Triage 4.0: On Death Algorithms and Technological Selection. Is Today's Data- Driven Medical System Still Compatible with the Constitution?

J Eur CME. 2021 Nov 17;10(1):1989243. doi: 10.1080/21614083.2021.1989243. eCollection 2021.

Abstract

Health data bear great promises for a healthier and happier life, but they also make us vulnerable. Making use of millions or billions of data points, Machine Learning (ML) and Artificial Intelligence (AI) are now creating new benefits. For sure, harvesting Big Data can have great potentials for the health system, too. It can support accurate diagnoses, better treatments and greater cost effectiveness. However, it can also have undesirable implications, often in the sense of undesired side effects, which may in fact be terrible. Examples for this, as discussed in this article, are discrimination, the mechanisation of death, and genetic, social, behavioural or technological selection, which may imply eugenic effects or social Darwinism. As many unintended effects become visible only after years, we still lack sufficient criteria, long-term experience and advanced methods to reliably exclude that things may go terribly wrong. Handing over decision-making, responsibility or control to machines, could be dangerous and irresponsible. It would also be in serious conflict with human rights and our constitution.

Keywords: Triage; artificial intelligence; big data; ethics; eugenics; technological selection; trolley problem.