Persons or data points? Ethics, artificial intelligence, and the participatory turn in mental health research.

This article identifies and examines a tension in mental health researchers' growing enthusiasm for the use of computational tools powered by advances in artificial intelligence and machine learning (AI/ML). Although there is increasing recognition of the value of participatory methods in science generally and in mental health research specifically, many AI/ML approaches, fueled by an ever-growing number of sensors collecting multimodal data, risk further distancing participants from research processes and rendering them as mere vectors or collections of data points. The imperatives of the "participatory turn" in mental health research may be at odds with the (often unquestioned) assumptions and data collection methods of AI/ML approaches. This article aims to show why this is a problem and how it might be addressed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Is There an App for That?: Ethical Issues in the Digital Mental Health Response to COVID-19.

Well before COVID-19, there was growing excitement about the potential of various digital technologies such as tele-health, smartphone apps, or AI chatbots to revolutionize mental healthcare. As the SARS-CoV-2 virus spread across the globe, clinicians warned of the mental illness epidemic within the coronavirus pandemic. Now, funding for digital mental health technologies is surging and many researchers are calling for widespread adoption to address the mental health sequelae of COVID-19. Reckoning with the ethical implications of these technologies is urgent because decisions made today will shape the future of mental health research and care for the foreseeable future. We contend that the most pressing ethical issues concern (1) the extent to which these technologies demonstrably improve mental health outcomes and (2) the likelihood that wide-scale adoption will exacerbate the existing health inequalities laid bare by the pandemic. We argue that the evidence for efficacy is weak and that the likelihood of increasing inequalities is high. First, we review recent trends in digital mental health. Next, we turn to the clinical literature to show that many technologies proposed as a response to COVID-19 are unlikely to improve outcomes. Then, we argue that even evidence-based technologies run the risk of increasing health disparities. We conclude by suggesting that policymakers should not allocate limited resources to the development of many digital mental health tools and should focus instead on evidence-based solutions to address mental health inequalities.

Mind the Gaps: Ethical and Epistemic Issues in the Digital Mental Health Response to Covid-19.

Well before the Covid-19 pandemic, proponents of digital psychiatry were touting the promise of various digital tools and techniques to revolutionize mental health care. As social distancing and its knock-on effects have strained existing mental health infrastructures, calls have grown louder for implementing various digital mental health solutions at scale. Decisions made today will shape the future of mental health care for the foreseeable future. Here, in hopes of countering this hype, we examine four ethical and epistemic gaps surrounding the growth of digital mental health: the evidence gap, the inequality gap, the prediction-intervention gap, and the safety gap. We argue that these gaps ought to be considered by policy-makers before society commits to a digital psychiatric future.

Why We Never Eat Alone: The Overlooked Role of Microbes and Partners in Obesity Debates in Bioethics.

Debates about obesity in bioethics tend to unfold in predictable epicycles between individual choices and behaviours (e.g., restraint, diet, exercise) and the oppressive socio-economic structures constraining them (e.g., food deserts, advertising). Here, we argue that recent work from two cutting-edge research programmes in microbiology and social psychology can advance this conceptual stalemate in the literature. We begin in section 1 by discussing two promising lines of obesity research involving the human microbiome and relationship partners. Then, in section 2, we show how this research has made viable novel strategies for fighting obesity, including microbial therapies and dyad-level interventions. Finally, in section 3, we consider objections to our account and conclude by arguing that attention to the most immediate features of our biological and social environment offers a middle ground solution, while also raising important new issues for bioethicists.

The moral self and moral duties.

Recent research has begun treating the perennial philosophical question, "what makes a person the same over time?" as an empirical question. A long tradition in philosophy holds that psychological continuity and connectedness of memories are at the heart of personal identity. More recent experimental work, however, has suggested that persistence of moral character, more than memories, is perceived as essential for personal identity. While there is a growing body of evidence supporting these findings, a recent critique suggests that this research program conflates personal identity with mere similarity. To address this criticism, we explore how loss of someone's morality or memories influences perceptions of identity change and perceptions of moral duties toward the target of the change. We present participants with a classic "body switch" thought experiment and after assessing perceptions of identity persistence, we present a moral dilemma, asking participants to imagine that one of the patients must die (Study 1) or be left alone in a care home for the rest of their life (Study 2). Our results highlight the importance of the continuity of moral character, suggesting that lay intuitions are tracking (something like) personal identity, not just mere similarity.

Addiction, Identity, Morality.

BACKGROUND: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a "brain disease" versus "moral weakness" model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent's identity, including whether or to what extent an individual is seen as the same person after becoming addicted. METHODS: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction. CONCLUSIONS: In Study 1, we found that U.S. participants judged an agent who became addicted to drugs as being closer to "a completely different person" than "completely the same person" as the agent who existed prior to the addiction. In Studies 2-6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves.

Bioethics and the Hypothesis of Extended Health.

Dominant views about the nature of health and disease in bioethics and the philosophy of medicine have presumed the existence of a fixed, stable, individual organism as the bearer of health and disease states, and as such, the appropriate target of medical therapy and ethical concern. However, recent developments in microbial biology, neuroscience, the philosophy of cognitive science, and social and personality psychology have produced a novel understanding of the individual and its fluid boundaries. Drawing on converging evidence from these disciplines, and following recent research in public health, we argue that certain features of our biological and social environment can be so tightly integrated as to constitute a unit of care extending beyond the intuitive boundaries of skin and skull. This paper develops and defends the Hypothesis of Extended Health (HEH), which denies the claim that health and disease states are predicated solely on the internal functioning of an organism. If this is correct, then the targets of medical invention and ethical concern are wider and more diverse than is usually assumed.