Your Robot Therapist Will See You Now: Ethical Implications of Embodied Artificial Intelligence in Psychiatry, Psychology, and Psychotherapy
Your Robot Therapist Will See You Now: Ethical Implications of Embodied Artificial Intelligence in Psychiatry, Psychology, and Psychotherapy
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DOI：
10.2196/13216
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发表时间：
2019-05-09
影响因子：
7.4
通讯作者：
Buyx, Alena
中科院分区：
文献类型：
--
作者：
Fiske, Amelia;Henningsen, Peter;Buyx, Alena
背景资料：具体化人工智能（AI）的研究在心理健康服务的治疗应用中具有越来越大的临床意义。随着从“虚拟心理治疗师”到痴呆症护理和自闭症障碍中的社交机器人，再到性障碍机器人的创新，人工智能虚拟和机器人代理越来越多地采取高水平的治疗干预措施，而这些干预措施过去只能由训练有素，熟练的卫生专业人员提供。为了使负责任的临床实施，道德和社会影响越来越多地使用体现人工智能在精神health.Objective：本文评估的伦理和社会影响翻译体现人工智能应用到精神卫生保健领域的精神病学，心理学和心理治疗。在此基础上分析，它开发了一套初步建议，就如何解决道德和社会的挑战，在当前和未来的应用体现AI.Methods：基于主题文献检索和医学伦理学的既定原则，目前体现AI应用的道德和社会方面的分析进行了跨领域的精神病学，心理学和心理治疗。为了能够进行全面的评价，分析围绕以下三个步骤进行：评估潜在的好处;分析首要的道德问题和关切;讨论干预措施的具体道德和社会问题。从伦理的角度来看，人工智能在心理健康方面的应用带来的重要好处包括新的治疗模式，吸引难以接触的人群的机会，更好的患者反应，为医生腾出时间。普遍存在的伦理问题和担忧包括：危害预防和各种数据伦理问题;缺乏对人工智能应用程序开发、临床整合和卫生专业人员培训的指导;伦理和监管框架中的“差距”;滥用的可能性，包括使用技术取代现有服务，从而可能加剧现有的健康不平等。具体的挑战包括：风险评估、转诊和监督问题;尊重和保护患者自主权的必要性;非人类治疗的作用;算法使用的透明度;以及这些应用对理解疾病和人类状况的长期影响的具体问题。结论：我们认为，具体的人工智能是一个很有前途的方法在整个精神健康领域;然而，需要进一步的研究来解决这些技术更广泛的伦理和社会问题，以协商最佳的研究和医疗实践创新的精神卫生保健。最后，我们指出了未来的研究领域，并为需要具体道德指导的高优先领域提出了建议。
Background: Research in embodied artificial intelligence (AI) has increasing clinical relevance for therapeutic applications in mental health services. With innovations ranging from 'virtual psychotherapists' to social robots in dementia care and autism disorder, to robots for sexual disorders, artificially intelligent virtual and robotic agents are increasingly taking on high-level therapeutic interventions that used to be offered exclusively by highly trained, skilled health professionals. In order to enable responsible clinical implementation, ethical and social implications of the increasing use of embodied AI in mental health need to be identified and addressed.Objective: This paper assesses the ethical and social implications of translating embodied AI applications into mental health care across the fields of Psychiatry, Psychology and Psychotherapy. Building on this analysis, it develops a set of preliminary recommendations on how to address ethical and social challenges in current and future applications of embodied AI.Methods: Based on a thematic literature search and established principles of medical ethics, an analysis of the ethical and social aspects of currently embodied AI applications was conducted across the fields of Psychiatry, Psychology, and Psychotherapy. To enable a comprehensive evaluation, the analysis was structured around the following three steps: assessment of potential benefits; analysis of overarching ethical issues and concerns; discussion of specific ethical and social issues of the interventions.Results: From an ethical perspective, important benefits of embodied AI applications in mental health include new modes of treatment, opportunities to engage hard-to-reach populations, better patient response, and freeing up time for physicians. Overarching ethical issues and concerns include: harm prevention and various questions of data ethics; a lack of guidance on development of AI applications, their clinical integration and training of health professionals; 'gaps' in ethical and regulatory frameworks; the potential for misuse including using the technologies to replace established services, thereby potentially exacerbating existing health inequalities. Specific challenges identified and discussed in the application of embodied AI include: matters of risk-assessment, referrals, and supervision; the need to respect and protect patient autonomy; the role of non-human therapy; transparency in the use of algorithms; and specific concerns regarding long-term effects of these applications on understandings of illness and the human condition.Conclusions: We argue that embodied AI is a promising approach across the field of mental health; however, further research is needed to address the broader ethical and societal concerns of these technologies to negotiate best research and medical practices in innovative mental health care. We conclude by indicating areas of future research and developing recommendations for high-priority areas in need of concrete ethical guidance.