Making good decisions in extremely complex and difficult processes and situations has always been both a key task as well as a challenge in the clinic and has led to a large amount of clinical, legal and ethical routines, protocols and reflections in order to guarantee fair, participatory and up-to-date pathways for clinical decision-making. Nevertheless, the complexity of processes and physical phenomena, time as well as economic constraints and not least further endeavours as well as achievements in medicine and healthcare (...) continuously raise the need to evaluate and to improve clinical decision-making. This article scrutinises if and how clinical decision-making processes are challenged by the rise of so-called artificial intelligence-driven decision support systems (AI-DSS). In a first step, this article analyses how the rise of AI-DSS will affect and transform the modes of interaction between different agents in the clinic. In a second step, we point out how these changing modes of interaction also imply shifts in the conditions of trustworthiness, epistemic challenges regarding transparency, the underlying normative concepts of agency and its embedding into concrete contexts of deployment and, finally, the consequences for (possible) ascriptions of responsibility. Third, we draw first conclusions for further steps regarding a ‘meaningful human control’ of clinical AI-DSS. (shrink)

In discourses on digitization and the data economy, it is often claimed that data subjects shall beownersof their data. In this paper, we provide a problem diagnosis for such calls fordata ownership: a large variety of demands are discussed under this heading. It thus becomes challenging to specify what—if anything—unites them. We identify four conceptual dimensions of calls for data ownership and argue that these help to systematize and to compare different positions. In view of this pluralism of data ownership (...) claims, we introduce, spell out and defend a constructive interpretative proposal: claims for data ownership are charitably understood as attempts to call for theredistributionof material resources and the socio-culturalrecognitionof data subjects. We argue that as one consequence of this reading, it misses the point to reject claims for data ownership on the grounds that property in data does not exist. Instead, data ownership brings to attention a claim to renegotiate such aspects of thestatus quo. (shrink)

New data-driven technologies yield benefits and potentials, but also confront different agents and stakeholders with challenges in retaining control over their data. Our goal in this study is to arrive at a clear picture of what is meant by data sovereignty in such problem settings. To this end, we review 341 publications and analyze the frequency of different notions such as data sovereignty, digital sovereignty, and cyber sovereignty. We go on to map agents they concern, in which context they appear, (...) and which values they allude to. While our sample reveals a considerable degree of divergence and an occasional lack of clarity about intended meanings of data sovereignty, we propose a conceptual grid to systematize different dimensions and connotations. Each of them relates in some way to meaningful control, ownership, and other claims to data articulated by a variety of agents ranging from individuals to countries. Data sovereignty alludes to a nuanced mixture of normative concepts such as inclusive deliberation and recognition of the fundamental rights of data subjects. (shrink)

Next SectionPublic discourse in continental Europe gives a uniquely prominent place to human dignity. The European Christianities have always taken this notion to be an outgrowth of their theological commitments. This sense of a conceptual continuity between Christianity and secular morality contributes to the way in which these Christianities, especially (but not exclusively) in Germany, have perceived their public role. In an exemplary manner, this essay engages the secularized societal environment. In meeting the secular discourse on its own home ground, (...) it seeks to recapture the theological roots of that discourse's defining value commitments. The challenges that modern societies present for Christians are seen not as a threat that would destroy a presumed original societas Christiana. Instead, these challenges create an opportunity to transform the Gospel's message so as to have it conform to, but also allow it to criticize, contemporary scientific knowledge about the world and man. Bonhoeffer's rendering of the Lutheran doctrine of the two kingdoms here makes it possible to link the Christian understanding of man as “in the image of God” with the secular affirmation of human dignity. As an intermediate concept, “incarnate reason” allows the bioethical discourse to preserve crucial aspects of the Christian tradition, while at the same time giving space to a constructive as well as critical exchange with secular discourse partners. (shrink)

This open access book presents an ethical approach to utilizing personal medical data. It features essays that combine academic argument with practical application of ethical principles. The contributors are experts in ethics and law. They address the challenges in the re-use of medical data of the deceased on a voluntary basis. This pioneering study looks at the many factors involved when individuals and organizations wish to share information for research, policy-making, and humanitarian purposes. Today, it is easy to donate blood (...) or even organs, but it is virtually impossible to donate one’s own medical data. This is seen as ethically unacceptable. Yet, data donation can greatly benefit the welfare of our societies. This collection provides timely interdisciplinary research on biomedical big data. Topics include the ethics of data donation, the legal and regulatory challenges, and the current and future collaborations. Readers will learn about the ethical and regulatory challenges associated with medical data donations. They will also better understand the special nature of using deceased data for research purposes with regard to ethical principles of autonomy, beneficence, and justice. In addition, the contributors identify the key governance issues of such a scheme. The essays also look at what we can learn in terms of best practice from existing medical data schemes. (shrink)

