Jose Luis Guerrero Quiñones

In ‘Digital Twins for Trans People in Healthcare: Queer, Phenomenological and Bioethical Considerations’,1 we examine the use of digital twin (DT) technology for transgender individuals. Our central thesis is that a DT does not merely represent the patient’s body, but actively produces a specific kind of body, thereby exerting significant influence on gender identity, self-understanding and embodiment. We propose a framework for the development and use of DTs for trans persons in healthcare as a starting point for future discussions on inclusive DT technology. This challenge has been taken up by many scholars, who have responded with commentaries that offer valuable insights and contributions to the ongoing discourse. Boretti highlights the practical and ethical challenges of creating inclusive DTs. Boretti proposes reinterpreting biomedical principles through a queer bioethical framework, reflects on more inclusive methods of data collection and explores participatory co-design for developing DTs that integrate the lived experiences of trans persons.2 Boretti also provides a helpful figure outlining the key ethical considerations. Wang focuses on how DTs can create false expectations at the physiological level, with patients relying more on the information provided by the technology than on their own bodily experiences.3 As a …

Health consciousness has become unavoidable, and with it an increase in the preoccupation to live according to the mandates of a specific lifestyle that promises to bring health, making us live better and longer. The rapid advances in AI-powered technologies contribute to the gathering and processing of millions of data points reflecting our health, which can be used to design more personalised plans that assist individuals in pursuing a healthier lifestyle. The result is a narrow conception of health that focuses on quantifiable data that can be analysed to generate a model of a healthy subject, who is, consequently, obsessed with optimising each of the variables that contribute to their health. This paper examines how technology delimits and prescribes specific concepts of health and well-being, being especially attentive to how the incorporation of AI into existing tracking medical devices exacerbates a quantified and reductive (self)interpretation of the individual.

Healthcare is one of the domains in which artificial intelligence (AI) is already having a major impact. Of interest is the idea of the digital twin (DT), an AI-powered technology that generates a real-time representation of the patient’s body, offering the possibility of more personalised care. Our main thesis in this paper is that the DT does not merely represent the patient’s body but produces a specific body. We argue, from a philosophical perspective and an ethical-phenomenological approach, that the virtual body created by the DT has a major impact on one’s self-understanding, having consequences for gender expression and identification, and for health. This has deep implications for people who do not conform to gender normativity, for example, trans individuals. We advocate that, with thoughtful development, DT technology can and should be empowering, contributing to better addressing the diversity of bodies and facilitating trans people’s experience in healthcare contexts.

The use of artificial intelligence in healthcare contexts is highly controversial for the (bio)ethical conundrums it creates. One of the main problems arising from its implementation is the lack of transparency of machine learning algorithms, which is thought to impede the patient’s autonomous choice regarding their medical decisions. If the patient is unable to clearly understand why and how an AI algorithm reached certain medical decision, their autonomy is being hovered. However, there are alternatives to prevent the negative impact of AI opacity in shared (healthcare professional–patient) decision-making processes, and benefit from the high accuracy of such systems. Despite these ethical issues, this paper advocates for its usage and also defends the positive role that it could have in enhancing patients’ autonomy. I advocate for a system where the implementation of AI is only partial, and humans will remain in control of oversighting algorithm interpretation of medical images and patients’ data.

This paper aims to explore and offer different hypotheses that could account for an adequate understanding of the duty to die and its relation to biopolitics from two neglected approaches. First, death will be analysed from a biopolitical perspective to understand the crucial role it has in biopower. Second, the focus lies on the two-folded implication that death has in biopower, for it could be either a defiance of it or the final sublimation of its control. Similarly, the next section addresses the relations between death and neoliberalism from a biopolitical perspective, exploring the possibility of understanding the duty to die as resistance to economic mandates or, on the contrary, as the fulfilment of neoliberal interests. Finally, as a continuation of the relations between the duty to die and neo-liberalism, the paper analyses a similar two-folded view of the former from a psychopolitical perspective.

This paper straightforwardly addresses one of the strongest, from an ethical perspective, objections presented to the duty to die, the one concerned with the lack of a normative theory to support it, offered by Seay in his paper Can there be a “duty to die” without a normative theory? The aim of the paper is to provide strong metaethical grounds to support the duty to die without the need of a moral normative theory. First, the definition and main argument for the duty to die will be presented. Second, Seay’s objection will be described and clearly explained. Third, our metaphysical assumptions and a preliminary metaethical discussion will be offered to situate and understand the context. Finally, we will show how the duty to die can be integrated within the metaethical approach previously presented, defending that there is no need of a normative theory to provide good justification and strong ethical grounds for the duty to die, because they will have already been provided by our metaethical argument.

When considering our own death, we normally weigh its impact on the people we love and care about, as well as worrying about the way in which our life might end, hoping that not too much suffering precedes it. However, such view, despite necessary, is a passive understanding of death, interpreted as something that merely happens to us, where we would have some control over timing if physician-assisted dying were legal in our countries. But what if our relation to death would not end there? What if special medical needs, such as the emergency situation resulting from the Covid-19 pandemic, could have a direct impact on us creating a moral duty to end our lives? That is the thesis that will be advocated for in this paper: a moral duty to die will arise in some people to save resources that will help others get through Covid-19. It is important to indicate that the duty to die is personally acknowledged and self-imposed, thus nobody can be coerced to carry it out; for autonomy would be lost and such action should be considered an instance of incitement to die, therefore being morally blameworthy.

Euthanasia and the duty to die have both been thoroughly discussed in the field of bioethics as morally justifiable practices within medical healthcare contexts. The existence of a narrow connection between both could also be established, for people having a duty to die should be allowed to actively hasten their death by the active means offered by euthanasia. Choosing the right time to end one’s own life is a decisive factor to retain autonomy at the end of our lives. However, there is no definitive consensus on why physicians should be the ones performing the medical procedure to end a person’s life. The moral problems arising from such assertion are not to be taken lightly, for medical tradition has long regarded the duty not to kill, not to actively end a patient’s life, as the core moral obligation that gives meaning to the medical profession. Our concern is to question the moral justifiability of the arguments offered by physicians not to actively help patients die.