Search

Technologies shape who we are, how we organize our societies and how we relate to nature. For example, social media challenges democracy; artificial intelligence raises the question of what is unique to humans; and the possibility to create artificial wombs may affect notions of motherhood and birth. Some have suggested that we address global warming by engineering the climate, but how does this impact our responsibility to future generations and our relation to nature? This book shows how technologies can be socially and conceptually disruptive and investigates how to come to terms with this disruptive potential. Four technologies are studied: social media, social robots, climate engineering and artificial wombs. The authors highlight the disruptive potential of these technologies, and the new questions this raises. The book also discusses responses to conceptual disruption, like conceptual engineering, the deliberate revision of concepts.

The proposition that digital innovations can put people in charge of their health has been accompanied by prolific talk of empowerment. In this paper we consider ethical challenges and opportunities of trying to achieve justice and empowerment using digital health initiatives. The language of empowerment can misleadingly suggest that by using technology, people can control their health and take responsibility for health outcomes to a greater degree than is realistic or fair. Also, digital health empowerment often primarily reaches people who already have high technological and health literacy, leaving others behind. We critically investigate whether the concept of health empowerment could be re-engineered to mean something different, namely the process of improving the health literacy and access of those who least possess it, in line with recent proposals for conceptual engineering in the service of justice. We settle on the weaker conclusion that underlying ethical values including justice should be used to interpret the existing concept of empowerment. To conclude, we take a high-level view of various strategies for achieving the ethical value associated with digital health empowerment.

How could ectogestative technology disrupt gender roles, parenting practices, and concepts such as “birth”, “body”, or “parent”? In this chapter, we situate this emerging technology in the context of the history of reproductive technologies, and analyse the potential social and conceptual disruptions to which it could contribute. An ectogestative device, better known as “artificial womb”, enables the extra-uterine gestation of a human being, or mammal more generally. It is currently developed with the main goal to improve the survival chances of extremely premature neonates. We argue that the intended use of the technology in neonatal intensive care units, as an alternative to current incubators (“partial- ectogestation”), challenges concepts such as “birth”, “fetus”, and “neonate”, and has several ethico-legal implications. We moreover address a more futuristic scenario where the entire embryological and fetal development could happen within an artificial womb (“full-ectogestation”). Such a scenario reveals the disruption of gender roles, parenting practices, and concepts such as “mother”, “father”, and “parent”. Both full- and partial-ectogestation would have implications for engineering and design, law-making, ethics, and philosophical anthropology.

Mobile health (mhealth) tools are regularly used in a wide range of mental health domains to assess and monitor patients, potentially increasing patient engagement. Recent studies demonstrated that tailored approaches provide better results than generic approaches. However, the effectiveness of tailoring has not yet been investigated empirically for patients with severe mental illnesses (SMIs). It also remains unclear how personalized goals, which are critical from a treatment point of view, impact engagement. Therefore, we designed a novel mHealth tool to increase SMI patient engagement with their personal goals which we evaluated empirically. We designed a two-period, two-arm within-subject crossover study in which 4 participants were exposed to personalized and non-personalized behavioral goals. Contrary to expectations, personalized behavioral goals did not have a significant impact on engagement levels. When considering our participant feedback and also in the context of flow theory, we rationalized that our goal personalization strategy was too static for SMI patients. Therefore, in our future work, we will investigate dynamic strategies that adapt goal difficulty over time.

In this paper we present an initial roadmap for the ethical development and eventual implementation of artificial amniotic sac and placenta technology in clinical practice. We consider four elements of attention: (1) framing and societal dialogue; (2) value sensitive design, (3) research ethics and (4) ethical and legal research resulting in the development of an adequate moral and legal framework. Attention to all elements is a necessary requirement for ethically responsible development of this technology. The first element concerns the importance of framing and societal dialogue. This should involve all relevant stakeholders as well as the general public. We also identify the need to consider carefully the use of terminology and how this influences the understanding of the technology. Second, we elaborate on value sensitive design: the technology should be designed based upon the principles and values that emerge in the first step: societal dialogue. Third, research ethics deserves attention: for proceeding with first-in-human research with the technology, the process of recruiting and counseling eventual study participants and assuring their informed consent deserves careful attention. Fourth, ethical and legal research should concern the status of the subject in the AAPT. An eventual robust moral and legal framework for developing and implementing the technology in a research setting should combine all previous elements. With this roadmap, we emphasize the importance of stakeholder engagement throughout the process of developing and implementing the technology; this will contribute to ethically and responsibly innovating health care.