individuals and the issues raised by the application of AI add to the already known issues. Nevertheless, pre-symptomatic testing should only be offered on request to avoid inflicted harm. We recommend developing training for physicians in communicating AI aided prediction.
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Keywords | autonomy justice population screening preclinical pre-symptomatic machine learning explicability informed consent |
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References found in this work BETA
Principles of Biomedical Ethics: Marking Its Fortieth Anniversary.James Childress & Tom Beauchamp - 2019 - American Journal of Bioethics 19 (11):9-12.
From What to How: An Initial Review of Publicly Available AI Ethics Tools, Methods and Research to Translate Principles Into Practices.Jessica Morley, Luciano Floridi, Libby Kinsey & Anat Elhalal - 2020 - Science and Engineering Ethics 26 (4):2141-2168.
The Right Not to Know and the Obligation to Know.Ben Davies - 2020 - Journal of Medical Ethics 46 (5):300-303.
How to Write a Systematic Review of Reasons.Daniel Strech & Neema Sofaer - 2012 - Journal of Medical Ethics 38 (2):121-126.
The Right Not to Know: The Case of Psychiatric Disorders.Lisa Bortolotti & Heather Widdows - 2011 - Journal of Medical Ethics 37 (11):673-676.
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