Ethics and Nanopharmacy: Value Sensitive Design of New Drugs

Reflections on Putting AI Ethics into Practice: How Three AI Ethics Approaches Conceptualize Theory and Practice

Critics currently argue that applied ethics approaches to artificial intelligence (AI) are too principles-oriented and entail a theory-practice gap. Several applied ethical approaches try to prevent such a gap by conceptually translating ethical theory into practice. In this article, we explore how the currently most prominent approaches of AI ethics translate ethics into practice. Therefore, we examine three approaches to applied AI ethics: the embedded ethics approach, the ethically aligned approach, and the Value Sensitive Design (VSD) approach. We analyze each of these three approaches by asking how they understand and conceptualize theory and practice. We outline the conceptual strengths as well as their shortcomings: an embedded ethics approach is context-oriented but risks being biased by it; ethically aligned approaches are principles-oriented but lack justification theories to deal with trade-offs between competing principles; and the interdisciplinary Value Sensitive Design approach is based on stakeholder values but needs linkage to political, legal, or social governance aspects. Against this background, we develop a meta-framework for applied AI ethics conceptions with three dimensions. Based on critical theory, we suggest these dimensions as starting points to critically reflect on the conceptualization of theory and practice. We claim, first, that the inclusion of the dimension of affects and emotions in the ethical decision-making process stimulates reflections on vulnerabilities, experiences of disregard, and marginalization already within the AI development process. Second, we derive from our analysis that considering the dimension of justifying normative background theories provides both standards and criteria as well as guidance for prioritizing or evaluating competing principles in cases of conflict. Third, we argue that reflecting the governance dimension in ethical decision-making is an important factor to reveal power structures as well as to realize ethical AI and its application because this dimension seeks to combine social, legal, technical, and political concerns. This meta-framework can thus serve as a reflective tool for understanding, mapping, and assessing the theory-practice conceptualizations within AI ethics approaches to address and overcome their blind spots.

The participatory value-sensitive design (VSD) of a mHealth app targeting citizens with dementia in a Danish municipality

The Sammen Om Demens (together for dementia), a citizen science project developing and implementing an AI-based smartphone app targeting citizens with dementia, is presented as an illustrative case of ethical, applied AI entailing interdisciplinary collaborations and inclusive and participative scientific practices engaging citizens, end users, and potential recipients of technological-digital innovation. Accordingly, the participatory Value-Sensitive Design of the smartphone app (a tracking device) is explored and explained across all of its phases (conceptual, empirical, and technical). Namely, from value construction and value elicitation to the delivery, after various iterations engaging both expert and non-expert stakeholders, of an embodied prototype built on and tailored to their values. The emphasis is on how moral dilemmas and value conflicts, often resulting from diverse people's needs or vested interests, have been resolved in practice to deliver a unique digital artifact with moral imagination that fulfills vital ethical-social desiderata without undermining technical efficiency. The result is an AI-based tool for the management and care of dementia that can be considered more ethical and democratic, since it meaningfully reflects diverse citizens' values and expectations on the app. In the conclusion, we suggest that the co-design methodology outlined in this study is suitable to generate more explainable and trustworthy AI, and also, it helps to advance towards technical-digital innovation holding a human face.

Which Framework to Use? A Systematic Review of Ethical Frameworks for the Screening or Evaluation of Health Technology Innovations

