Tag: life insurance

Bioethics News

Japanese Company Replaces Office Workers with Artificial Intelligence

January 6, 2017

(The Guardian) – A future in which human workers are replaced by machines is about to become a reality at an insurance firm in Japan, where more than 30 employees are being laid off and replaced with an artificial intelligence system that can calculate payouts to policyholders. Fukoku Mutual Life Insurance believes it will increase productivity by 30% and see a return on its investment in less than two years. The firm said it would save about 140m yen (£1m) a year after the 200m yen (£1.4m) AI system is installed this month. Maintaining it will cost about 15m yen (£100k) a year.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Response to Call for Essays: Read the Fine Print Before Sending Your Spit to 23andMe

Editor’s note: This essay responds to an invitation (issued here and here) to submit commentaries on the ethical implications of partnerships between social media companies and biomedical researchers. The invitation is ongoing.   

Our genomic sequence constitutes the most sensitive and personal of information: uniquely identifying us, revealing our propensity to develop certain diseases and conditions, and exposing familial connections of close genetic relatives. In recent years, Big Data has taken firm hold in numerous sectors, revolutionizing the volume and velocity at which businesses can collect, curate, and use digital information. Consumers can track what they eat, their fertility, whether they are exercising, and how much they are sleeping. Combining these pieces of data with genomic and health information such as family history, health conditions, disease state, and demographic information constitutes a gold mine for scientific research.

 23andMe capitalized on the quantified self movement and consumers’ effusive willingness to collect and share personal data, transforming it into a highly profitable venture. Within the past year, 23andMe rapidly reinvigorated its business model, introducing Food and Drug Administration-compliant Carrier Screening Reports as part of its new Personal Genome Service, introduced on online recruitment platform for disease specific research cohorts, and publicized multimillion dollar partnerships with pharmaceutical giants such as Genentech.

In numerous media interviews, 23andMe CEO and cofounder Anne Wojcicki beams with positivity about how this model will revolutionize health care; empowering consumers with an awareness of the secrets of their genome while accelerating the speed of research and drug discovery. As one article in the San Francisco Chronicle characterized it, “23andMe wants to do for health what Google has done for the search: make massive quantities of information digital, accessible, and personal.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

When Family Surrogates Go Too Far In Directing Medical Treatment

The role of family surrogates in providing a voice for
incapacitated patients is of crucial importance. Usually, surrogates have the
best interests of the patient in mind and try to work with the physician in
charge to provide the best treatment possible for the patient. In most cases
there is agreement between the surrogate and the physician about the treatment
plan and the goals of care. But as those of us who do clinical ethics
consultations know, there are some cases, maybe 5% or fewer, where there are
serious conflicts between surrogates of patients lacking capacity and
physicians. I want to briefly explore a type of conflict that we seem to be
seeing more often—when the surrogate attempts to get too involved in the
medical management of the patient. Let me use a couple of sample cases to
illustrate the type of conflict I have in mind.

The first is the case of an elderly patient with dementia
and with multiple medical problems, including severe pressure ulcers. This
patient requires regular dressing changes for the pressure ulcers in order to
keep them clean and well managed, requiring the patient to be turned, which
causes her significant discomfort. When these dressing changes happen, the
standard of care is to make sure the patient suffers as little as possible, so
a small amount of morphine is given. But the family surrogate informed the
nurse that she should not use morphine, as she wanted the patient to remain as
alert as possible at all times. When the nurse tries to perform the dressing
changes without giving morphine the patient groans, grimaces, and appears
agitated and in pain.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Why defining death leaves me cold

by John Banja, PhD

*Editor’s note: In case you missed our annual Zombies and Zombethics (TM) Symposium entitled Really, Most Sincerely Dead. Zombies, Vampires and Ghosts. Oh my! you can watch our opening keynote by Dr. Paul Root Wolpe by clicking on the image below. We recommend starting at 9:54 min.


Two weeks ago, I attended a panel session on brain death at the annual conference of the American Society for Bioethics and Humanities. Forgive the bad pun, but the experience left me cold and …lifeless(?). The panel consisted of three scholars revisiting the more than a decade old conversation on defining death. Despite a standing room only crowd, there was utterly nothing new. Rather, we heard a recitation of the very familiar categories that have historically figured in the “What does it mean to be dead?” debate, e.g., the irreversible cessation of cardio-respiratory activity, the Harvard Brain Death criteria, the somatic integration account, the 2008 Presidential Commission’s “loss of the drive to breathe,” and so on. I walked out thinking that we could come back next year, and the year after that, and the year after that and get no closer to resolving what it means to be dead.

