Abstract
Should we be allowed to refuse any involvement of artificial intelligence (AI) technology in diagnosis and treatment planning? This is the relevant question posed by Ploug and Holm in a recent article in Medicine, Health Care and Philosophy. In this article, I adhere to their conclusions, but not necessarily to the rationale that supports them. First, I argue that the idea that we should recognize this right on the basis of a rational interest defence is not plausible, unless we are willing to judge each patient’s ideology or religion. Instead, I consider that the right must be recognized by virtue of values such as social pluralism or individual autonomy. Second, I point out that the scope of such a right should be limited at least under three circumstances: (1) if it is against a physician’s obligation to not cause unnecessary harm to a patient or to not provide futile treatment, (2) in cases where the costs of implementing this right are too high, or (3) if recognizing the right would deprive other patients of their own rights to adequate health care.
Similar content being viewed by others
References
Article 29 Data Protection Working Party. 2018. ARTICLE29 Guidelines on Automated Individual Decision-Making and Profiling for the Purposes of Regulation 2016/679 (wp251rev.01). https://ec.europa.eu/newsroom/article29/item-detail.cfm?item_id=612053. Accessed 20 July 2019
Charter of Fundamental Rights of the European Union (CFR), 2012/C 326/02. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:12012P/TXT. Accessed 20 July 2019
Council of Europe, European Convention for the Protection of Human Rights and Fundamental Freedoms, as amended by Protocols Nos. 11 and 14, 4 November 1950, ETS 5. https://www.refworld.org/docid/3ae6b3b04.html. Accessed 18 Jan 2020
Dreyer, S., and W. Schulz. 2019. The General Data Protection Regulation and Automated Decision-making: Will it deliver? Potentials and limitations in ensuring the rights and freedoms of individuals, groups and society as a whole. Working Paper. Bertelsmann Stiftung. https://www.bertelsmann-stiftung.de/fileadmin/files/BSt/Publikationen/GrauePublikationen/GDPR.pdf. Accessed 11 Aug 2019
Hartzband, P., and J. Groopman. 2009. Keeping the patient in the equation—Humanism and health care reform. New England Journal of Medicine 361: 554–555.
Howard, B.M. 2008. First, do not punish: Individual incentives in health policy, virtual mentor. AMA Journal of Ethics 10 (11): 719–723. https://doi.org/10.1001/virtualmentor.2008.10.11.conl1-0811.
Luce, J.M. 1995. Physicians do not have a responsibility to provide futile or unreasonable care if a patient or family insists. Critical Care Medicine 23: 760–766.
Macklin, R. 2003. Applying the four principles. Journal of Medical Ethics 29: 275–280.
Mitchell, C., and C. Ploem. 2018. Legal challenges for the implementation of advanced clinical digital decision support systems in Europe. Journal of Clinical and Translational Research 3 (Suppl 3): 424–430.
Nikolentzos, A., E. Nolte, and N. Mays. 2008. Paying for (expensive) drugs in the statutory system: An overview of experiences in 13 countries. London: London School of Hygiene & Tropical Medicine. https://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_ 089990. Accessed 20 Aug 2019.
Paris, J.J. 2010. Autonomy does not confer sovereignty on the patient: A commentary on the Golubchuk case. American Journal of Bioethics 10 (3): 54–56.
Petrini, C. 2014. Ethical and legal aspects of refusal of blood transfusions by Jehovah's Witnesses, with particular reference to Italy. Blood Transfusion 12 (Suppl 1): s395–s401. https://doi.org/10.2450/2013.0017-13.
Ploug, T., and S. Holm., 2019. The right to refuse diagnostics and treatment planning by artificial intelligence. Medicine, Health Care and Philosophy. https://doi.org/10.1007/s11019-019-09912-8. [Epub ahead of print]
Schmidt, H. 2007. Patients' charters and health responsibilities. BMJ 335 (7631): 1188.
Turner, L. 2004. Bioethics in pluralistic societies. Medicine, Health Care and Philosophy 7 (2): 201–208.
Varelius, J. 2006. The value of autonomy in medical ethics. Medicine, Health Care and Philosophy 9 (3): 377–788.
Wachter, S., B. Mittelstadt, and L. Floridi. 2017. Why a right to explanation of automated decision-making does not exist in the general data protection regulation. International Data Privacy Law 7 (2): 76–99.
Wilkinson, D., and J. Savulescu. 2018. Cost-equivalence and pluralism in publicly-funded health-care systems. Health Care Analysis 26 (4): 287.
Acknowledgements
Iñigo de Miguel Beriain’s work was supported by the Government of the Basque Country, Grant IT-1066-16 and the EU Commission, H2020 SWAFS Programme, PANELFIT Project, research Grant Number 788039.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
de Miguel Beriain, I. Should we have a right to refuse diagnostics and treatment planning by artificial intelligence?. Med Health Care and Philos 23, 247–252 (2020). https://doi.org/10.1007/s11019-020-09939-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11019-020-09939-2