La vulnerabilidad antropotécnica: una propuesta para la interpretación de las transformaciones de la relación médico paciente en la era de la inteligencia artificial
La inteligencia artificial (IA), al ser una tecnología autónoma, evolutiva y altamente eficiente, promete automatizar y optimizar procesos en diversos sectores, incluyendo el político, económico, empresarial y de la salud. Esta promesa conlleva una potencial transformación en múltiples actividades h...
- Autores:
-
Riaño Moreno, Julián Camilo
- Tipo de recurso:
- https://purl.org/coar/resource_type/c_db06
- Fecha de publicación:
- 2024
- Institución:
- Universidad El Bosque
- Repositorio:
- Repositorio U. El Bosque
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.unbosque.edu.co:20.500.12495/12842
- Acceso en línea:
- https://hdl.handle.net/20.500.12495/12842
- Palabra clave:
- Inteligencia Artificial
Relación médico-paciente
Salud Digital
Interacción humano-máquina
Vulnerabilidad
Bioética
Ética médica
Artificial Intelligence
Doctor-Patient Relationship
Digital Health
Human-Machine Interaction
Vulnerability
Bioethics
Medical Ethics
WB60
- Rights
- closedAccess
- License
- Acceso cerrado
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La vulnerabilidad antropotécnica: una propuesta para la interpretación de las transformaciones de la relación médico paciente en la era de la inteligencia artificial |
| dc.title.translated.none.fl_str_mv |
The anthropotechnical vulnerability: a proposal for interpreting the transformations of the doctor-patient relationship in the era of artificial intelligence |
| title |
La vulnerabilidad antropotécnica: una propuesta para la interpretación de las transformaciones de la relación médico paciente en la era de la inteligencia artificial |
| spellingShingle |
La vulnerabilidad antropotécnica: una propuesta para la interpretación de las transformaciones de la relación médico paciente en la era de la inteligencia artificial Inteligencia Artificial Relación médico-paciente Salud Digital Interacción humano-máquina Vulnerabilidad Bioética Ética médica Artificial Intelligence Doctor-Patient Relationship Digital Health Human-Machine Interaction Vulnerability Bioethics Medical Ethics WB60 |
| title_short |
La vulnerabilidad antropotécnica: una propuesta para la interpretación de las transformaciones de la relación médico paciente en la era de la inteligencia artificial |
| title_full |
La vulnerabilidad antropotécnica: una propuesta para la interpretación de las transformaciones de la relación médico paciente en la era de la inteligencia artificial |
| title_fullStr |
La vulnerabilidad antropotécnica: una propuesta para la interpretación de las transformaciones de la relación médico paciente en la era de la inteligencia artificial |
| title_full_unstemmed |
La vulnerabilidad antropotécnica: una propuesta para la interpretación de las transformaciones de la relación médico paciente en la era de la inteligencia artificial |
| title_sort |
La vulnerabilidad antropotécnica: una propuesta para la interpretación de las transformaciones de la relación médico paciente en la era de la inteligencia artificial |
| dc.creator.fl_str_mv |
Riaño Moreno, Julián Camilo |
| dc.contributor.advisor.none.fl_str_mv |
Escobar Triana, Jaime |
| dc.contributor.author.none.fl_str_mv |
Riaño Moreno, Julián Camilo |
| dc.subject.none.fl_str_mv |
Inteligencia Artificial Relación médico-paciente Salud Digital Interacción humano-máquina Vulnerabilidad Bioética Ética médica |
| topic |
Inteligencia Artificial Relación médico-paciente Salud Digital Interacción humano-máquina Vulnerabilidad Bioética Ética médica Artificial Intelligence Doctor-Patient Relationship Digital Health Human-Machine Interaction Vulnerability Bioethics Medical Ethics WB60 |
| dc.subject.keywords.none.fl_str_mv |
Artificial Intelligence Doctor-Patient Relationship Digital Health Human-Machine Interaction Vulnerability Bioethics Medical Ethics |
| dc.subject.nlm.none.fl_str_mv |
WB60 |
| description |