Dr. Banja in his natural habitat.

I’d suggest that the reason for this failure is the stubborn persistence of scholars to mistake a social practice, i.e., defining death, for a metaphysical event. Philosophers who insist on keeping the “defining death” conversation alive are invariably moral realists: They mistakenly believe that death is an objectively discernible, universally distributed, a priori, naturally occurring phenomenon that philosophical reasoning and analysis can divine.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Quantified Self: Your Life in Data

by Craig Klugman, Ph.D.

How much did you sleep last night? How many calories did you burn? How many steps did you walk? What was your average resting heart rate? How many calories did you consume? What was your blood oxygen level? If you were a part of the “Quantified Self” movement, then you would have all of these numbers logged on your wearable, your mobile, your phone, your tablet, and your laptop.

The Quantified Self movement is an attempt to use technology to keep track of all physiological aspects of a person’s life. The goal is to quantify yourself by taking biometric measurements so that you can track your health. Similar to a company trying to improve its performance, you can use your metrics to try to improve your numbers, which are used as a stand in for your health and fitness.

The term comes from 2007 when two Wired editors, Kevin Kelly and Gary Wolf, were thinking about what it meant that there were new devices that allowed a person to track their lives. Each person becomes an experiment seeing how habits, actions, activities, and health choices affect the numbers. There are now QS conference, meet up groups, blogs, articles, devices, and programs.

But that’s not all, more than just trying to improve your numbers, you can share your data through websites that can help you keep track of those numbers, share them with your doctor, or even make them available for researchers. You can track your life and contribute to improving other people’s health at the same time.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Caveat Scholasticus

Note: The Bioethics Program blog will be moving to its new home on April 1, 2015. Be sure to change your bookmarks to http://bioethics.uniongraduatecollege.edu/blog/

by Sean Philpott-Jones, Director of the Center for Bioethics and Clinical Leadership

Economists talk a lot about scarcity. Scarcity occurs when we have fewer resources than are necessary to fill our basic needs and wants. Price is usually a good indicator of scarcity. Despite the recent short-term glut of oil, for instance, increasing demand and decreasing supplies of fossil fuels means that gasoline prices will inevitably rise in the coming years.

Ethicists like myself also talk about scarcity. Medical resources are often in short supply and must be rationed. The limited number of beds in the intensive care unit means that doctors must sometimes make difficult choices about which critically ill patients are admitted to the ICU and which are not. Vaccines may also be rationed. In the event of a serious flu epidemic, for example, the New York State Department of Health has a four-tiered vacccine allocation system, with critically needed staff such as doctors, nurses, police and firefighters given priority over grocery clerks, plumbers, mechanics, and stay-at-home dads. But one thing we never thought would be an increasingly scarce resource, at least in the medical setting, was privacy.

Everyone is increasingly concerned about privacy today, and rightfully so. In a progressively wired and interconnected age, there is little about a person that isn’t public knowledge. In fact, despite all our protestations, we as individuals are largely responsible for this loss of personal privacy.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In the Journals — January, Part 2, and February 2015 by Aaron Seaman

This month’s post is extra large, as it gathers the tail end of last month as well. Also, if you haven’t already, check out the special issues listed at the end of this post. Enjoy!

January 2015, Part 2  (You can find Part 1 here)

Medical Anthropology

Anthropologies In and Of Evidence Making In Global Health Research and Policy (Invited Editorial)
Christopher J. Colvin

Anthropologists are not generally known for being optimistic about the state and status of their discipline’s contribution to health research, policy, and practice. Contemporary debates around the forms and effects of knowledge production in health often focus—despairingly, and with good reason—on the continuing dominance of quantitative, narrowly defined biomedical ways of knowing, the rise of the clinical trial and its broader project of evidence-based medicine (EBM), and the conflicted nexus between science and ‘Big Pharma’s’ pursuit of new pharmaceutical knowledge, technologies, and profits (Goldacre 2013; Lambert, Gordon, and Bogdan-Lovis 2006; Mykhalovskiy and Weir 2004; Petryna 2009). Despite the long-standing efforts of advocates from anthropology, sociology, history, and other disciplines to promote the importance of ‘neglected’ forms of social and behavioral research in health—research often glossed as ‘qualitative research’—the picture that most often emerges of the health arena is of a terrain that consists almost entirely of lab experiments, computer modeling, and randomized controlled trials (RCTs). In the last few years, however, I have had the opportunity to be involved in two small, but potentially revealing developments in qualitative health research that might complicate this conventional narrative in useful ways.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Predicting Alzheimer’s Disease: Potential Ethical, Legal, and Social Consequences

(This post oriignally appeared, in very slightly different form,  in the Neuroethics Blog on June 17, 2014, here.)

