Ethics: January 2024 UPSC Current Affairs | Current Affairs & Hindu Analysis: Daily, Weekly & Monthly PDF Download

Ethical Use of Generative AI in Healthcare

Context

Recently, the World Health Organization (WHO) has released guidance on the ethical use and governance of Large Multi-Modal Models (LMM) in healthcare, acknowledging the transformative impact of Generative Artificial Intelligence (AI) technologies like ChatGPT, Bard, and Bert.

What are Large Multi-Modal Models (LMM)?

• LMMs are models that use multiple senses to mimic human-like perception. This allows AI (Artificial Intelligence) to respond to a wider range of Human communication, making interactions more natural and intuitive.
• LMMs integrate multiple data types, such as images, text, language, audio, and other heterogeneity. This allows the models to understand images, videos, and audio, and converse with users.
• Some examples of multimodal LLMs include GPT-4V, MedPalm M, Dall-E, Stable Diffusion, and Midjourney.

What are the WHO’s Guidelines Regarding the Use of LMMs in Healthcare?

• The new WHO guidance outlines five broad applications of LMMs in healthcare:
• Diagnosis and clinical care, such as responding to patients’ written queries;
• Patient-guided use, such as for investigating symptoms and treatment;
• Clerical and administrative tasks, such as documenting and summarizing patient visits within electronic health records;
• Medical and nursing education, including providing trainees with simulated patient encounters, and;
• Scientific research and drug development, including to identify new compounds.

What Concerns has WHO Raised about LMMs in Healthcare?

• Rapid Adoption and Need for Caution:
  • LMMs have experienced unprecedented adoption, surpassing the pace of any previous consumer technology.
  • LMM is known for their ability to mimic human communication and perform tasks without explicit programming.
  • However, this rapid uptake underscores the critical importance of carefully weighing their benefits against potential risks.
• Risks and Challenges:
  • Despite their promising applications, LMMs pose risks, including the generation of false, inaccurate, or biased statements that could misguide health decisions.
  • The data used to train these models can suffer from quality or bias issues, potentially perpetuating disparities based on race, ethnicity, sex, gender identity or age.
• Accessibility and Affordability of LMMs:
  • There are broader concerns as well, such as the accessibility and affordability of LMMs, and the risk of Automation Bias (tendency to rely too much on automated systems) in healthcare, leading professionals and patients to overlook errors.
• Cybersecurity:
  • Cybersecurity is another critical issue, given the sensitivity of patient information and the reliance on the trustworthiness of these algorithms.

What are the Key Recommendations of WHO Regarding LMMs?

• Called for a collaborative approach involving governments, technology companies, healthcare providers, patients and civil society, in all stages of LMM development and deployment.
• Stressed on the need for global cooperative leadership to regulate AI technologies effectively. Governments from all countries must cooperatively lead efforts to effectively regulate the development and use of AI technologies, such as LMMs.
• The new guidance offers a roadmap for harnessing the power of LMMs in healthcare while navigating their complexities and ethical considerations.
  • In May 2023, the WHO had highlighted the importance of applying ethical principles and appropriate governance, as enumerated in the WHO guidance on the ethics and governance of AI for health, when designing, developing and deploying AI for health.
• The six core principles identified by WHO are:
  • Protect autonomy
  • Promote human well-being, human safety, and the public interest
  • Ensure transparency, explainability, and intelligibility
  • Foster responsibility and accountability
  • Ensure inclusiveness and equity
  • Promote AI that is responsive and sustainable.

Decoding Psychoanalysis

Context

Recently, the Delhi Police revealed that six individuals accused in the Parliament breach incident underwent psychoanalysis to decipher their motives.

What is Psychoanalysis?

• About: Psychoanalysis is a set of theories and therapeutic techniques that treat mental disorders.
• It aims to treat a range of mental health issues by investigating the relationship between the unconscious and conscious elements of psychological experience.
• It was pioneered by Sigmund Freud, a Viennese psychiatrist, in the late 19th and early 20th centuries
• Key Aspects Related to Psychoanalysis:
  • Unconscious Mind: Freud proposed that much of human behavior is influenced by unconscious desires, fears, memories, and conflicts, often stemming from early childhood experiences.
  • Psychoanalysis delves into the unconscious mind, exploring how it shapes thoughts, behaviors, emotions, and personality
  • Id, Ego, Superego: Freud introduced a structural model of mind comprising the id (driven by instincts and pleasure), ego (mediates between id and reality), and superego (internalizes societal norms and values).
  • This model helps understand conflicts within the mind.
  • Psychoanalytic Therapy: It involves verbal exchanges between the patient and therapist, aimed at exploring unconscious conflicts and gaining insight into one’s emotions and behaviors.

What are the Ethical Aspects Involved in Psychoanalysis?