Background Big data and AI applications now play a major role in many health contexts. Much research has already been conducted on ethical and social challenges associated with these technologies. Likewise, there are already some studies that investigate empirically which values and attitudes play a role in connection with their design and implementation. What is still in its infancy, however, is the comparative investigation of the perspectives of different stakeholders. Methods To explore this issue in a multi-faceted manner, we conducted (...) semi-structured interviews as well as focus group discussions with patients and clinicians. These empirical methods were used to gather interviewee’s views on the opportunities and challenges of medical AI and other data-intensive applications. Results Different clinician and patient groups are exposed to medical AI to differing degrees. Interviewees expect and demand that the purposes of data processing accord with patient preferences, and that data are put to effective use to generate social value. One central result is the shared tendency of clinicians and patients to maintain individualistic ascriptions of responsibility for clinical outcomes. Conclusions Medical AI and the proliferation of data with import for health-related inferences shape and partially reconfigure stakeholder expectations of how these technologies relate to the decision-making of human agents. Intuitions about individual responsibility for clinical outcomes could eventually be disrupted by the increasing sophistication of data-intensive and AI-driven clinical tools. Besides individual responsibility, systemic governance will be key to promote alignment with stakeholder expectations in AI-driven and data-intensive health settings. (shrink)

Genome Editing Techniques are seen to be at the frontier of current research in the field of emerging biotechnologies. The latest revolutionary development, the so-called CRISPR technology, represents a paradigmatic example of the ambiguity of such techniques and has resulted in an international interdisciplinary debate on whether or not it is necessary to ban the application of this technique by means of a moratorium on its use for human germline modifications, particularly in human embryos in the reproduction process. However, given (...) that other germline engineering techniques like mitochondrial DNA transfer techniques are already permitted and applied, the question arises what lies at the root of the apparent social unease about the modification of the human germline by Genome Editing Techniques like CRISPR. Against this background, the book seeks to make a substantial contribution to the current debate about a responsible and participatory framework for research on emerging biotechnologies by analysing underlying perceptions, attitudes, arguments and the reasoning on Genome Editing Techniques. (shrink)

Die vorliegende Studie empfiehlt, Leistungsansprüche für Personen mit interventionsfordernden Risiken anhand einer neuen Rechtskategorie, der ‚risikoadaptieren Prävention‘, abzubilden. Spätestens seit dem bioinformatischen Innovationsschub kann eine risikoadaptierte Anwendung von prophylaktischen Maßnahmen umfassend gewährleistet werden. Jedoch können die gegebenen Rechtskategorien das medizinische Anwendungsfeld nicht adäquat steuern. Die Autoren Friedhelm Meier, Anke Harney, Kerstin Rhiem, Anja Neumann, Silke Neusser, Matthias Braun, Jürgen Wasem, Rita Schmutzler, Stefan Huster und Peter Dabrock haben zusammen im BMBF geförderten Projekt SYSKON. Re-Konfiguration von Gesundheit und Krankheit. Ethische, psychosoziale, (...) rechtliche und gesundheitsökonomische Herausforderungen der Systemmedizin die vorliegende Governance Perspective erarbeitet. This book is published open access under a CC BY 4.0 license. (shrink)

Genome editing techniques are seen to be at the frontier of current research in the field of emerging biotechnologies. However, such biotechnological research is tensioned at the interface of science, technology and society. On the one hand, this means that it offers a tremendous potential to provide new concepts, methods and – in the long run – novel applications for urgent challenges and needs within society.

