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Five Things Bioethicists See in Our Future

Bioethicists from the U.S., Canada, and other countries gathered two weeks ago in Pittsburgh for the annual meeting of the American Society for Bioethics and Humanities.  Here are five themes that emerged:

  • The breakdown of trust between institutions is having direct effects on public health and research, setting the stage for greater inequality.  Researchers are finding that many people, including racial and ethnic minorities, are unwilling to participate in studies, and medical professionals are confronting skepticism from patients who are disregarding their advice.  There is growing discussion that to build trust, we need to shift from relying on simply telling the facts to discussing values, with the goal of naming values that we have in common.
  • U.S. society is completely unprepared for the massive wave of older Americans who will need long-term assistance, with the population over age 80 set to increase by 79% by 2030. Most of them will not be able to pay for their basic needs.
  • Technology, particularly artificial intelligence, has the potential to reduce disparities but also to exacerbate them. “Black box” algorithms, built on biased datasets, can repeat stereotypes and reinforce discrimination. Yet some AI systems, such as new forms of pattern recognition, are offering great medical breakthroughs and could make sophisticated diagnostics, particularly in radiology, available to impoverished people around the world.
  • Gene editing technology has the potential to not only allow parents to modify their future children to avoid disease, but also to enhance them, making them “better than well.”  These changes would be permanent and heritable across generations.  In the rush to innovate, some proponents of new technologies are failing to adequately engage regulators and society.
  • Growing economic disparities in the U.S. are motivating bioethicists to address a wider range of justice issues, and to consider the structural determinants of health and well-being, such as lack of affordable housing. There were calls to address structural injustices at the population level in addition to the longstanding focus of bioethics on ethical choices confronting individuals.