• Informed Consent: The patient must be fully informed about the nature of psychoanalysis, its potential benefits, risks and alternatives before beginning treatment.
• This is crucial because the process often involves delving into personal and sensitive topics.
• Furthermore, obtaining informed consent also safeguards against potential violations of Article 21, as highlighted in the Selvi vs State of Karnataka & Anr Case (2010).
• Confidentiality: Maintaining patient confidentiality is paramount in therapy. However, in some situations, therapists may face ethical dilemmas, such as when a patient poses a danger to themselves or others.
• Balancing confidentiality with the duty to warn or protect can be challenging.
• Transference and Countertransference: Both the patient and therapist can experience strong feelings or reactions toward each other due to past experiences or unresolved issues.
• Managing these emotions ethically to ensure they don't interfere with treatment or professional boundaries is important.
• Cultural Sensitivity: Therapists need to be culturally competent and aware of their biases to ensure they provide appropriate care and respect diverse perspectives.

How Psychoanalysis can Help in Criminal Rehabilitation?

• Developing Empathy: Psychoanalysis can foster empathy by helping individuals understand the impact of their actions on others.
• Through self-reflection and insight gained in therapy, offenders can develop a greater understanding of the consequences of their behavior, leading to increased empathy.
• Impulse Control: For individuals with a history of violent or impulsive behavior, psychoanalysis can assist in understanding and managing these tendencies.
• By exploring deep-seated emotions and unresolved conflicts, individuals can learn to better regulate their emotions and impulses, reducing the likelihood of reoffending.
• Preventing Recidivism: By addressing the core motivations, individuals are better equipped to break free from destructive patterns and reintegrate into society in a meaningful way.

Case Study 1

Environment v/s Development

Industrial chemicals are produced on a big scale by a conglomerate. It suggested establishing a second unit. Due to its negative impact on the environment, many states rejected this proposal. But one state government acceded to the request and permitted the unit close to a city, brushing aside all opposition. Further, the unit was set up 10 years ago and was in full swing till recently. The pollution caused by the industrial effluents was affecting the land, water, and crops in the area. It was also causing serious health problems to human beings and animals. This gave rise to a series of agitations demanding the closure of the plant. In a recent agitation, thousands of people took part, creating a law-and-order problem necessitating stern police action. Following the public outcry, the State government ordered the closure of the factory. The closure of the factory resulted in the unemployment of not only those workers who were engaged in the factory but also those who were working in the ancillary units. It also very badly affected those industries which depended on the chemicals manufactured by it.
As a senior officer entrusted with the responsibility of handling these issues, how are you going to address it?
Sol: 

Approach

• Briefly introduce the ethical issue involved in the above case.
• Discuss about various stakeholders and ethical dilemmas involved in the case.
• Discuss your course of action as a senior officer.
• In conclusion, choose a way forward to resolve the issue.

Introduction

• The case involves the conflict between public health and environment safety v/s livelihood of people. It requires proper balance between environmental ethics and developmental ethics.

Body

• Stakeholders involved in the case are as under:
  • Me as a senior officer who is responsible to solve this case,
  • People living in the area,
  • Employee of the closed factory,
  • Ancillary units,
  • State government which gave permission to set up industrial unit,
  • MLA/MP of the area
• Ethical issues involved:
  • Emotional Intelligence: It would help senior officer in handling the difficult situation arising from the above case.
  • Empathy: It is an awareness of the needs and feelings of others both individually and in groups and being able to see things from the point of view of others.
• Ethical dilemmas involved:
  • Environmental responsibility v/s development: There is a conflict between development and saving nature from degradation due to setting up of industrial unit.
• Course of action:
  • My course of action:
  • My plan would be to look for solution that will keep the factory running under better environmental conditions as well as keep the jobs of the people.
  • I would firstly visit the factory to analyze what were the issues that led to the factory closure. I would try to see if the factory could be modified with advance equipment that does not harm the nearby environment.
  • If the conditions are good for modification, I would request for a special group of experts who can look for solutions for developing the factory under acceptable conditions.
  • When the plans of modification worked well and environmental degradation is reduced, then I would need to convince the people for their approval for this project to go ahead. I would then provide them with proof so that they trust the administration.
  • The factory administration would need to make the changes according to the environmental standards. If the factory does not have any funds, I would consider providing them with necessary resources in short term as a loan so that they can go ahead with the approved plan.
  • In a scenario where no modification can be undertaken, then I would brainstorm alternative plans, so that people do not suffer. This can be done through setting up of another industry that is less polluting.
  • If no such industry is set up, I would have to take steps that can allow the job losers to attain financial security. This can be done through transferring them to other industries as per their requirements and further, supporting them with self-employment opportunities by providing them with loans to set up small cooperative industries or small business.
  • I would be conducting an investigation to find out whether environmental rules were flouted while giving permission to set up factory ten years back or there are any loopholes in the state’s Environmental Impact Assessment norms which were used by company. At the same time the inspection should be done to find out that other companies are not flouting norms and polluting the environment.
  • Alternatively, I may order the shutdown of the industrial unit due to public outcry, then it would be short sighted solution as, it would shift the problem to some other place and consequently putting the health of people there at risk rather than providing a sustainable solution for the existing problem.
  • However, this option is not viable and best course for action.