La inteligencia artificial (IA), al ser una tecnología autónoma, evolutiva y altamente eficiente, promete automatizar y optimizar procesos en diversos sectores, incluyendo el político, económico, empresarial y de la salud. Esta promesa conlleva una potencial transformación en múltiples actividades humanas, incluyendo la práctica médica, y en particular, la relación médico-paciente (RMP). La inserción de la IA en el ámbito médico coloca tanto al médico como al paciente en el núcleo de un complejo industrial y digital imponente. El médico adopta el rol de intermediario de información, mientras que el paciente actúa como consumidor, gestor y productor en el entorno digital. En este contexto, la IA prioriza valores vinculados con su industria, como la eficiencia y precisión, así como la privatización y rendimiento económico, en lugar de valores intrínsecos a la RMP, tales como la honestidad, confianza y confidencialidad. Esta dinámica engendra nuevas formas de vulnerabilidad, que requieren un análisis cuidadoso desde una perspectiva que integre la relación entre vulnerabilidad y tecnología. Al analizar las interacciones entre vulnerabilidad e IA, se observa que las perspectivas comunes sobre vulnerabilidad suelen ser técnicas y centradas en la ingeniería y el diseño, enfocándose en la identificación y minimización de amenazas y riesgos. Aunque este enfoque es esencial, es notable su adopción similar en la medicina, lo que indica una percepción instrumental de la IA en este campo y una urgencia por su implementación en las ciencias de la salud, acorde con un tecno-solucionismo médico. Esto también señala un alineamiento de la medicina con los valores de los actores e industrias del mundo digital. Por otro lado, los enfoques tradicionales de vulnerabilidad en la atención sanitaria se centran en el cuidado y protección de las personas, considerando la vulnerabilidad como una característica inherente a individuos cuya autonomía está comprometida o como un adjetivo aplicable a grupos que no pueden protegerse a sí mismos o son dependientes. Esto conlleva a que, en la RMP, generalmente solo los pacientes sean vistos como vulnerables, ignorando la vulnerabilidad inherente tanto al médico como al paciente. Esta limitación en los entendimientos de vulnerabilidad, restringidos a contextos de atención sanitaria o ingenierías, es problemática porque ignora la complejidad de la vulnerabilidad en la RMP, reduciéndola a un asunto meramente técnico o instrumental y no ético. Por ende, en el marco de esta investigación, se hace necesario avanzar más allá de la perspectiva técnica de vulnerabilidad, integrándola, para orientarla hacia el ámbito bioético. Esto conduce a cuestionamientos sobre las relaciones y significados de vulnerabilidad y tecnología en los análisis bioéticos, y si estos son adecuados para abordar las transformaciones en la RMP impulsadas por la IA. Se busca comprender cómo estos enfoques bioéticos pueden ofrecer respuestas a los desafíos planteados por la incorporación de la IA en la medicina, especialmente en lo que respecta a las dinámicas de vulnerabilidad entre médicos y pacientes. Para responder a estas cuestiones, se realizó un análisis de las fundamentaciones más recientes sobre vulnerabilidad desde tres perspectivas éticas diferentes: la bioética global de Henk ten Have, la ética de la caricia de Corine Pelluchon y la ética de la tecnología de Mark Coeckelbergh. Este análisis se llevó a cabo mediante una metodología hermenéutica, utilizando un análisis semántico por CAQDAS y un ejercicio dialéctico-interpretativo siguiendo la “hermenéutica de la distancia” de Paul Ricoeur. La anticipación de sentido central de este trabajo fue, que los que los significados de vulnerabilidad dependen de los significados de tecnología de cada autor, un aspecto frecuentemente pasado por alto en el discurso tradicional de la bioética. Así, comprender las transformaciones de la RMP provocadas por la IA implica repensar los significados de vulnerabilidad a partir de la tecnología, considerando nuevos tipos de actores y relaciones, como la interacción hombre-máquina. La metodología y el desarrollo de la anticipación se detallan en el primer capítulo de la tesis. Este capítulo establece tres objetivos específicos que orientan el propósito central del estudio: comprender las transformaciones en la RMP provocadas por la IA, analizando las relaciones y significados de vulnerabilidad y tecnología según Henk Ten Have, Corine Pelluchon y Mark Coeckelbergh. Estos objetivos se desarrollan en los capítulos dos al cuatro. El primer objetivo, abordado en el segundo capítulo, es describir las transformaciones de la RMP impulsadas por la IA entre 2010 y 2021. El segundo objetivo, tratado en el tercer capítulo, es explicar las convergencias y divergencias entre los significados de vulnerabilidad y tecnología en las reflexiones de los autores mencionados. El tercer objetivo, expuesto en el cuarto capítulo, es proponer un modelo de vulnerabilidad que permita entender la RMP en el contexto de la IA, basándose en los significados de vulnerabilidad y tecnología de estos autores. Estos capítulos forman una secuencia que describe la situación