There is a growing interest in applying the concept of digital twins for preventive medicine and personalised medicine. Originating from industrial design, the concept of digital twins capitalises on data of specific objects to simulate replicas in the virtual world. Its primary function is predictive analysis of safety risks and testing of different optimisation solutions. Applied to the healthcare sector, a digital twin can, for example, be a virtual replica of a particular patient that reflects the unique genetic make-up of the patient, or a simulated 3D model that exhibits the characteristics of a patient’s heart. With the continuous flow of health-related data, a dynamic digital twin allows medical professionals to better assess health risks, determine if early intervention is desirable, and personalise the treatment course. Ideally, these digital twins will allow clinicians to offer more personalised healthcare to individual patients.
However, this novel approach to personalised healthcare also raises new social and ethical issues. Bruynseels et al. (2018) argue that implementing digital twins into the healthcare system will redefine the notion of ‘normality’ or ‘health’ and change our understanding of treatment and enhancement. Recently, Nyholm (2021) suggests that a medical digital twin may be viewed as an extension of a patient’s body. From this perspective, a patient’s digital twin will have a radically different status from the patient’s electronic healthcare records, creating new issues beyond data ownership. From an environmental perspective (see, e.g. Richie, 2020), it is also unclear whether implementing digital twins into the healthcare system will reduce health care’s carbon emissions by promoting preventive medicine or increase carbon intensive personalised medicine.
In this panel, we aim to further explore, and promote research on, the ethical and social implications of digital twins for personalised healthcare.
References
Bruynseels, K., Santoni de Sio, F., & van den Hoven, J. (2018). Digital Twins in Health Care: Ethical Implications of an Emerging Engineering Paradigm. Front Genet, 9, 31. doi:10.3389/fgene.2018.00031
Nyholm, S. (2021). Should a medical digital twin be viewed as an extension of the patient’s body? Journal of Medical Ethics, 47(6), 401-402. doi:10.1136/medethics-2021-107448
Richie, C. (2020). Can United States healthcare become environmentally sustainable? Towards green healthcare reform. Journal of Law, Medicine & Ethics, 48(4), 643 - 652.
Mapping the Ethical Issues of Digital Twins for Personalised Healthcare Service
Dr Pei-hua Huang | Erasmus Medical Centre | Netherlands
Show details
Author:
Dr Pei-hua Huang | Erasmus Medical Centre | Netherlands
The concept of digital twins has great potential for transforming the existing healthcare system by making it more personalised. As a convergence of healthcare, artificial intelligence, and information and communication technologies, personalised healthcare services developed under the concept of digital twins raise a myriad of ethical issues. While some of the ethical issues are known to researchers working on digital health and personalised medicine, currently there is no comprehensive review that maps major ethical risks of digital twins for personalised healthcare services. This creates challenges for developers and relevant parties to proactively address these issues during the designing phase. This paper fills this research gap by identifying major ethical risks of digital twins for personalised healthcare services.
Ethical Implications of a new Engineering Paradigm
Dr Koen Bruynseels | Delft University of Technology | Netherlands
Show details
Author:
Dr Koen Bruynseels | Delft University of Technology | Netherlands
Digital twins constitute an emerging paradigm in traditional engineering disciplines. A digital twins approach seeks high predictive control over individual artifacts. It does so via the usage of tightly coupled and individualized computer models of those individual artifacts.
This promise of ‘predictive maintenance’ of highly complex systems also appeals to medicine. Digital twins can provide a tool to better deal with multifactorial diseases, and obtain higher predictability of treatment outcomes. Transposition of this methodology from the field of engineering to medicine though requires careful consideration, since it originally concerns a methodology developed for increased control over artifacts. Ethical boundaries that are absent in the engineering of artifacts become prominent when applied to human beings and need careful consideration. These ethical boundaries cannot be derived from the data themselves though. Next to this, the philosophical ramifications of digital twins for the concept of medicine in general requires further analysis, in view of its underpinning assumptions and aspirations.
The Ethical and Social Implications of the Rising Digital Twin Paradigm in Healthcare: Environmental Sustainability
Dr Cristina Richie | Delft University of Technology | Netherlands
Show details
Author:
Dr Cristina Richie | Delft University of Technology | Netherlands
The carbon emissions of global healthcare activities make up 4-5% of total world emissions, placing the healthcare industry on par with the food sector. Yet, the environmental impact of health care has been underconsidered, in part, because of the belief that all available health care technologies are medically necessary and therefore carbon emissions are morally irrelevant. As such, when the carbon impact of health care is evaluated, it is primarily at the institutional level—that is, the carbon of hospital buildings. This paradigm circumvents accountability for the environmental impact of healthcare delivery, even though hospital care and physician and clinical services are the two largest carbon contributors to health care—exceeding even healthcare structures. From an environmental perspective, it is unclear whether implementing digital twins into the healthcare system will reduce health care’s carbon emissions by promoting preventive medicine or increase carbon intensive personalised medicine. As technology becomes an integrated and essential part of health care, ethical reflection must include the potential to negatively impact the environment, evaluated the larger framework of biomedical ethics and environmental ethics.
How should we think about the relation between a patient and their digital twin?
Dr. Sven Nyholm | Utrecht University | Netherlands
Show details
Author:
Dr. Sven Nyholm | Utrecht University | Netherlands
Matthias Braun has suggested that not only can we view a digital twin as a representation of a patient's body (or a particular body part of a patient); we can also view a digital twin as an extension of a patient's body. In a recent paper, I have compared this idea to the so-called extended mind thesis put forward by Andy Clark and David Chalmers. My paper was a rather short response to Braun's paper, and in it I did not have space to develop this comparison in any detail. In this presentation, I would like to develop this comparison in more detail to see whether it indeed makes sense to view a digital twin as an extension of a patient's body.