Background The use of Artificial Intelligence (AI) has the potential to provide relief in the challenging and often stressful clinical setting for physicians. So far, however, the actual changes in work for physicians remain a prediction for the future, including new demands on the social level of medical practice. Thus, the question of how the requirements for physicians will change due to the implementation of AI is addressed. Methods The question is approached through conceptual considerations based on the potentials that (...) AI already offer and the focus on central normative concepts of trust, explainability, and responsibility which play an important role when implementing AI in everyday clinical practice. Conclusion Interpersonal communication will not disappear upon implementation of AI. Instead, it is much more likely that the exchange between various actors in medical practice will become increasingly important. This adds another level of complexity to practical concepts such as Shared-Decision-Making, which must be addressed in empirical research, including the involvement of AI systems as actors in communication. (shrink)

According to the judgement of the European Court of Justice in 2014, human parthenogenetic stem cells are excluded from the patenting prohibition of procedures based on hESC by the European Biopatent Directive, because human parthenotes are not human embryos. This article is based on the thesis that in light of the technological advances in the field of stem cell research, the attribution of the term ‘human embryo’ to certain entities on a descriptive level as well as the attribution of a (...) normative protection status to certain entities based on the criterion of totipotency, are becoming increasingly unclear. The example of human parthenotes in particular demonstrates that totipotency is not at all a necessary condition for the attribution of the term ‘human embryo’. Furthermore, the example of hiPSC and somatic cells particularly shows that totipotency is also not a sufficient condition for the attribution of a normative protection status to certain entities. Therefore, it is not a suitable criterion for distinguishing between human embryos worthy of protection and human non-embryos not worthy of protection. Consequently, this conclusion has repercussions for the patenting question. The strict delineation between an ethically problematic commercial use of human embryos and the concomitant patenting prohibition of hESC-based procedures and an ethically unproblematic commercial use of human non-embryos and the therefore either unrestrictedly permitted or even unregulated patenting of procedures based on these alleged alternatives becomes increasingly blurred. (shrink)

This paper presents a social-theologically informed interpretation of the term integrity, as it occurs in fundamental law. It explores the manifestations of integrity violations and proceeds to draw an inference: an integrity violation can directly emanate from a misconception regarding integrity itself, as well as the implementation of protective measures that follow it. Integrity in its wholeness dimension is understood as open-endedness and non-seclusion rather than as a substantial, clearly definable characteristic of a person. This open-endedness and non-seclusion results from (...) the relational constitution of an individual. Consequently, it follows that a violation of integrity occurs when the open-endedness and non-seclusion of a person and their relational Becoming is hindered. The new definition of integrity is particularly important when it comes to the governance of new health technologies, especially Digital Twins that can become representatives of a person. Human integrity is non-violated only when it is understood as open to relational Becoming and this Becoming shows its expression in the mutual enabling and support of self-articulation. (shrink)

The use of Artificial Intelligence and Big Data in health care opens up new opportunities for the measurement of the human. Their application aims not only at gathering more and better data points but also at doing it less invasive. With this change in health care towards its extension to almost all areas of life and its increasing invisibility and opacity, new questions of transparency arise. While the complex human-machine interactions involved in deploying and using AI tend to become non-transparent, (...) the use of these technologies makes the patient seemingly transparent. Papers on the ethical implementation of AI plead for transparency but neglect the factor of the “transparent patient” as intertwined with AI. Transparency in this regard appears to be Janus-faced: The precondition for receiving help - e.g., treatment advice regarding the own health - is to become transparent for the digitized health care system. That is, for instance, to donate data and become visible to the AI and its operators. The paper reflects on this entanglement of transparent patients and (non-) transparent technology. It argues that transparency regarding both AI and humans is not an ethical principle per se but an infraethical concept. Further, it is no sufficient basis for avoiding harm and human dignity violations. Rather, transparency must be enriched by intelligibility following Judith Butler’s use of the term. Intelligibility is understood as an epistemological presupposition for recognition and the ensuing humane treatment. Finally, the paper highlights ways to testify intelligibility in dealing with AI in health care ex ante, ex post, and continuously. (shrink)

Biobanks, collecting human specimen, medical records, and lifestyle-related data, face the challenge of having contradictory missions: on the one hand serving the collective welfare through easy access for medical research, on the other hand adhering to restrictive privacy expectations of people in order to maintain their willingness to participate in such research. In this article, ethical frameworks stressing the societal value of low-privacy expectations in order to secure biomedical research are discussed. It will turn out that neither utilitarian nor communitarian (...) or classical libertarian ethics frameworks will help to serve both goals. Instead, John Rawls’ differentiation of the “right” and the “good” is presented in order to illustrate the possibility of “serving two masters”: individual interests of privacy, and societal interests of scientific progress and intergenerational justice. In order to illustrate this counterbalancing concept with an example, the five-pillar concept of the German Ethics Council will be briefly discussed. (shrink)