actual (capítulo dos), proporciona un marco analítico (capítulo tres) y presenta una propuesta (capítulo cuatro). El análisis secuencial realizado en este trabajo culmina en la propuesta de una ética de la vulnerabilidad fundamentada en la idea de "vulnerabilidad antropoténica". Esta concepción se nutre de diversas teorías y filosofías, entre ellas la posfenomenología, la teoría de la interacción, la teoría de los sistemas sociotécnicos (STS), la antropotécnica de Sloterdijk, y la imaginación moral. Este enfoque proporciona una perspectiva novedosa para abordar las transformaciones observadas en la RMP en el contexto de la IA, teniendo en cuenta no solo los actores tradicionales de la RMP sino también, otros actores humanos como desarrolladores y diseñadores, también, actores no humanos como los mismos dispositivos tecnológicos, y meta actores, como la industria digital, entre otras. Para abarcar la complejidad de la RMP en la era de la IA, se propone el "modelo STS de la IMP/RMP", como un marco analítico que permite la exploración detallada de estas transformaciones y de la vulnerabilidad emergente. Este modelo, al integrar aspectos sociotécnicos y reconoce la tecnología como “sistema”, ofrece una comprensión más profunda de cómo la interacción médico-paciente (IMP) se ve influenciada y modificada por diferentes actores y formas de interacción que emergen a causa de la IA. De esta manera, la propuesta de “vulnerabilidad antropoténica”, como concepto central desarrollado en este trabajo, sugiere que la vulnerabilidad en el contexto de la RMP no es estática ni unidimensional, sino que es dinámica y se ve afectada por múltiples factores tecnológicos y humanos. Esta perspectiva amplía el entendimiento de la vulnerabilidad más allá de una simple categorización de individuos o grupos como "vulnerables", hacia una comprensión más integrada de cómo la tecnología y la interacción humana colectiva conforman y redefinen la vulnerabilidad en el ámbito de la salud. Este trabajo representa uno de los primeros acercamientos en Latinoamérica para proponer elementos fundacionales para una bioética de la IA, superando los enfoques tradicionales de las éticas de la IA, los humanismos de la IA, y las dimensiones reduccionistas de las éticas prácticas y su modelo ingenieril. Ofrece un marco epistemológico y metodológico para analizar la vulnerabilidad, una categoría generalmente desatendida en la ética de la IA y comúnmente abordada desde una perspectiva de ingeniería que limita la reflexión sobre la vulnerabilidad. Así, este trabajo se posiciona como una contribución pionera a la ética biomédica y la bioética en la era digital. |
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2024 |
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2024-08-06T19:49:28Z |
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2024-08-06T19:49:28Z |
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2024-07 |
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Escobar Triana, JaimeRiaño Moreno, Julián Camilo2024-08-06T19:49:28Z2024-08-06T19:49:28Z2024-07https://hdl.handle.net/20.500.12495/12842instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coLa inteligencia artificial (IA), al ser una tecnología autónoma, evolutiva y altamente eficiente, promete automatizar y optimizar procesos en diversos sectores, incluyendo el político, económico, empresarial y de la salud. Esta promesa conlleva una potencial transformación en múltiples actividades humanas, incluyendo la práctica médica, y en particular, la relación médico-paciente (RMP). La inserción de la IA en el ámbito médico coloca tanto al médico como al paciente en el núcleo de un complejo industrial y digital imponente. El médico adopta el rol de intermediario de información, mientras que el paciente actúa como consumidor, gestor y productor en el entorno digital. En este contexto, la IA prioriza valores vinculados con su industria, como la eficiencia y precisión, así como la privatización y rendimiento económico, en lugar de valores intrínsecos a la RMP, tales como la honestidad, confianza y confidencialidad. Esta dinámica engendra nuevas formas de vulnerabilidad, que requieren un análisis cuidadoso desde una perspectiva que integre la relación entre vulnerabilidad y tecnología. Al analizar las interacciones entre vulnerabilidad e IA, se observa que las perspectivas comunes sobre vulnerabilidad suelen ser técnicas y centradas en la ingeniería y el diseño, enfocándose en la identificación y minimización de amenazas y riesgos. Aunque este enfoque es esencial, es notable su adopción