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Health Care, Capabilities, and AI Assistive Technologies

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Scenarios involving the introduction of artificially intelligent (AI) assistive technologies in health care practices raise several ethical issues. In this paper, I discuss four objections to introducing AI assistive technologies in health care practices as replacements of human care. I analyse them as demands for felt care, good care, private care, and real care. I argue that although these objections cannot stand as good reasons for a general and a priori rejection of AI assistive technologies as such or as replacements of human care, they demand us to clarify what is at stake, to develop more comprehensive criteria for good care, and to rethink existing practices of care. In response to these challenges, I propose a (modified) capabilities approach to care and emphasize the inherent social dimension of care. I also discuss the demand for real care by introducing the ‘Care Experience Machine’ thought experiment. I conclude that if we set the standards of care too high when evaluating the introduction of AI assistive technologies in health care, we have to reject many of our existing, low-tech health care practices.

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  1. Since this is the discussion I know best, I will mainly refer to the literature on care and robots. However, the arguments presented in this paper are relevant to other AI assistive technologies as well.

  2. Note that it also hurts to see a person’s health gradually diminish. And it is also not always easy, when dealing with a terminally ill patient, for instance, to take and show the ‘right’ emotional attitude towards that person. What does a particular person at a given moment in time need most? Compassion? Encouragement? Which feelings should I show? Should I talk or should I listen?

  3. The latter principles may also be understood as requirements that flow from the principle of (respect for) autonomy.

  4. Although the principles of beneficence and justice seem to be positive principles, they are commonly used in a negative way.

  5. I am aware that to add ‘enhancement’ to this list is very controversial and there are serious difficulties with defining what enhancement means. Therefore, I leave ‘enhancement’ out of my discussion in this paper.

  6. See for instance experiments by Ishiguro and others with the ‘android father’: as far as eye movements of the child go, Ishiguro and others found that the child responds to the android father as if it were her real father - knowing, however, that it is not the real father. For what the presence of a robot does to children see for example the experiments by Nishio et al. (2007).


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Thanks to Nicole Vincent, Nicholas Munn, Aimee van Wynsberghe, and other participants of the International Applied Ethics Conference 2008 (Hokkaido University, Sapporo, Japan), the January 2009 research seminar of the Philosophy section at Delft University of Technology, and the Good Life meetings at the Philosophy Department of Twente University for the discussions we had about robots and care. I also wish to thank the anonymous reviewers for their helpful comments, which improved the quality of my arguments.

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Correspondence to Mark Coeckelbergh.

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Coeckelbergh, M. Health Care, Capabilities, and AI Assistive Technologies. Ethic Theory Moral Prac 13, 181–190 (2010).

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