Loizzo: ‘We want digital therapies to be reimbursable’; Magi: ‘The goal is always the patient’s wellbeing’; Ferrari: ‘Europe needs a culture of data approach’; Malva: ‘Trust in AI is difficult to explain? An act of faith is also needed’; Giacobbe: ‘AI useful against antibiotic resistance’.
UniCamillus University has organised and hosted, in its auditorium, the conference ‘Medicine and Ethics in the Age of Artificial Intelligence: training Health Professionals between Technology and Digital Culture’.
The event was attended by numerous experts, healthcare professionals and academics, confirming the University’s commitment to promoting dialogue and innovation in the field of digital medicine. Two round tables were organised: the first, ‘Digital Innovation and AI in Healthcare’, was moderated by Donatella Padua, Associate Professor of Digital Sociology at UniCamillus, as well as Delegate to the University’s Third Mission; the second, ‘Digital Innovation and the New Medicine’, was coordinated by Alberto Malva, SIICP Digital Medicine Area Manager, MedQuestio Contact Person.
Extraordinary advances and fundamental ethical questions
The advent of Artificial Intelligence has revolutionised many aspects of our daily lives, but no field has been so profoundly affected as medicine. The integration of digital tools and AI has led to extraordinary advances in diagnosis, therapy, and health data management. However, fundamental ethical questions also arise that require in-depth reflection and clear guidance.
The intersection of medicine, ethics and digital technology is not just a topic of academic interest but has concrete implications for people’s health and wellbeing. The way we use and regulate AI in the medical context will have a lasting impact on the quality of care and trust in healthcare systems.
Regulation needed
Antonio Magi, President of the Rome Medical Board, said: ‘The correlation between Medicine and Ethics is inherent in the Board itself. That is why we look at AI both with interest and concern: is it being used to improve the doctor’s work or to save time? Let’s not forget that our goal is always the patient’s wellbeing’.
‘Regulatory control, not restriction’, echoes Giuseppe Ippolito, Professor of Infectious Diseases at UniCamillus. Regulation is necessary in view of the fact that, as Giuseppe Recchia, co-founder of daVi Digital Medicine and Vice President of the TESSA Foundation, emphasises, ‘there are currently around 500-600 thousand pieces of software and apps dedicated to health, and regulating them is indispensable because they are used by different stakeholders, who change their use and purpose, such as doctors, patients and health directors’.
Simona Loizzo, Member of the Italian Parliament and President of the Parliamentary Intergroup for Digital Health and Digital Therapies, who participated in the event remotely, is in full agreement on this issue. She stated: ‘As a dedicated Intergroup, we have presented a bill to obtain digital therapies to become reimbursable, creating ways to verify their effectiveness over time’. In this regard, we recall that, in Italy, the digital health segment is valued at over 32.150 billion euros, with a strong public component. A market that is destined to grow.
Speaking at the European level, ‘on 13 March the European Parliament approved the Artificial Intelligence Act, which regulates the use of health data in Europe’, explains Roberta Taurino, Territorial Administrative Director of ASL Roma2 and DPO of UniCamillus. She added: ‘The AI Act is based on two extremely cautious approaches: the first is the anthropocentric one, i.e. AI must support human beings and not replace them; the second is based on the avoidance of any kind of risk for European citizens’. Indeed, as Taurino points out, ‘the circulation of data is wealth’, and wealth also produces dangers. However, ‘the European gap is due to a lack of data culture’, replies Fabio Ferrari, founder and board member of Ammagamma. ‘While in the US data is used for business purposes, and in Asia for control, in Europe we do not have a well-defined approach: that is why training in this new global set-up is crucial’.
But how do we regulate something so complex that, being digital, is at risk of escaping control? In Ferraris’ words, ‘the model of data analysis by AI does not have a human logic, i.e. a deterministic one. It uses a stochastic process, which means that not only are the most important data correlations examined, but all of them are examined, even the apparently random ones. A human being is not able to do this, which is why there is a sort of ‘black box’ that is difficult to explain’. How, then, is it to be relied on and trusted? ‘Following the directions of AI, after all, must be a bit of an act of faith’, summarises Alberto Malva.
AI and privacy: good practices
AI can itself be a tool of ethics. ‘At Philips Healthcare we produce medical devices that must necessarily respect these characteristics: they must be truly supportive of people, they must improve processes to achieve a result, and they must be sustainable for the environment as well as accessible for disadvantaged populations’, says Andrea Celli, CEO of Philips Italia.
And that’s not all: in order to get around the problem of privacy in health data, ‘we are developing so-called ‘synthetic patients’’, adds Daniele Di Ianni, Customer Innovation Manager at Roche Italia. ‘These are prototype patients created by AI on the basis of real statistical data: in this way, no privacy is violated and, at the same time, research progress is promoted’.
Another significant aspect relates to a problem that bedevils our times, and which AI addresses very well: antibiotic resistance. Daniele Roberto Giacobbe, Associate Professor of Infectious Diseases DISSAL, University of Genoa, explains how AI, with its infinite calculation potential, can ‘draw up extremely accurate risk profiles, to understand which antibiotic to administer on the basis of the patient’s medical record’.
But isn’t Artificial Intelligence in danger of changing the patient-doctor relationship? ‘When a person goes to their doctor, they have already consulted the Internet’, says Alessandro Boccanelli, Professor of Moral Philosophy at UniCamillus. ‘However, the doctor must realise that they must necessarily listen to the patient, as this step is crucial for a good diagnosis: it is the core of the so-called ‘narrative medicine’. Often, however, the patient will be more eager to tell their story without filters to a machine than to a person and will be more at ease with it’.
This shows that ‘today’s healthcare system is multidimensional: social, clinical, technological and relational’, concludes Donatella Padua. ‘Models have changed, and this requires educational institutions, such as universities, to prepare for new educational approaches’.