Innovations permeate healthcare settings on an ever-increasing scale. Health technology innovations (HTIs) impact our perceptions and experiences of health, care, disease, etc. Because of the fast pace these HTIs are being introduced in different healthcare settings, there is a growing societal consensus that these HTIs need to be governed by ethical reflection. This paper reports a systematic review of argument-based literature which focused on articles reporting on ethical frameworks to screen or evaluate HTIs. To do this a four step methodology was followed: (1) Literature search conducted in five electronic literature databases; (2) Identification of relevant articles; (3) Development of data-extraction tool to analyze the included articles; (4) Analysis, synthesis of data and reporting of results. Fifty-seven articles were included, each reporting on a specific ethical framework. These ethical frameworks existed out of characteristics which were grouped into five common ones: (1) Motivations for development and use of frameworks; (2) Objectives of using frameworks; (3) Specific characteristics of frameworks (background context, scope, and focus); (4) Ethical approaches and concepts used in the frameworks; (5) Methods to use the frameworks. Although this multiplicity of ethical frameworks shows an increasing importance of ethically analyzing HTIs, it remains unclear what the specific role is of these analyses. An ethics of caution, on which ethical frameworks rely, guides HTIs in their design, development, implementation, without questioning their technological paradigm. An ethics of desirability questions this paradigm, without guiding HTIs. In the end, a place needs to be found in-between, to critically assess HTIs.

Mapping value sensitive design onto AI for social good principles

Value sensitive design (VSD) is an established method for integrating values into technical design. It has been applied to different technologies and, more recently, to artificial intelligence (AI). We argue that AI poses a number of challenges specific to VSD that require a somewhat modified VSD approach. Machine learning (ML), in particular, poses two challenges. First, humans may not understand how an AI system learns certain things. This requires paying attention to values such as transparency, explicability, and accountability. Second, ML may lead to AI systems adapting in ways that ‘disembody’ the values embedded in them. To address this, we propose a threefold modified VSD approach: (1) integrating a known set of VSD principles (AI4SG) as design norms from which more specific design requirements can be derived; (2) distinguishing between values that are promoted and respected by the design to ensure outcomes that not only do no harm but also contribute to good, and (3) extending the VSD process to encompass the whole life cycle of an AI technology to monitor unintended value consequences and redesign as needed. We illustrate our VSD for AI approach with an example use case of a SARS-CoV-2 contact tracing app.

Designing AI for Explainability and Verifiability: A Value Sensitive Design Approach to Avoid Artificial Stupidity in Autonomous Vehicles

One of the primary, if not most critical, difficulties in the design and implementation of autonomous systems is the black-boxed nature of the decision-making structures and logical pathways. How human values are embodied and actualised in situ may ultimately prove to be harmful if not outright recalcitrant. For this reason, the values of stakeholders become of particular significance given the risks posed by opaque structures of intelligent agents. This paper explores how decision matrix algorithms, via the belief-desire-intention model for autonomous vehicles, can be designed to minimize the risks of opaque architectures. Primarily through an explicit orientation towards designing for the values of explainability and verifiability. In doing so, this research adopts the Value Sensitive Design (VSD) approach as a principled framework for the incorporation of such values within design. VSD is recognized as a potential starting point that offers a systematic way for engineering teams to formally incorporate existing technical solutions within ethical design, while simultaneously remaining pliable to emerging issues and needs. It is concluded that the VSD methodology offers at least a strong enough foundation from which designers can begin to anticipate design needs and formulate salient design flows that can be adapted to the changing ethical landscapes required for utilisation in autonomous vehicles.

Value-Oriented and Ethical Technology Engineering in Industry 5.0: A Human-Centric Perspective for the Design of the Factory of the Future

Although manufacturing companies are currently situated at a transition point in what has been called Industry 4.0, a new revolutionary wave—Industry 5.0—is emerging as an ‘Age of Augmentation’ when the human and machine reconcile and work in perfect symbiosis with one another. Recent years have indeed assisted in drawing attention to the human-centric design of Cyber-Physical Production Systems (CPPS) and to the genesis of the ‘Operator 4.0’, two novel concepts that raise significant ethical questions regarding the impact of technology on workers and society at large. This paper argues that a value-oriented and ethical technology engineering in Industry 5.0 is an urgent and sensitive topic as demonstrated by a survey administered to industry leaders from different companies. The Value Sensitive Design (VSD) approach is proposed as a principled framework to illustrate how technologies enabling human–machine symbiosis in the Factory of the Future can be designed to embody elicited human values and to illustrate actionable steps that engineers and designers can take in their design projects. Use cases based on real solutions and prototypes discuss how a design-for-values approach aids in the investigation and mitigation of ethical issues emerging from the implementation of technological solutions and, hence, support the migration to a symbiotic Factory of the Future.