similar en la medicina, lo que indica una percepción instrumental de la IA en este campo y una urgencia por su implementación en las ciencias de la salud, acorde con un tecno-solucionismo médico. Esto también señala un alineamiento de la medicina con los valores de los actores e industrias del mundo digital. Por otro lado, los enfoques tradicionales de vulnerabilidad en la atención sanitaria se centran en el cuidado y protección de las personas, considerando la vulnerabilidad como una característica inherente a individuos cuya autonomía está comprometida o como un adjetivo aplicable a grupos que no pueden protegerse a sí mismos o son dependientes. Esto conlleva a que, en la RMP, generalmente solo los pacientes sean vistos como vulnerables, ignorando la vulnerabilidad inherente tanto al médico como al paciente. Esta limitación en los entendimientos de vulnerabilidad, restringidos a contextos de atención sanitaria o ingenierías, es problemática porque ignora la complejidad de la vulnerabilidad en la RMP, reduciéndola a un asunto meramente técnico o instrumental y no ético. Por ende, en el marco de esta investigación, se hace necesario avanzar más allá de la perspectiva técnica de vulnerabilidad, integrándola, para orientarla hacia el ámbito bioético. Esto conduce a cuestionamientos sobre las relaciones y significados de vulnerabilidad y tecnología en los análisis bioéticos, y si estos son adecuados para abordar las transformaciones en la RMP impulsadas por la IA. Se busca comprender cómo estos enfoques bioéticos pueden ofrecer respuestas a los desafíos planteados por la incorporación de la IA en la medicina, especialmente en lo que respecta a las dinámicas de vulnerabilidad entre médicos y pacientes. Para responder a estas cuestiones, se realizó un análisis de las fundamentaciones más recientes sobre vulnerabilidad desde tres perspectivas éticas diferentes: la bioética global de Henk ten Have, la ética de la caricia de Corine Pelluchon y la ética de la tecnología de Mark Coeckelbergh. Este análisis se llevó a cabo mediante una metodología hermenéutica, utilizando un análisis semántico por CAQDAS y un ejercicio dialéctico-interpretativo siguiendo la “hermenéutica de la distancia” de Paul Ricoeur. La anticipación de sentido central de este trabajo fue, que los que los significados de vulnerabilidad dependen de los significados de tecnología de cada autor, un aspecto frecuentemente pasado por alto en el discurso tradicional de la bioética. Así, comprender las transformaciones de la RMP provocadas por la IA implica repensar los significados de vulnerabilidad a partir de la tecnología, considerando nuevos tipos de actores y relaciones, como la interacción hombre-máquina. La metodología y el desarrollo de la anticipación se detallan en el primer capítulo de la tesis. Este capítulo establece tres objetivos específicos que orientan el propósito central del estudio: comprender las transformaciones en la RMP provocadas por la IA, analizando las relaciones y significados de vulnerabilidad y tecnología según Henk Ten Have, Corine Pelluchon y Mark Coeckelbergh. Estos objetivos se desarrollan en los capítulos dos al cuatro. El primer objetivo, abordado en el segundo capítulo, es describir las transformaciones de la RMP impulsadas por la IA entre 2010 y 2021. El segundo objetivo, tratado en el tercer capítulo, es explicar las convergencias y divergencias entre los significados de vulnerabilidad y tecnología en las reflexiones de los autores mencionados. El tercer objetivo, expuesto en el cuarto capítulo, es proponer un modelo de vulnerabilidad que permita entender la RMP en el contexto de la IA, basándose en los significados de vulnerabilidad y tecnología de estos autores. Estos capítulos forman una secuencia que describe la situación actual (capítulo dos), proporciona un marco analítico (capítulo tres) y presenta una propuesta (capítulo cuatro). El análisis secuencial realizado en este trabajo culmina en la propuesta de una ética de la vulnerabilidad fundamentada en la idea de "vulnerabilidad antropoténica". Esta concepción se nutre de diversas teorías y filosofías, entre ellas la posfenomenología, la teoría de la interacción, la teoría de los sistemas sociotécnicos (STS), la antropotécnica de Sloterdijk, y la imaginación moral. Este enfoque proporciona una perspectiva novedosa para abordar las transformaciones observadas en la RMP en el contexto de la IA, teniendo en cuenta no solo los actores tradicionales de la RMP sino también, otros actores humanos como desarrolladores y diseñadores, también, actores no humanos como los mismos