Neben grundsätzlichen konzeptionellen Fragen der sog. Individualisierten Medizin (IM), prägen ethische Bedenken und Fragen die aktuellen Debatten um die IM. Allerdings ist bislang noch nicht geklärt, in welchem methodischen Rahmen diese Fragen verortet werden können. Für die Entwicklung eines solchen Rahmens wird das Modell der First- und Second-Wave-Bioethics diskutiert und an zwei konkreten Herausforderungen – 1) dem Verhältnis der IM zur evidenz-basierten Medizin und 2) am Konzept der genetischen Risikoperson – aufgezeigt. Eine solche Kontextualisierung der IM-Debatte legt den Grundstein für (...) eine adäquate Erfassung und Bearbeitung sozialethischer Fragen (z. B. im Hinblick auf das Problem der Eigenverantwortung). (shrink)

ZusammenfassungNeben grundsätzlichen konzeptionellen Fragen der sog. Individualisierten Medizin (IM), prägen ethische Bedenken und Fragen die aktuellen Debatten um die IM. Allerdings ist bislang noch nicht geklärt, in welchem methodischen Rahmen diese Fragen verortet werden können. Für die Entwicklung eines solchen Rahmens wird das Modell der First- und Second-Wave-Bioethics diskutiert und an zwei konkreten Herausforderungen – 1) dem Verhältnis der IM zur evidenz-basierten Medizin und 2) am Konzept der genetischen Risikoperson – aufgezeigt. Eine solche Kontextualisierung der IM-Debatte legt den Grundstein für (...) eine adäquate Erfassung und Bearbeitung sozialethischer Fragen (z. B. im Hinblick auf das Problem der Eigenverantwortung). (shrink)

ZusammenfassungNeben grundsätzlichen konzeptionellen Fragen der sog. Individualisierten Medizin, prägen ethische Bedenken und Fragen die aktuellen Debatten um die IM. Allerdings ist bislang noch nicht geklärt, in welchem methodischen Rahmen diese Fragen verortet werden können. Für die Entwicklung eines solchen Rahmens wird das Modell der First- und Second-Wave-Bioethics diskutiert und an zwei konkreten Herausforderungen – 1) dem Verhältnis der IM zur evidenz-basierten Medizin und 2) am Konzept der genetischen Risikoperson – aufgezeigt. Eine solche Kontextualisierung der IM-Debatte legt den Grundstein für eine (...) adäquate Erfassung und Bearbeitung sozialethischer Fragen. (shrink)

Facing the impending rationing in health care and consequently necessary priorisation, this article pleads for primarily following the capability approach of justice. The decent minimum of just health care is onentated to the capability of leading a personally responsible life, functioning in its respective society. The capability approach is on the one band semantically justified by considering different ideas of humankind; on the other band, its capability of application is structurally checked by a network of further criteria conceming justice.

The article presents Observations of Catholic moral teaching from the perspective of Protestant theology in the form of theses. In a first section, main traits and distinctions, especially in the tradition of the claimed Magisterium of the Catholic Church, are outlined. The second section deals with typical Protestant critiques and misunderstandings of the Catholic approach. Following this article they are caused by confounding different Ievels of argumentation: the Ievels of a) the doctrines of teaching, b) the acting of teaching and (...) c) the comprehensive cultural practice. Unfolding these distinctions and their particular functionings the article draws the surprising conclusion that Protestant theology and ethics often do not match Catholic thinking although they think they do by using the same words. This conclusion may have a huge impact on ecumenical ventures and the Protestant self-understanding. A third section, a brief outlook on these questions, completes the train of thoughts. (shrink)