Practices of Responsible Research and Innovation: A Review

This paper presents results of a systematic literature review of RRI practices which aimed to gather insights to further both the theoretical and practical development of RRI. Analysing practices of RRI and mapping out main approaches as well as the values, dimensions or characteristics pursued with those practices, can add to understanding of the more conceptual discussions of RRI and enhance the academic debate. The results, based on a corpus of 52 articles, show that practices already reflect the rich variety of values, dimensions and characteristics provided in the main definitions in use, although not all are addressed yet. In fact, articles dealing with uptake of RRI practices may be improved by including more methodological information. RRI practices may further the conceptual debate by including more reflection, and these may foster mutual responsiveness between theory and practice by early anticipating impacts.

Exploring Human Values in the Design of a Web-Based QoL-Instrument for People with Mental Health Problems: A Value Sensitive Design Approach

Quality of life (QoL) is an important outcome measure in mental health care. Currently, QoL is mainly measured with paper and pencil questionnaires. To contribute to the evaluation of treatment, and to enhance substantiated policy decisions in the allocation of resources, a web-based, personalized, patient-friendly and easy to administer QoL instrument has been developed: the QoL-ME. While human values play a significant role in shaping future use practices of technologies, it is important to anticipate on them during the design of the QoL-instrument. The value sensitive design (VSD) approach offers a theory and method for addressing these values in a systematic and principled manner in the design of technologies. While the VSD approach has been applied in the field of somatic care, we extended the VSD approach to the field of mental healthcare with the aim to enable developers of the QoL-instrument to reflect on important human values and anticipate potential value conflicts in its design. We therefore explored how VSD can be used by investigating the human values that are relevant for the design of the QoL-ME. Our exploration reveals that the values autonomy, efficiency, empowerment, universal usability, privacy, redifinition of roles, (redistribution) of responsibilites, reliability, solidarity, surveillance and trust are at stake for the future users of the technology. However, we argue that theoretical reflections on the potential ethical impact of a technology in the design phase can only go so far. To be able to comprehensively evaluate the usability the VSD approach, a supplementary study of the use practices of the technology is needed.

Imaginative Value Sensitive Design: Using Moral Imagination Theory to Inform Responsible Technology Design

Safe-by-design (SBD) frameworks for the development of emerging technologies have become an ever more popular means by which scholars argue that transformative emerging technologies can safely incorporate human values. One such popular SBD methodology is called value sensitive design (VSD). A central tenet of this design methodology is to investigate stakeholder values and design those values into technologies during early stage research and development. To accomplish this, the VSD framework mandates that designers consult the philosophical and ethical literature to best determine how to weigh moral trade-offs. However, the VSD framework also concedes the universalism of moral values, particularly the values of freedom, autonomy, equality trust and privacy justice. This paper argues that the VSD methodology, particularly applied to nano-bio-info-cogno technologies, has an insufficient grounding for the determination of moral values. As such, an exploration of the value-investigations of VSD are deconstructed to illustrate both its strengths and weaknesses. This paper also provides possible modalities for the strengthening of the VSD methodology, particularly through the application of moral imagination and how moral imagination exceeds the boundaries of moral intuitions in the development of novel technologies.

Atomically Precise Manufacturing and Responsible Innovation

Although continued investments in nanotechnology are made, atomically precise manufacturing (APM) to date is still regarded as speculative technology. APM, also known as molecular manufacturing, is a token example of a converging technology, has great potential to impact and be affected by other emerging technologies, such as artificial intelligence, biotechnology, and ICT. The development of APM thus can have drastic global impacts depending on how it is designed and used. This article argues that the ethical issues that arise from APM - as both a standalone technology or as a converging one - affects the roles of stakeholders in such a way as to warrant an alternate means furthering responsible innovation in APM research. This article introduces a value-based design methodology called value sensitive design (VSD) that may serve as a suitable framework to adequately cater to the values of stakeholders. Ultimately, it is concluded that VSD is a strong candidate framework for addressing the moral concerns of stakeholders during the preliminary stages of technological development.

