Future machine @ re:publica
May 21, 2021, 6pm
At re:publica 2021, we will travel into a possible future in which artificial intelligence is used to test patients' capacity to give consent. We will discuss different perspectives, contexts and consequences with interested people and experts from different disciplines.
How does this concern me?
In some way or another we all eventually become patients. However, medical treatment is only given if we consent to it. This is part of our right as a patient. Effective consent requires thatwe are capable of giving consent. If there are any doubts about our capacity to consent, the physician treating us will check whether we are actually capable of giving consent.
Why is this relevant?
Lack of capacity to consent and limited decision-making capacity are serious problems: "[E]stimatessuggest that more than one-third of elderly and psychiatric hospital inpatients lack decision-making capacity."7
The German Medical Association (2019, 1133) points out that two ethically and legally problematic constellations can arise in the assessment of capacity to consent, which must be avoided: "On the one hand, if the patient is capable of consenting but is wrongly classified as incapable of consenting and, on the other hand, if the patient is incapable of consenting but is wrongly regarded as capable of consenting. Both can lead to the patient's rights being violated [translated by SMART]."8
This is because these misjudgements are very likely to happen again and again:
In a study of people with mild dementia, only 56% of the possible agreement rate between assessing physicians was achieved.9
Another study reported that physicians only recognised the lack of capacity to consent in 42% of the patients concerned.10
Why are we doing this?
Up until now, the social discourse on new technologies has primarily taken place when they are already in widespread use and society lives with the consequences. This has many disadvantages, e.g. that we as a society do not actively and consciously steer where our society is heading. What is missing is a vision of how we want to live in the future - with the possibilities of technology. With this format, we want to contribute to stimulating social discourse on AI in medicine and society.
We discuss: What could a future look like in which artificial intelligence determines the ability of patients to give consent?
>> 21 May, 6 pm
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References
7. Lamanna, C., & Byrne, L. (2018). Should artificial intelligence augment medical decisionmaking? The case for an autonomy algorithm. AMA Journal of Ethics 20(9), E902-E910
8. Bundesärztekammer (2019). Hinweise und Empfehlungen der Bundesärztekammer zum Umgang mit Zweifeln an der Einwilligungsfähigkeit bei erwachsenen Patienten. Deutsches Ärzteblatt 116(22): A-1133/B-933/C-921
9. Marson D. C., McInturff B., Hawkins L., Bartolucci A., & L.E. Harrell (1997). Consistency of physician judgments of capacity to consent in mild Alzheimer's disease. Journal of the American Geriatrics Society, 45(4), 453–457
10. Sessums L.L., Zembrzuska H. & J.L. Jackson (2011). Does this patient have medical decisionmaking capacity? JAMA 306(4), 420–427.