Die Gattungsbestimmung stellt die Gesellschaft im Kontext biotechnologischer Entwicklungen immer wieder vor neue ethische, rechtliche und soziale Herausforderungen. Scheinbar längst geklärte Probleme tauchen neu auf, und konsensfähige Annahmen werden brüchig. So hat sich in weiten Teilen der akademischen Bioethik die Auffassung durchgesetzt, dass dem biologischen Menschsein als solchem keine moralische Bedeutung zukommt. Auf der anderen Seite ist in jüngster Zeit die Forderung nach einer eigenen 'Gattungsethik' erhoben worden. Mit diesem Programm verbinden sich freilich eine Reihe von konzeptuellen und argumentativen Schwierigkeiten. (...) Der vorliegende Band geht der Gattungsbestimmung aus der Perspektive von Biologie, Philosophie, Recht, Theologie, Soziologie und Kulturwissenschaften nach, um ihre deskriptive und normative Erschließungskraft auf den Prüfstand zu stellen. Was leistet sie innerhalb ethischer Diskurse? Wie kann sie für rechtliche Regelungen bedeutsam werden? Mit Beiträgen von:Jörn Ahrens, Steffen Augsberg, Peter Dabrock, Ruth Denkhaus, Wilfried Härle, Gerald Hartung, Jan C. Joerden, Nikolaus Knoepffler, Gesa Lindemann, Elisabeth List, Thomas Potthast, Markus Rothhaar, Stephan Schaede, Marianne Schark, Ludwig Siep, Klemens Störtkuhl, Manfred Weinberg, Martin G. Weiss. (shrink)

This article offers a critical appreciation of a theory of justice puttoward by 0. Höffe. Höffe suggests that commutative justice forms the basis for every understanding of justice, not only in market relationships but also in the legal and social state. Beginning with Räffes' application of his theory to the health system, this article argues that Höffes' theory is not empirically sufficent; nor does it suffice in the discourse of Iegitimation for law and state. Distributive justice can only be excluded (...) as the fundamental justice for legal and state function at the cost of participation and solidarity. The paradigm change for which Höffe calls cannot, therefore, count upon the support of Christian social ethics. (shrink)

To act and to refrain from actions comprises according to the logic of ethical consequentialism to be responsible in any case. This argument is particularly important in medical ethics: Setting actively limits to a life or permitting a long-term suffering of a patient is sometimes interpreted as equally important in the view of morals or ethics. The foundation of this argument is a one-sided theory of causation. The essay presented here tries to differentiate between the idea of causation in activities (...) and the ascription of consequences of non-interference in certain cases. In former times nature presented reasons for nonintervention: God was at work. But when the idea of God is deficient in evidence in certain Western societies a qualified idea of life could replace the former basis of naturallaw or natural theology. (shrink)

Debates about moral, legal and political attributions of responsibility do not, as can be seen in the past, occur in a vacuum. Against this background, the following chapter does not directly address the pending ethical questions about human germline editing, but calls attention to several stages of social and ethical discourse. The goal, not simply in the interest of history, is to uncover the genealogy of the climate of the debate. After all, the hidden genealogy of discourses often contributes to (...) the societal framing of a debate. Making these taken-for-granted assumptions explicit is of intrinsic value for further ethical debate. For possible argumentative short circuits, or abstractions, can be avoided through this making-explicit, and things forgotten or non-self-evident can be recalled in the advanced course of the debate. The focal point of this critical genealogy is the transition from the seemingly rather reserved statement of the so called Washington Summit of December 2015 to the about-face undertaken by the leading American academies in the report they published in February 2017. Finally, how trust in science can be maintained beyond such perceptible interest-led transformations is explained in the concluding chapter. (shrink)

Dealing with the reform of the Transplantation Law, the first issue of the new rubric “Philosophie aktuell” met with strong and lively interest from our readers. Subsequent to this discussion a growing number of reports were published dealing with violations of mandatory rules of conduct in transplantation medicine. Therefore the topic is revisited here from the slightly different vantage point “organ transplantation II: elucidation and confidence”.

English summary: Questions of orientation in a globalized world social ethics answered with a Theology of Real. German text. German description: Theologie als Selbstreflexion der Kirche bestimmt deren Identitat dogmatisch. Wenn die Kirche jedoch gefragt ist und Gestalt annimmt, indem sie zum Orientierungswissen der Gesellschaft beitragt, dann antwortet die christliche Traditionsgemeinschaft sozialethisch. Beides wird zusammengehalten durch eine Theologie des Wirklichen. Sie verhindert, dass Verantwortungsethik ins Leere lauft. Dies dokumentieren die Beitrage des vorliegenden Bandes. Die Autoren stehen dabei in der Traditionslinie (...) einer Theologie des Wirklichen, mit der Georg Wunsch vor 80 Jahren in Marburg die deutsche Tradition des Fachgebietes begrundete. Wolfgang Huber, Peter Dabrock und Wolfgang Nethofel zeigen, wie diese Sozialethik sich der Zukunft stellt. Die protestantische Kombination von Freiheit und sozialer Verantwortung fuhrt heute auch die Kirche vor Ort hinein in prinzipiell transdisziplinare und globalisierte Fragestellungen. Sozialethik bewahrt sich dabei im Dialog zwischen verschiedenen Kulturen und Fachdisziplinen. Oekologisch-okonomische Zusammenhange, Bio- und Nanotechnologie eroffnen neue Fragehorizonte und ermoglichen paradigmatische Erfahrungen, die bereits heute in ungewohnten, aber fur die ubrigen theologischen Disziplinen wegweisenden Organisationsformen abgearbeitet werden. Die Gegenwartsdimensionen einer zeitgenossischen Verantwortungsethik eroffnen die Autoren, indem sie fundamental- und materialethische Fragestellungen auch im Kontext der neueren Theologiegeschichte erortern. Und schliesslich zeigen die Beitrage, dass neben der Fach- und Sachkritik auch die geschichtsbewusste Selbstkritik der Sozialethik notwendige Dimensionen einer Verantwortungsethik in protestantischer Tradition sind. (shrink)