Moving from value sensitive design to virtuous practice design

Purpose

The purpose of this paper is to develop a critique of value sensitive design (VSD) and to propose an alternative approach that does not depart from a heuristic of value(s), but from virtue ethics, called virtuous practice design (VPD).

Design/methodology/approach

This paper develops a philosophical argument, draws from a philosophical method (i.e. virtue ethics) and applies this method to a particular case study that draws from a narrative interview.

Findings

In this paper, authors show how an approach that takes virtue instead of value as the central notion for aiming at a design that is sensitive to ethical concerns can be fruitful both in theory and in practice.

Originality/value

This paper presents the first attempt to ground an approach aimed at ethical technology design on the tradition of virtue ethics. As such, it presents VPD as a potentially fruitful alternative to VSD.

Beneficial Artificial Intelligence Coordination by Means of a Value Sensitive Design Approach

This paper argues that the Value Sensitive Design (VSD) methodology provides a principled approach to embedding common values into AI systems both early and throughout the design process. To do so, it draws on an important case study: the evidence and final report of the UK Select Committee on Artificial Intelligence. This empirical investigation shows that the different and often disparate stakeholder groups that are implicated in AI design and use share some common values that can be used to further strengthen design coordination efforts. VSD is shown to be both able to distill these common values as well as provide a framework for stakeholder coordination.

Co-design of water services and infrastructure for Indigenous Canada: A scoping review

There is movement in engineering fields and in Indigenous communities for enhancement of local participation in the design of community infrastructure. Inclusion of community priorities and unique cultural, spiritual, and traditional values harmonize the appearance, location, and functionality of developments with the social and cultural context in which they are built and contribute to holistic wellness. However, co-design processes that align community values and the technical needs of water facilities are difficult to find. A scoping review was conducted to explore the state of knowledge on co-design of water infrastructure in Indigenous Canada to build a knowledge base from which practices and processes could emerge. The scoping results revealed that articles and reports emerged only in recent years, contained case studies and meta-reviews with primary (qualitative) data, and involved community members in various capacities. Overall, 13 articles were reviewed that contributed to understanding co-design for water infrastructure in Indigenous Canada. Barriers to co-design included funding models for Indigenous community infrastructure, difficulties in engineers and designers understanding Indigenous worldviews and paradigms, and a lack of cooperation among stakeholders that contribute to ongoing design failures. A working definition of co-design for Indigenous water infrastructure is presented.

Digital Twins in Health Care: Ethical Implications of an Emerging Engineering Paradigm

Personalized medicine uses fine grained information on individual persons, to pinpoint deviations from the normal. ‘Digital Twins’ in engineering provide a conceptual framework to analyze these emerging data-driven health care practices, as well as their conceptual and ethical implications for therapy, preventative care and human enhancement. Digital Twins stand for a specific engineering paradigm, where individual physical artifacts are paired with digital models that dynamically reflects the status of those artifacts. When applied to persons, Digital Twins are an emerging technology that builds on in silico representations of an individual that dynamically reflect molecular status, physiological status and life style over time. We use Digital Twins as the hypothesis that one would be in the possession of very detailed bio-physical and lifestyle information of a person over time. This perspective redefines the concept of ‘normality’ or ‘health,’ as a set of patterns that are regular for a particular individual, against the backdrop of patterns observed in the population. This perspective also will impact what is considered therapy and what is enhancement, as can be illustrated with the cases of the ‘asymptomatic ill’ and life extension via anti-aging medicine. These changes are the consequence of how meaning is derived, in case measurement data is available. Moral distinctions namely may be based on patterns found in these data and the meanings that are grafted on these patterns. Ethical and societal implications of Digital Twins are explored. Digital Twins imply a data-driven approach to health care. This approach has the potential to deliver significant societal benefits, and can function as a social equalizer, by allowing for effective equalizing enhancement interventions. It can as well though be a driver for inequality, given the fact that a Digital Twin might not be an accessible technology for everyone, and given the fact that patterns identified across a population of Digital Twins can lead to segmentation and discrimination. This duality calls for governance as this emerging technology matures, including measures that ensure transparency of data usage and derived benefits, and data privacy.

