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Interview: Ralf Jox

Dr. Jox is an associate professor of medical ethics at the University of Lausanne and a physician trained in neurology and palliative care. He's serving as a panelist for a session taking place on the second day of the 2020 INS Annual Meeting, 'Challenges of Artificial Intelligence and Neuroscience to Democracy.'

What’s your current position and field of research?

I actually have two positions. I'm an associate professor of medical ethics at the University of Lausanne in the Faculty of Biology and Medicine. In that position, I'm responsible for the ethics teaching of medical students, I do ethics research, and I supervise the clinical ethics consultation here in the hospital.

My second position has more to do with my clinical background. I'm a physician trained in neurology and palliative care, so I have half a position in geriatric palliative care. It's also an academic chair, but with a bit more contact to clinical projects and policymaking in the area of palliative and end-of-life care.

What are some neuroethical aspects of your work?

I have training as a neurologist and I worked as a neurologist in Germany for several years, and this actually got me into neuroethics. For example, I had contact with epilepsy patients who had invasive diagnostic EEG monitoring, patients who are in the vegetative state, and patients who are suffering from disorders of consciousness or stroke. All of these conditions provoke a lot of ethical questions. I also studied philosophy and I was always interested in bioethics. Initially, I worked on brain death and specific neurologic populations. For example, I began with ethics in ALS and ethical issues in patients with stroke or disorders of consciousness, and then slowly I moved to the more technological neuroethics or interventional neuroethics. I had a big international project on brain-computer interfaces, which I worked on for several years before moving onto some smaller side projects, like neuroimaging and memory modification using psychopharmaceuticals in the military.

This got me into neuroethics and I actually founded a neuroethics interest group when I was in Germany. I tried to coordinate the work of neuroethics scholars in Germany and in Central Europe. In that group, we have also pursued a research on what neuroethics is in theory. What does neuroethics mean? Is it different from bioethics? Is it something exceptional and why is it exceptional? We also did an empirical survey on neuroethics in the German speaking part of Europe to investigate what kind of topics people work on, what kind of methods they use, and where their background is. For instance, are they philosophers, doctors, psychiatrists, social scientists, or something entirely different?

Quite recently I've been –– as everyone seems to be –– more into the artificial intelligence domain. This is a big issue in medicine and health care now. Even if there's only a slight contact of AI with neuroscience and neuroethics, it's still an important issue. Recently, I participated in a conference on consumer neurotechnology and AI. So that’s roughly my background in neuroethics and artificial intelligence that brought me to this conference.

In relation to your panel at the annual meeting, ‘Challenges of AI and neuroscience to democracy,’ what do you see as some implications for democracy that are created by AI and neuroscience?

I think you have to look really closely at what applications of AI and neurotechnology we're talking about. The potential of these technologies is vast. The first things that come to my mind when we talk about the impact of AI and neurotechnology on democracy is the misuse or the abuse of AI in manipulating elections. For example, using chatbots or other kinds of AI technology on social media. Obviously there has been some influence on elections, and now with the U.S election approaching, Facebook has announced that they’ll try to prevent these manipulations or abuses from happening. I'm not sure whether it will be successful or not, but this is one area that I'm concerned about.

Another area is face recognition. For instance, we have a lot of CCTV cameras all over our public spaces, and when this is coupled with AI you could actually identify people. It goes beyond that: you could even identify emotions of people, and possibly much more. If you’re able and allowed to combine this data with other private sensitive data, this could definitely be a threat to democracy.

Tell me about your research involving neuroethics as a field itself.

It's really fascinating. We try to approach the topic from the theoretical and empirical side of things. Empirically speaking, there are quite a few people working in neuroethics in Europe. We have, for example, various groups working on neuroethics in Germany, Italy, the UK and Switzerland as well. However, this is very, very heterogeneous. For example, they are psychiatrists working on neuroethics, philosophers of mind, clinical ethicists, bioethicists, and also social scientists. It's a very, very diverse field, and the topics that people find interesting are also very, very diverse. We have created a list of 30 different topics –– unfortunately, it's not yet published –– but this is really a vast area of research.

Our problem here in Europe, in contrast to the US, is that the field isn’t really united. There's no platform to exchange ideas, there's no ‘European Conference on Neuroethics,’ there's only one European journal on neuroethics, and there's no European society. So there's this huge potential of people working in isolation on their own neuroethics issues, but they're not yet really brought together. I think that's an important challenge if we want to strengthen the field, improve the quality of research, and coordinate this research. I think we need to further cooperation in our neuroethics across the Atlantic.

Do you feel that the virtual format of this year's annual meeting is going to help with that collaboration?

Absolutely. Although I've been a member for five or six years, I've never actually made it to the conference, so this is the first time that I actually can participate in the INS meeting.

For example, I attended the Conference of the European Academy of Neurology, which was one of the first virtual conferences in the COVID-19 period. This was an online conference, and for the first time it attracted 48,000 participants from all over the world. Several thousand people from South America, for example, who usually do not have the resources to travel elsewhere to attend this conference. So I think that's a real potential now for the INS virtual meeting to have more attendees from resource poor countries and to really unite the scientific community in neuroethics.

What are you looking forward to about the annual meeting?

The meeting program is very interesting. There’s excellent speakers and I'm really looking forward to the several panels and discussions on AI. I think that’s a technology that will really revolutionize medicine and change medicine profoundly. Additionally, making the link with social justice in the era of COVID-19 is important. I’m also looking forward to the time we’ll have to discuss topics. That's obviously the challenge of virtual meetings –– you can listen to talks and presentations, but you don't really engage a lot –– so I’m glad there will be time set aside to discuss these topics. And lastly, I'm simply curious to get to know and listen to colleagues who are experts in the field.

Our Digital Future: Building Networks Across Neuroscience, Technology and Ethics

The 2020 Annual Meeting of the International Neuroethics Society (INS) will convene virtually on Thursday and Friday, October 22-23, 2020. Sessions will address the many areas in which brain technologies and data concerning the brain are developed, deployed, utilized and regulated. We hope you will attend!