Background Palliative care is an integral part of health care, which in term has become increasingly technologized in recent decades. Lately, innovative smart sensors combined with artificial intelligence promise better diagnosis and treatment. But to date, it is unclear: how are palliative care concepts and their underlying assumptions about humans challenged by smart sensor technologies (SST) and how can care benefit from SST? -/- Aims The paper aims to identify changes and challenges in palliative care due to the use of (...) SST. In addition, normative guiding criteria for the use of SST are developed. -/- Methods The principle of Total Care used by the European Association for Palliative Care (EAPC) forms the basis for the ethical analysis. Drawing on this, its underlying conceptions of the human and its socio-ethical aspects are examined with a phenomenological focus. In the second step, the advantages, limitations, and socio-ethical challenges of using SST with respect to the Total Care principle are explored. Finally, ethical-normative requirements for the application of SST are derived. -/- Results and Conclusion First, SST are limited in their measurement capabilities. Second, SST have an impact on human agency and autonomy. This concerns both the patient and the caregiver. Third, some aspects of the Total Care principle are likely to be marginalized due to the use of SST. The paper formulates normative requirements for using SST to serve human flourishing. It unfolds three criteria according to which SST must be aligned: (1) evidence and purposefulness, (2) autonomy, and (3) Total Care. (shrink)

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 18 Heft: 1 Seiten: 173-198.

The book considers the relationship between governance and participation, and the ways participation has been understood, framed and applied in the context of synthetic biology (SB) governance approaches. Based on fundamental questions about the scope, purpose, and responsibilities assigned to public participation activities, the authors conducted an literature review of policy reports and articles on SB governance. The authors identify key characteristics of synthetic biology, such as the complex interplay of research, engineering and IT expertise in the field, as well (...) as the challenges these characteristics pose in designing governance frameworks. Drawing on insights from a literature review, the authors contest calls for “earlier” and “more” participation on the basis that such calls fail to consider the necessary structural adjustments and resources needed for such endeavors. The brief addresses ethical questions arising in synthetic biology that could be used for developing frameworks of governance in the ongoing COVID-19 crisis and the consequent innovations in vaccine research. (shrink)

Since uncertainty is a major challenge in medicine and bears the risk of causing incorrect diagnoses and harmful treatment, there are many efforts to tackle it. For some time, AI technologies have been increasingly implemented in medicine and used to reduce medical uncertainties. What initially seems desirable, however, poses challenges. We use a multimethod approach that combines philosophical inquiry, conceptual analysis, and ethical considerations to identify key challenges that arise when AI is used for medical certainty purposes. We identify several (...) challenges. Where AI is used to reduce medical uncertainties, it is likely to result in (a) patients being stripped down to their measurable data points, and being made disambiguous. Additionally, the widespread use of AI technologies in health care bears the risk of (b) human physicians being pushed out of the medical decision-making process, and patient participation being more and more limited. Further, the successful use of AI requires extensive and invasive monitoring of patients, which raises (c) questions about surveillance as well as privacy and security issues. We outline these several challenges and show that they are immediate consequences of AI-driven security efforts. If not addressed, they could entail unfavorable consequences. We contend that diminishing medical uncertainties through AI involves a tradeoff. The advantages, including enhanced precision, personalization, and overall improvement in medicine, are accompanied by several novel challenges. This paper addresses them and gives suggestions about how to use AI for certainty purposes without causing harm to patients. (shrink)