Innovation process and ethics in technology: an approach to ethical (responsible) innovation governance

In general, innovation governance models, which deal with organizational structure, innovation process, strategy and leadership, are becoming increasingly important for innovative companies for effective innovation management. Moreover, responsible innovation (RI) as a topic among academic scholars and policy makers is gaining importance, in order to address some of the ethical concerns and dilemmas as issues of governance in general and with special reference to technological innovations. This article attempts to show that technological innovation processes require a circular RI process instead of a linear one with embedded ethical decision-making framework for ethical innovation governance.

What makes a good home-based nocturnal seizure detector? A value sensitive design

A device for the in-home detection of nocturnal seizures is currently being developed in the Netherlands, to improve care for patients with severe epilepsy. It is recognized that the design of medical technology is not value neutral: perspectives of users and developers are influential in design, and design choices influence these perspectives. However, during development processes, these influences are generally ignored and value-related choices remain implicit and poorly argued for. In the development process of the seizure detector we aimed to take values of all stakeholders into consideration. Therefore, we performed a parallel ethics study, using "value sensitive design." Analysis of stakeholder communication (in meetings and e-mail messages) identified five important values, namely, health, trust, autonomy, accessibility, and reliability. Stakeholders were then asked to give feedback on the choice of these values and how they should be interpreted. In a next step, the values were related to design choices relevant for the device, and then the consequences (risks and benefits) of these choices were investigated. Currently the process of design and testing of the device is still ongoing. The device will be validated in a trial in which the identified consequences of design choices are measured as secondary endpoints. Value sensitive design methodology is feasible for the development of new medical technology and can help designers substantiate the choices in their design.

Recommendations for nanomedicine human subjects research oversight: an evolutionary approach for an emerging field

The nanomedicine field is fast evolving toward complex, "active," and interactive formulations. Like many emerging technologies, nanomedicine raises questions of how human subjects research (HSR) should be conducted and the adequacy of current oversight, as well as how to integrate concerns over occupational, bystander, and environmental exposures. The history of oversight for HSR investigating emerging technologies is a patchwork quilt without systematic justification of when ordinary oversight for HSR is enough versus when added oversight is warranted. Nanomedicine HSR provides an occasion to think systematically about appropriate oversight, especially early in the evolution of a technology, when hazard and risk information may remain incomplete. This paper presents the consensus recommendations of a multidisciplinary, NIH-funded project group, to ensure a science-based and ethically informed approach to HSR issues in nanomedicine, and to integrate HSR analysis with analysis of occupational, bystander, and environmental concerns. We recommend creating two bodies, an interagency Human Subjects Research in Nanomedicine (HSR/N) Working Group and a Secretary's Advisory Committee on Nanomedicine (SAC/N). HSR/N and SAC/N should perform 3 primary functions: (1) analysis of the attributes and subsets of nanomedicine interventions that raise HSR challenges and current gaps in oversight; (2) providing advice to relevant agencies and institutional bodies on the HSR issues, as well as federal and federal-institutional coordination; and (3) gathering and analyzing information on HSR issues as they emerge in nanomedicine. HSR/N and SAC/N will create a home for HSR analysis and coordination in DHHS (the key agency for relevant HSR oversight), optimize federal and institutional approaches, and allow HSR review to evolve with greater knowledge about nanomedicine interventions and greater clarity about attributes of concern.