The Reilly Center’s 1st Annual List of Emerging Ethical Dilemmas and Policy Issues in Science and Technology for 2013
Click the links below to read more about each issue and get links to news stories and other resources.
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Personal genetic tests/personalized medicine
Within the last ten years, the creation of fast, low-cost genetic sequencing has given the public direct access to genome sequencing and analysis, with little or no guidance from physicians or genetic counselors on how to process the information. Genetic testing has resulted in huge public health successes (for example, for diseases that can be prevented or helped by early intervention), but also creates a new set of moral, legal, ethical, and policy issues surrounding the use of these tests. If the testing is useful, how do we provide equal access? What are the potential privacy issues and how do we protect this very personal and private information? Which genetic abnormalities warrant some kind of intervention? How do we ensure that the information provided by genome analysis is correct (especially in the case of at-home tests)? Are we headed towards a new era of therapeutic intervention to increase quality of life, or a new era of eugenics?
Hacking into medical devices
The US Government Accountability Office has released a report claiming that implanted medical devices, such as pacemakers, are susceptible to hackers. Barnaby Jack, a hacker and director of embedded device security at IOActive Inc., recently demonstrated the vulnerability of a pacemaker by breaching the security of the wireless device from his laptop and reprogramming it to deliver an 830-volt shock. Because many devices are programmed to allow doctors easy access in case reprogramming is necessary in an emergency, the design of many of these devices is not geared toward security. We don’t yet have evidence of a hacker breaching the security of a medical device with malicious intent, although we now know that it’s possible, and over the last few months, government and health care agencies have been discussing the best ways to protect patients.
In three states – Nevada, Florida, and California – it is now legal for Google to operate its driverless cars. A human in the vehicle is still required, but not at the controls. Google’s goal is to create a fully automated vehicle that is safer and more effective than a human-operated vehicle and they plan to marry this idea with the concept of the Zipcar, fleets of automobiles shared by a group of users on an as-needed basis, paying annual fees, per-mileage charges, and insurance costs. The driverless Zipcar will transform not just the way we travel, but also the entire urban/suburban landscape, and our social and economic structures. The ethics of automation and equality of access for people of different income levels are just a taste of the difficult ethical, legal, and policy questions we will need to address.
Scientists are attempting to use 3-D printing to create everything from architectural models to human organs. While the technology still lags behind the hype (in other words, we’re not getting Star Trek-style replicators anytime soon), we could be looking at a future when we can print personalized pharmaceuticals or home-printed guns and explosives. On November 29, 2012, Staples Office Center announced that they would begin providing 3-D printing services to their customers, starting next year, in the Netherlands and Belgium. So for now, 3-D printing is largely the realm of artists and designers, but we can easily envision a future where 3-D printers are affordable and patterns abound for products both benign and malicious, and that cut out the manufacturing sector completely.
Adaptation to climate change
The differential susceptibility of peoples around the world to climate change warrants an ethical discussion. We need to identify effective and safe ways to help people deal with the effects of climate change, as well as learn to manage and manipulate wild species and nature in order to preserve biodiversity. Some of these adaptation strategies might be highly technical (e.g. building sea walls to stem off sea level rise), but others are social and cultural (e.g., changing agricultural practices).
Low-quality and counterfeit pharmaceuticals
Until recently, detecting low-quality and counterfeit pharmaceuticals required access to complex testing equipment, often unavailable in developing countries where these problems abound. The enormous amount of trade in pharmaceutical intermediaries and active ingredients raise a number of issues, from the technical (improvement in manufacturing practices and analytical capabilities) to the ethical and legal (for example, India ruled in favor of manufacturing life-saving drugs, even If it violates US patent law).
Machines (both for peaceful purposes and for war fighting) are increasingly evolving from human-controlled, to automated, to autonomous, with the ability to act on their own without human input. Autonomous systems will continue to emerge in a number of areas in the coming decades, from robots on the battlefield, to autonomous robotic surgical devices. As these systems operate without human control and are designed to function and make decisions on their own, the ethical, legal, social, and policy implications have grown exponentially. Who is responsible for the actions undertaken by autonomous systems? If robotic technology can potentially reduce the number of human fatalities, is it the responsibility of scientists to design these systems?
Human-animal hybrids (chimeras)
The idea of a chimera comes straight out of Greek mythology, but so far scientists have kept human-animal hybrids on the cellular level. According to some, even more modest experiments involving animal embryos and human stem cells violate human dignity and blur the line between species. But scientists have received support (particularly in the UK) from both the government and the public, after explaining the process as well as their (so far benign) research goals. Is interspecies research the next frontier in understanding humanity and curing disease, or a slippery slope, rife with ethical dilemmas, toward creating new species?
Ensuring access to wireless and spectrum
Mobile wireless connectivity is having a profound effect on society in both developed and developing countries. The penetration of smart phones and tablets has led to consistent doubling of mobile data usage on an annual basis, which is putting tremendous pressure on telecommunication networks and the government bodies that regulate the radio frequency (RF) spectrum. These technologies are completely transforming how we communicate, conduct business, learn, form relationships, navigate, and entertain ourselves. At the same time, government agencies increasingly rely on radio spectrum for their critical missions. This confluence of wireless technology developments and societal needs present numerous challenges and opportunities for making the most effective use of the radio spectrum. We now need to have a policy conversation about how to make the most effective use of the precious radio spectrum, and to close the digital access divide for underserved (rural, low-income, developing areas) populations.
Data collection and privacy
We (sometimes) think about privacy when we post something to a webpage or social media. But do we do consider the massive amounts of data we give to commercial entities when we use store discount cards or order goods via the Internet? Your healthcare data is often available to physicians and research entities and insurance companies and is not protected by privacy or anonymity laws in every case. Now that microprocessors and permanent memory are inexpensive technology, we need to think about the kinds of information that should be collected and retained. Should we create a diabetic insulin implant that could notify your doctor or insurance company when you make poor diet choices, and should that decision make you ineligible for certain types of medical treatment? Should cars be equipped to monitor speed and other measures of good driving, and should this data be subpoenaed by the authorities following a crash? These issues require appropriate policy discussions in order to bridge the gap between data collection and meaningful outcomes.
Pharmaceutical, surgical, mechanical, and neurological enhancements are already available for therapeutic purposes. But these same enhancements can be used to magnify human biological function beyond the societal norm. Where do we draw the line between therapy and enhancement? How do we justify enhancing human bodies when so many individuals still lack access to basic therapeutic medicine?