Would you want to know the date and time of your death? Life-Line, the first published fiction by Robert A. Heinlein, one of the giants of 20th century science fiction, explored that question. The story’s protagonist, Hugo Pinero, had invented a machine that could tell precisely when individuals would die, but, as Pinero found to his distress, he could not intervene to change their fates.

Would you want to know whether you would be diagnosed with Alzheimer disease (AD)? This question is rapidly leaving the realm of science fiction; indeed, it already has for some unlucky people. Our ability to predict who will suffer from this evil (and I chose that word carefully) condition is proceeding on several fronts and may already be coming into clinical use.

This post will briefly note the ways in which AD prediction is advancing and what some of the ethical, legal, and social implications of such an ability would be, before asking “should we care?”

Science

Several different techniques are providing information about an individual’s risk of being diagnosed with AD, including genetics, biomarkers, and neuroimaging.

Genetics can predict AD with great confidence for about one person in a thousand. People who carry a mutated version of the PS1 gene (or, much more rarely, mutated versions of the PS2 or APP genes) are nearly certain to be diagnosed with AD, unless they die earlier from something else, and with an early onset version that typically strikes in one’s 40s or 50s.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Predicting Alzheimer’s Disease: Potential Ethical, Legal, and Social Consequences

By Henry T. Greely, J.D.


Henry T. (Hank) Greely is the Deane F. and Kate Edelman Johnson Professor of Law and Professor, by courtesy, of Genetics at Stanford University. He directs the Stanford Center for Law and the Biosciences and the new Stanford Program in Neuroscience and Society  SPINS). He is also a member of the AJOB Neuroscience Editorial Board.

Would you want to know the date and time of your death? Life-Line, the first published fiction by Robert A. Heinlein, one of the giants of 20th century science fiction, explored that question. The story’s protagonist, Hugo Pinero, had invented a machine that could tell precisely when individuals would die, but, as Pinero found to his distress, he could not intervene to change their fates.

Would you want to know whether you would be diagnosed with Alzheimer disease (AD)? This question is rapidly leaving the realm of science fiction; indeed, it already has for some unlucky people. Our ability to predict who will suffer from this evil (and I chose that word carefully) condition is proceeding on several fronts and may already be coming into clinical use.

This post will briefly note the ways in which AD prediction is advancing and what some of the ethical, legal, and social implications of such an ability would be, before asking “should we care?”

Via the BBC


Science

Several different techniques are providing information about an individual’s risk of being diagnosed with AD, including genetics, biomarkers, and neuroimaging.

Genetics can predict AD with great confidence for about one person in a thousand.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Latest Challenge to Health Privacy: Health Care Consolidation

The American health care industry is undergoing a transformation in several respects, including the substantial integration and consolidation of health care providers. Three of the leading ways in which this is taking place are through mergers of hospitals and health systems, development of accountable care organizations (networks of providers that share responsibility for coordinating patient care), and hospitals purchasing physician practices. There has been considerable discussion about the effects of consolidation on health care cost and quality, but there has been virtually no discussion about the significant effects of consolidation on health privacy.  

A brief example involving a hospital purchasing a physician practice will illustrate how health care consolidation threatens health privacy. Assume that you received mental health treatment from a psychiatrist in private practice, and your mental health records were stored at your psychiatrist’s office and not disclosed without your authorization. Further assume that a local hospital subsequently purchased your psychiatrist’s practice. When you later visit the hospital’s emergency department for treatment of a sprained ankle sustained in the company softball game, the physicians and nurses access your integrated electronic health record (EHR), including records from all of the hospital-owned practices. As a result, your mental health records, which you assumed were confidential, are now accessible by the physicians and nurses treating your ankle.  

Eventually, the interoperability of EHRs will permit health information exchanges (HIEs) or comparable entities to aggregate individual health information stored by various providers. It is not clear, however, whether individuals will have the ability to opt out of participating in an HIE or to segment certain sensitive information.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.