Ethical AI in Dementia Care: Ensuring Innovation Promotes Health Equity
The implementation of artificial intelligence in healthcare, particularly for dementia and frailty early diagnosis, prevention and care, requires ethical frameworks that address both universal principles and context-specific challenges. Within the COMFORTage project, CyberEthics Lab. is developing and applying a comprehensive methodology that combines complementary approaches to evaluate and support the implementation of AI systems in healthcare settings.
ETHAI Framework: A Comprehensive Ethical Approach
The ETHAI (ethics of AI) framework integrates the European Commission’s Ethics Guidelines for Trustworthy AI with care ethics perspectives. The principlist foundation provides seven key requirements: human agency and oversight, technical robustness, privacy, transparency, non-discrimination, societal wellbeing, and accountability.
In the COMFORTage approach, these requirements are interpreted through the lens of four bioethics principles: respect for autonomy, beneficence, non-maleficence, and justice. This ethical approach is then complemented by the ethics of care, which emphasises empathy, relationships and healthcare as a social system.
Addressing Complex Challenges in the European Care Landscape
In the current European landscape, for example, several intersecting challenges shape the broad context of care. The growing aging population, combined with welfare systems weakened by austerity measures, and the erosion of traditional family support networks, creates a complex scenario that demands careful consideration.
This means that ethical innovation for the care of age-related diseases must be aware of these circumstances and it must be responsive to the complexity of relationships between patients, healthcare providers, and caregivers, to ensure that technological advancements promote health equity rather than create new disparities and exclusions. The priority must be protecting vulnerable populations with cognitive impairments and their families throughout all stages of the innovation lifecycle – a principle reinforced by the European Commission’s Silver Deal[1]. This includes addressing, since the early stages of research and development, the age-related challenges, ensuring ethical research practices with all subjects affected by the vulnerabilities caused by dementia and frailty, as well as the digital literacy gaps. Maintaining human dignity in care relationships remains paramount throughout all the proposed initiatives.
CyberEthics Lab’s Methodology Implementation in COMFORTage
At an early stage of COMFORTage project, CyberEthics Lab.’s methodology implementation occurs through three streams: co-designing technical requirements with developers, conducting participatory impact assessments with stakeholders – particularly those potentially affected by AI systems – and feeding results back into the research and innovation process.
The elaboration of these results leads to improved requirements for addressing the ethics concerns through design adjustments. Beyond informing value-sensitive design, this approach enables solutions to identified challenges through governance and policy recommendations.
Recent Developments: Engaging Stakeholders and Strengthening Collaboration
In COMFORTage’s recent meeting in Bucharest, CyberEthics Lab. researchers engaged technical partners in translating ethics principles into technical requirements and involved pilot studies leaders in AI risk assessment.
The first helped opening a channel of communication among ethicists and technical partners, which is essential to drive effective translation of ethics principles and alignment with social values.
The second, contributed to bring in domain knowledge and contextual elements so that they are embedded in the design of AI-based systems.
The next phase will strengthen collaboration within the ethicists and the technical project partners, while expanding engagement to include citizens, particularly through patients’ associations, families and professional caregivers, to continue this work.
Advancing Ethical AI in Healthcare
There is a lot of work ahead, but the early results suggest this approach enables more comprehensive ethics assessment and co-design, particularly through identifying value tensions and trade-offs at an early stage, with the ultimate objective of developing ethically sound technology, aligned with social values and ensuring all human subjects involved enjoy equal access to quality care.
References
[1] «A Silver Deal for Europe: EU and its Member States should assure quality long-term care for its older population in a regulated market | EESC». Consulted: 28 November 2024. [Online]. Available at: https://www.eesc.europa.eu/en/news-media/press-releases/silver-deal-europe-eu-and-its-member-states-should-assure-quality-long-term-care-its-older-population-regulated-market-0
**Article written by Lorena Volpini, Valerio Prosseda – CyberEthics Lab. a key partner in the COMFORTage project
