WP1 (concluded) was a scoping WP to find where the most prominent ethical disruptions are located and in which areas reorientation of ethical principles are most urgently needed. When submitting the grant proposal, it was hypothesized that the two main clusters would arise around (a) informed consent and confidentiality/privacy and around (b) the duty of care and professional responsibility and thus disruptions of the concepts of (a) patient autonomy and (b) ‘primum non nocere’. However, the two concepts that have acquired a prominent position in the ethics of disruptive innovation in health care are (a) empowerment and (b) trust (both closely intertwined with patient autonomy and responsibility), but also concepts such as veracity and a meta-ethical shift in medical ethics have come to our attention in the context of disruptive innovation. Several manuscripts have been published based on the research within this first WP, regarding trust (why is trusting a doctor disempowering, but trusting an mHealth tool empowering?), regarding empowerment (what does the empowerment rhetoric mean in the context of healthcare and is it truthful?), regarding the explosion of health-related responsibilities (can I be pregnant and not use a monitoring app?) and regarding the value of veracity (is it morally permissible to make patients believe that they are interacting with humans, when they are interacting with robots/AI ?)
WP2 (ongoing) focuses on developing normative arguments regarding which fundamental procedures, principles or theories in medical ethics ought to be reinforced, adapted or replaced in the face of disruptive innovations to better cope with the challenges ahead. Several manuscripts and commentaries have been published for WP2, regarding the general impact of disruptive innovation in the field of medical ethics; the difficulty of maintaining the “ought implies can” dictum in medical ethics in the face of new disruptive technologies; shifts in the goals of medicine as we are moving to preventive and participatory healthcare; the need for a "principle of explainability"; the need for data cosmopolitanism; the concept of dignity in AI ethics; the epistemological impact of AI and digital health and the risk of epistemic injustice.
WP3 focuses on shifting responsibilities from (a) physicians to patients and (b) from more specialized to less specialized healthcare providers. Several publications on the use of the empowerment rhetoric in the marketing of digital health tools have been published.
WP4 focuses on shifting responsibilities from (a) health care professionals to non-medical players and from (b) healthcare providers to data collectors. This WP is characterised by a global perspective on disruptive innovations, both in methodology, including Ubuntu philosophy, and content, focussing on impact in low
income countries.
So far, we have organized 3 workshops:
“Does disruptive innovation in healthcare require a disruption in medical ethics?” (IAB, Basel, 2022)
“Disruptive Innovation in Healthcare through mHealth: Enhancing or Endangering Personal Autonomy?” (EACME, Warsaw, 2023)
"Shifting responsibilities in healthcare due to disruptive innovation: ethical, legal, and social implications" (Brocher Foundation, Geneva, 2024)
Our research was also presented by the different team members on other academic conferences and workshops, in webinars, and to lay audiences (podcast and lectures).
In summary, the DIME project is currently on track to meet and exceed the deliverables set forward in the application for all 4 work packages. An up-to-date list of our publications can be found at dime.ugent.be/publications.
