Written by Lieve Van Woensel with Sarah McCormack,
The use of Cyber-Physical Systems (CPS) in healthcare is ever increasing, and we have to examine what impact they will have on the lives of citizens, especially those of patients, disabled and elderly citizens. CPS are technical systems where networked computers and robots interact with the physical world. A study on the ‘Ethics of Cyber-Physical Systems’ has recently been published by the Science and Technology Options Assessment (STOA) Panel. This study examines seven key areas, where Cyber-Physical Systems (CPS) will have a significant impact.
What changes are we going to see in healthcare?
CPS can be used in healthcare in the form of smart devices and alarms. These can provide medical professionals with accurate real-time information regarding the health of a patient. An example of CPS used in healthcare is insulin pumps. These provide people suffering from diabetes with doses of insulin as required, to help keep their blood glucose continuously at a stable level. Another benefit from the use of CPS in healthcare will be a reduction in patient recovery times, due to the use of robots to perform surgery. Robots can perform surgery with increased precision, which leads to less invasive operations with fewer medical errors, and resulting in quicker recovery times. CPS will not only help the disabled and elderly through their ability to reduce recovery times, but their application in smart homes (which use a variety of sensors) will make it possible for medical professionals to collect real-time data on residents. This increased data flow will, through the use of data-mining tools, provide better care, insights into treatment, rehabilitation options and diagnosis. CPS can also improve home care, resulting in disabled and elderly citizens being able to stay longer at home. Intelligent prostheses will also help the disabled by measuring and converting brain signals into a physical action by the prosthesis, so that the person can interact with the physical environment.
Who will be responsible if something goes wrong?
In the future, robotic autonomy will further increase. This will allow robots to act more independently, make decisions and suggest evidence-based treatment. However, with this increased autonomy we will need to examine what power the robots will have in decision-making. Should they be able to make a decision on behalf of the patients, or allow the patients to make their own choice, even if it results in a negative health outcome? Is it the responsibility of the robots to inform medical professionals in this situation, or should they simply be allowed to override a patient’s wishes? With increased robot autonomy, we will need to explore who should be responsible if the action taken results in harm to a patient. Is the producer, programmer, medical professional or patient responsible? It is evident that these systems will bring new challenges for the healthcare sector to address, so that we can trust CPS to ensure that the correct decision is made.
What will happen to doctor-patient relations and confidentiality?
In a healthcare system where CPS are integrated, will medical professional secrecy still exist? As the data gathered by CPS are of particular interest to pharmaceutical and health insurance companies, how can we be certain that patient data will not be shared with or sold to them? Should anonymised data be gathered to develop improved medical treatments to help other patients? What will happen if the system is hacked and data become compromised? With the increased collection of data, we will need to place more trust in these systems. Trust is an important factor when considering CPS in healthcare. We will need to establish whether people will want CPS to partly replace the patient-doctor care relationship and be treated by robots. Will the elderly and disabled individuals trust CPS to assist them daily? It is vital that CPS support physicians and do not threaten the trust which exists between doctors and patients. However, we must ask ourselves, should certain types of care still be undertaken by humans, even when there are robotic options available?
CPS are here to stay, and there are many expected benefits from the development of these technologies in relation to healthcare and the lives of patients, including disabled and elderly citizens. Nevertheless, we cannot ignore the concerns about these systems and the ethical questions they raise. With the increased use of CPS in healthcare, we can expect to witness changes in this sector. It is evident that the development of these systems will require changes in legislation to take into account the risks that these systems pose in terms of data protection and liability to ensure that patients benefit from healthcare with integrated CPS.
For more information about CPS check out this STOA video.
This blog post was prepared using information from technical briefing papers written for the ‘Ethics of Cyber-Physical Systems’ study by Professor Adriana Tapus (ENSTA-ParisTech, France), Professor Bram Vanderborght (Vrije Universiteit Brussel, Belgium) and Chiel Scholte (Technopolis Group, The Netherlands).