dispositivos tecnológicos, y meta actores, como la industria digital, entre otras. Para abarcar la complejidad de la RMP en la era de la IA, se propone el "modelo STS de la IMP/RMP", como un marco analítico que permite la exploración detallada de estas transformaciones y de la vulnerabilidad emergente. Este modelo, al integrar aspectos sociotécnicos y reconoce la tecnología como “sistema”, ofrece una comprensión más profunda de cómo la interacción médico-paciente (IMP) se ve influenciada y modificada por diferentes actores y formas de interacción que emergen a causa de la IA. De esta manera, la propuesta de “vulnerabilidad antropoténica”, como concepto central desarrollado en este trabajo, sugiere que la vulnerabilidad en el contexto de la RMP no es estática ni unidimensional, sino que es dinámica y se ve afectada por múltiples factores tecnológicos y humanos. Esta perspectiva amplía el entendimiento de la vulnerabilidad más allá de una simple categorización de individuos o grupos como "vulnerables", hacia una comprensión más integrada de cómo la tecnología y la interacción humana colectiva conforman y redefinen la vulnerabilidad en el ámbito de la salud. Este trabajo representa uno de los primeros acercamientos en Latinoamérica para proponer elementos fundacionales para una bioética de la IA, superando los enfoques tradicionales de las éticas de la IA, los humanismos de la IA, y las dimensiones reduccionistas de las éticas prácticas y su modelo ingenieril. Ofrece un marco epistemológico y metodológico para analizar la vulnerabilidad, una categoría generalmente desatendida en la ética de la IA y comúnmente abordada desde una perspectiva de ingeniería que limita la reflexión sobre la vulnerabilidad. Así, este trabajo se posiciona como una contribución pionera a la ética biomédica y la bioética en la era digital.Doctor en BioéticaDoctoradoArtificial Intelligence (AI), as an autonomous, evolving, and highly efficient technology, promises to automate and optimize processes in various sectors, including politics, economics, business, and healthcare. This promise entails a potential transformation in multiple human activities, including medical practice, and particularly, the doctor-patient relationship (DPR). The insertion of AI in the medical field places both the doctor and the patient at the core of an imposing industrial and digital complex. The doctor adopts the role of information intermediary, while the patient acts as a consumer, manager, and producer in the digital environment. In this context, AI prioritizes values linked to its industry, such as efficiency and precision, as well as privatization and economic performance, instead of values intrinsic to the DPR, such as honesty, trust, and confidentiality. This dynamic engenders new forms of vulnerability, which require careful analysis from a perspective that integrates the relationship between vulnerability and technology. When analyzing the interactions between vulnerability and AI, it is observed that common perspectives on vulnerability tend to be technical and centered on engineering and design, focusing on identifying and minimizing threats and risks. Although this approach is essential, its similar adoption in medicine is notable, indicating an instrumental perception of AI in this field and an urgency for its implementation in health sciences, in line with medical techno-solutionism. This also signals an alignment of medicine with the values of actors and industries in the digital world. On the other hand, traditional approaches to vulnerability in healthcare focus on the care and protection of people, considering vulnerability as an inherent characteristic of individuals whose autonomy is compromised or as an adjective applicable to groups that cannot protect themselves or are dependent. This leads to, in the DPR, generally only patients being seen as vulnerable, ignoring the inherent vulnerability of both the doctor and the patient. This limitation in the understandings of vulnerability, restricted to healthcare contexts or engineering, is problematic because it ignores the complexity of vulnerability in the DPR, reducing it to a merely technical or instrumental issue and not an ethical one. Therefore, within the framework of this research, it becomes necessary to move beyond the technical perspective of vulnerability, integrating it, to orient it towards the bioethical realm. This leads to questions about the relationships and meanings of vulnerability and technology in bioethical analyses, and whether these are adequate to address the transformations in