Respect for patient autonomy and data privacy are generally accepted as foundational western bioethical values. Nonetheless, as our society embraces expanding forms of personal and health monitoring, particularly in the context of an aging population and the increasing prevalence of chronic
diseases, questions abound about how artificial intelligence (AI) may change the way we define or understand what it means to live a free and healthy life. Who should have access to our health and recreational data and for what purpose? How can we find a balance between users' physical safety and
their autonomy? Should we allow individuals to forgo continuous health monitoring, even if such monitoring may minimize injury risks and confer health and societal benefits? Would being continuously watched by connected devices ironically render patients more isolated and their data more exposed
than ever?
Drawing on different use cases of AI health monitoring, this book explores the socio-relational contexts that frame the promotion of AI health monitoring, as well as the potential consequences of such monitoring for people's autonomy. It argues that the evaluation, design, and
implementation of AI health monitoring should be guided by a relational conception of autonomy, which addresses both people's capacity to exercise their agency and broader issues of power asymmetry and social justice. It explores how interpersonal and socio-systemic conditions shape the cultural
meanings of personal responsibility, healthy living and aging, trust, and caregiving. These norms in turn structure the ethical space within which expectations regarding predictive analytics, risk tolerance, privacy, self-care, and trust relationships are expressed. Through an analysis of home
health monitoring for older and disabled adults, direct-to-consumer health monitoring devices, and medication adherence monitoring, this book proposes ethical strategies at both the professional and systemic levels that can help preserve and promote people's relational autonomy in the digital era.
Abbreviations
Acknowledgments
Preface
Introduction
Chapter 1: Artificial Autonomy or Relational Intelligence: How Relationality Matters in Health Monitoring
Chapter 2: Independent Living With(out) Privacy: AI Home Health Monitoring
Chapter 3:
Artificial Doctoring: The Case of Direct-to-Consumer Health Monitoring
Chapter 4: A Digital Pill to Swallow: AI Monitoring for Medication Adherence and Therapeutic Relationship
Chapter 5: From One-Way Mirror to Two-Way Street: Realigning Goals and Practices of AI Health
Monitoring
Prologue
Bibliography
Index
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Anita Ho is Associate Professor at the UCSF Bioethics Program, Clinical Associate Professor at the Centre for Applied Ethics at the University of British Columbia, and Scientist at the Centre for Health Evaluation and Outcomes Sciences. She is also a Senior Director of Ethics at Providence.
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