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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.
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