the DPR driven by AI. It seeks to understand how these bioethical approaches can offer responses to the challenges posed by the incorporation of AI in medicine, especially regarding the dynamics of vulnerability between doctors and patients. To answer these questions, an analysis of the most recent foundations on vulnerability was carried out from three different ethical perspectives: Henk ten Have's global bioethics, Corine Pelluchon's ethics of caress, and Mark Coeckelbergh's ethics of technology. This analysis was conducted using a hermeneutic methodology, utilizing a semantic analysis by CAQDAS and a dialectical interpretative exercise following Paul Ricoeur's "hermeneutics of distance." The central anticipation of meaning in this work was that the meanings of vulnerability depend on the meanings of technology of each author, an aspect often overlooked in traditional bioethical discourse. Thus, understanding the transformations of the DPR caused by AI implies rethinking the meanings of vulnerability based on technology, considering new types of actors and relationships, such as human-machine interaction. The methodology and development of the anticipation are detailed in the first chapter of the thesis. This chapter establishes three specific objectives that guide the central purpose of the study: to understand the transformations in the DPR caused by AI, analyzing the relationships and meanings of vulnerability and technology according to Henk Ten Have, Corine Pelluchon, and Mark Coeckelbergh. These objectives are developed in chapters two through four. The first objective, addressed in the second chapter, is to describe the transformations of the DPR driven by AI between 2010 and 2021. The second objective, dealt with in the third chapter, is to explain the convergences and divergences between the meanings of vulnerability and technology in the reflections of the mentioned authors. The third objective, presented in the fourth chapter, is to propose a model of vulnerability that allows understanding the DPR in the context of AI, based on the meanings of vulnerability and technology of these authors. These chapters form a sequence that describes the current situation (chapter two), provides an analytical framework (chapter three), and presents a proposal (chapter four). The sequential analysis carried out in this work culminates in the proposal of an ethics of vulnerability based on the idea of "anthropotenic vulnerability." This conception draws from various theories and philosophies, including post-phenomenology, interaction theory, sociotechnical systems theory (STS), Sloterdijk's anthropotechnics, and moral imagination. This approach provides a novel perspective to address the observed transformations in the DPR in the context of AI, considering not only the traditional actors of the DPR but also other human actors such as developers and designers, as well as non-human actors such as the technological devices themselves, and meta-actors, such as the digital industry, among others. To encompass the complexity of the DPR in the AI era, the "STS model of DPI/DPR" is proposed as an analytical framework that allows for detailed exploration of these transformations and emerging vulnerability. This model, by integrating sociotechnical aspects and recognizing technology as a "system," offers a deeper understanding of how the doctor-patient interaction (DPI) is influenced and modified by different actors and forms of interaction that emerge due to AI. In this way, the proposal of "anthropotenic vulnerability," as the central concept developed in this work, suggests that vulnerability in the context of the DPR is neither static nor one-dimensional, but dynamic and affected by multiple technological and human factors. This perspective broadens the understanding of vulnerability beyond a simple categorization of individuals or groups as "vulnerable," towards a more integrated understanding of how technology and collective human interaction shape and redefine vulnerability in the health field. This work represents one of the first approaches in Latin America to propose foundational elements for bioethics of AI, surpassing traditional approaches of AI ethics, AI humanisms, and reductionist dimensions of practical ethics and their engineering model. It offers an epistemological and methodological framework to analyze vulnerability, a category generally neglected in AI ethics and commonly approached from an engineering perspective that limits reflection on vulnerability. 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