Rasita Vinay

Anthropomorphisation -- the phenomenon whereby non-human entities are ascribed human-like qualities -- has become increasingly salient with the rise of large language model (LLM)-based conversational agents (CAs). Unlike earlier chatbots, LLM-based CAs routinely generate interactional and linguistic cues, such as first-person self-reference, epistemic and affective expressions that empirical work shows can increase engagement. On the other hand, anthropomorphisation raises ethical concerns, including deception, overreliance, and exploitative relationship framing, while some authors argue that anthropomorphic interaction may support autonomy, well-being, and inclusion. Despite increasing interest in the phenomenon, literature remains fragmented across domains and varies substantially in how it defines, operationalizes, and normatively evaluates anthropomorphisation. This scoping review maps ethically oriented work on anthropomorphising LLM-based CAs across five databases and three preprint repositories. We synthesize (1) conceptual foundations, (2) ethical challenges and opportunities, and (3) methodological approaches. We find convergence on attribution-based definitions but substantial divergence in operationalization, a predominantly risk-forward normative framing, and limited empirical work that links observed interaction effects to actionable governance guidance. We conclude with a research agenda and design/governance recommendations for ethically deploying anthropomorphic cues in LLM-based conversational agents.

Introduction: The coronavirus disease 2019 pandemic has placed intensive care units (ICU) triage at the center of bioethical discussions. National and international triage guidelines emerged from professional and governmental bodies and have led to controversial discussions about which criteria—e.g. medical prognosis, age, life-expectancy or quality of life—are ethically acceptable. The paper presents the main points of agreement and disagreement in triage protocols and reviews the ethical debate surrounding them. Sources of data: Published articles, news articles, book chapters, ICU triage guidelines set out by professional societies and health authorities. Areas of agreement: Points of agreement in the guidelines that are widely supported by ethical arguments are (i) to avoid using a first come, first served policy or quality-adjusted life-years and (ii) to rely on medical prognosis, maximizing lives saved, justice as fairness and non-discrimination. Areas of controversy: Points of disagreement in existing guidelines and the ethics literature more broadly regard the use of exclusion criteria, the role of life expectancy, the prioritization of healthcare workers and the reassessment of triage decisions. Growing points: Improve outcome predictions, possibly aided by Artificial intelligence (AI); develop participatory approaches to drafting, assessing and revising triaging protocols; learn from experiences with implementation of guidelines with a view to continuously improve decision-making. Areas timely for developing research: Examine the universality vs. context-dependence of triaging principles and criteria; empirically test the appropriateness of triaging guidelines, including impact on vulnerable groups and risk of discrimination; study the potential and challenges of AI for outcome and preference prediction and decision-support.

On March 11, 2020 the World Health Organization classified COVID‐19, caused by Sars‐CoV‐2, as a pandemic. Although not much was known about the new virus, the first outbreaks in China and Italy showed that potentially a large number of people worldwide could fall critically ill in a short period of time. A shortage of ventilators and intensive care resources was expected in many countries, leading to concerns about restrictions of medical care and preventable deaths. In order to be prepared for this challenging situation, national triage guidance has been developed or adapted from former influenza pandemic guidelines in an increasing number of countries over the past few months. In this article, we provide a comparative analysis of triage recommendations from selected national and international professional societies, including Australia/New Zealand, Belgium, Canada, Germany, Great Britain, Italy, Pakistan, South Africa, Switzerland, the United States, and the International Society of Critical Care Medicine. We describe areas of consensus, including the importance of prognosis, patient will, transparency of the decision‐making process, and psychosocial support for staff, as well as the role of justice and benefit maximization as core principles. We then probe areas of disagreement, such as the role of survival versus outcome, long‐term versus short‐term prognosis, the use of age and comorbidities as triage criteria, priority groups and potential tiebreakers such as ‘lottery’ or ‘first come, first served’. Having explored a number of tensions in current guidance, we conclude with a suggestion for framework conditions that are clear, consistent and implementable. This analysis is intended to advance the ongoing debate regarding the fair allocation of limited resources and may be relevant for future policy‐making.