Conclusion

Thus, my final course of action would be combination of the first and second option where both people’s employment and environmental pollution are given focus. Further, if both the issues are addressed then I would consider this a successful operation.

Case study 2

Emotional Intelligence in Corporate Offices

Ranbir is the Chief executive officer of a company. The Company has been growing and has recruited quite a few specialists recently. The functional heads in the company have to meet their staff in an open meeting every two months. Ranbir detested these meetings. It was open to everyone in the office. The staff came up with a long list of trivial and tiresome complaints and grievances. They repeated the same things and spoke at length. Even when the staff knew of the constraints, they went on with their complaints. They wanted more space for lounge, for bathrooms and crèche. Ranbir pointed to lack of space, and yet the staff continued to complain. Ranbir cultivated a habit of sitting through the meeting with a cheerful face, but with his mind switched off from the proceedings. The meeting became a tiresome ritual he had to get through. Due these issues many employees had left the company and its further hampering the Business of the company.
Q. In Ranbir’s situation what action would you have taken and why?
Sol: The question focuses on understanding the needs of a team and the leader’s role in resolution of mundane problems of the team members. The source of the problem in this case is perhaps rooted in the fact that success of the company has brought forth induction of new team members and the present accommodation has thereby become inadequate and the situation had become worse due to Ranbir's attitude towards the grievances of the employees, lackadaisical approach towards the meeting with the employees.

• Stakeholders involved in the case are:
  • Company’s Ceo
  • Employees of the Company
  • New & old employees
  • Shareholders of the Company
• The situational challenges that are faced by the CEO are:
  • Crisis Management: Handling crisis efficiently with limited resources and without or minimum adverse effects on the employees.
  • Timely decision making to prevail the healthy work culture in the office and trust among the public for efficient decision making.
  • Conflict management: Conflict management is another skill that managers need. The conflicts here mean the quarrels and disputes which frequently arise in organizations.
• Ethical Components that could be utilised:
  • Emotional Intelligence: Emotional intelligence refers to ‘the ability to identify one’s own emotions and those of others, harness and apply them to tasks, and to regulate and manage them.
  • Emotional Quotient (EQ): It is a measure of one’s EI i.e., through a standardized test, one’s awareness of emotions in relation to self and others is known.
  • Empathy: It is an awareness of the needs and feelings of others both individually and in groups, and being able to see things from the point of view of others.
  • Social Skills: It is applying empathy and balancing the wants and requirements of others with one’s. It includes building good rapport with others.
  • CEO’s course of action to resolve the issue,
• Concrete Plan of Action:
  • Since the business of the company is thriving and more specialist staffers have been recruited, Ranbir should quickly look for a bigger and better workplace.
• If employees still face issue:
  • Till such time that office expansion takes place relieving the pressure on facilities, he can take some small steps like:
  • Cleaning Toilet: Taking very small steps to impress the employees like cleaning toilet on regular basis, but the problem is of space and not cleanliness, this step could impress the employees for few days but it would not be the final solution.
• Attentive listening:
  • By Carefully listening to the employee’s and then solving their problem are marks of sincere concern for any individual or group as a whole. Leaders in office need to show this quality. So, he has to be attentive however much he dislikes the grievances or narration thereof in the meetings.
  • He need not switch off in the meeting, rather he should listen to the grievances of the employees more empathically. These meetings serve a purpose. If he ignores all that the staff members have to say, the present employees could also resign. He has also to be responsive to what staff members say.
  • Ignoring their Demands: He can ignore their demand and work as nothing has happened, but this step could hamper the productivity and future prospect of the company.
  • Work from Home alternative: This step could be the possible alternative, as by providing hybrid model of work, it will ease the problem of space as employees can easily work from home and some employees can still come to office, so it eases the pressure on the office infrastructure.
  • Allocation of office space on rent: By allocating a separate rental office space nearby only for temporary period till the proper office space is not required could solve the problems of faced by employees and satisfy all the parties to the dispute.

Conclusion

The conflict can only be resolved through the collective effort by all the stakeholders involved in the situation, where the company need to take initiatives to improve emotional intelligence, empathy and emotional quotient among its CEO, employees and other staff, so, there could be an open discussion and employees can freely express their concerns and CEO and management of the company should listen to the problems more attentively and should take proper measures to address the issues in due time.