Digital Twins in Health Care: Ethical Implications of an Emerging Engineering Paradigm.
Digital Twins in Health Care: Ethical Implications of an Emerging Engineering Paradigm.
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DOI：
10.3389/fgene.2018.00031
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发表时间：
2018
影响因子：
3.7
通讯作者：
van den Hoven J
中科院分区：
文献类型：
--
作者：
Bruynseels K;Santoni de Sio F;van den Hoven J
个性化医疗使用个人的细粒度信息，以查明与正常情况的偏差。工程学中的“数字双胞胎”提供了一个概念框架来分析这些新兴的数据驱动的医疗保健实践，以及它们对治疗，预防性护理和人类增强的概念和伦理影响。数字双胞胎代表一种特定的工程范式，其中单个物理工件与动态反映这些工件状态的数字模型配对。当应用于人时，数字双胞胎是一种新兴技术，它建立在个体的计算机表示上，动态地反映分子状态，生理状态和生活方式。我们使用数字双胞胎作为假设，即随着时间的推移，一个人将拥有非常详细的生物物理和生活方式信息。这种观点重新定义了“正常”或“健康”的概念，即在人口模式的背景下，对特定个体来说是有规律的一组模式。这种观点也将影响什么是治疗，什么是增强，正如可以说明的情况下，'无症状的疾病'和生命延长通过抗衰老药物。这些变化是在有测量数据的情况下如何得出含义的结果。也就是说，道德上的区别可能是基于这些数据中的模式以及嫁接在这些模式上的意义。探讨了数字孪生的伦理和社会影响。数字双胞胎意味着数据驱动的医疗保健方法。这种方法有可能提供显着的社会效益，并可以作为一个社会均衡器，允许有效的均衡增强干预措施。它也可能是不平等的驱动因素，因为数字孪生可能不是每个人都可以使用的技术，而且在数字孪生人群中识别的模式可能导致分割和歧视。随着这种新兴技术的成熟，这种双重性需要治理，包括确保数据使用和衍生利益的透明度以及数据隐私的措施。
Personalized medicine uses fine grained information on individual persons, to pinpoint deviations from the normal. ‘Digital Twins’ in engineering provide a conceptual framework to analyze these emerging data-driven health care practices, as well as their conceptual and ethical implications for therapy, preventative care and human enhancement. Digital Twins stand for a specific engineering paradigm, where individual physical artifacts are paired with digital models that dynamically reflects the status of those artifacts. When applied to persons, Digital Twins are an emerging technology that builds on in silico representations of an individual that dynamically reflect molecular status, physiological status and life style over time. We use Digital Twins as the hypothesis that one would be in the possession of very detailed bio-physical and lifestyle information of a person over time. This perspective redefines the concept of ‘normality’ or ‘health,’ as a set of patterns that are regular for a particular individual, against the backdrop of patterns observed in the population. This perspective also will impact what is considered therapy and what is enhancement, as can be illustrated with the cases of the ‘asymptomatic ill’ and life extension via anti-aging medicine. These changes are the consequence of how meaning is derived, in case measurement data is available. Moral distinctions namely may be based on patterns found in these data and the meanings that are grafted on these patterns. Ethical and societal implications of Digital Twins are explored. Digital Twins imply a data-driven approach to health care. This approach has the potential to deliver significant societal benefits, and can function as a social equalizer, by allowing for effective equalizing enhancement interventions. It can as well though be a driver for inequality, given the fact that a Digital Twin might not be an accessible technology for everyone, and given the fact that patterns identified across a population of Digital Twins can lead to segmentation and discrimination. This duality calls for governance as this emerging technology matures, including measures that ensure transparency of data usage and derived benefits, and data privacy.
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影响因子：
12.3
作者：
Lloyd-Price J;Abu-Ali G;Huttenhower C
通讯作者：
Huttenhower C
影响因子：
18.4
作者：
Savulescu, J;Foddy, B;Clayton, M
通讯作者：
Clayton, M
CRISPR/Cas9介导的人类三核受精卵基因编辑
影响因子：
21.1
作者：
Liang, Puping;Xu, Yanwen;Zhang, Xiya;Ding, Chenhui;Huang, Rui;Zhang, Zhen;Lv, Jie;Xie, Xiaowei;Chen, Yuxi;Li, Yujing;Sun, Ying;Bai, Yaofu;Songyang, Zhou;Ma, Wenbin;Zhou, Canquan;Huang, Junjiu
通讯作者：
Huang, Junjiu
影响因子：
2.2
作者：
Kahane, Guy;Savulescu, Julian
通讯作者：
Savulescu, Julian
影响因子：
17.3
作者：
NOVELL, JR
通讯作者：
NOVELL, JR