arXiv subjects

Robert Ranisch

Publications and source records attributed to Robert Ranisch.

6 recordsLinked to original sources

arXiv2026

Agentic AI, Medical Morality, and the Transformation of the Patient-Physician Relationship

The emergence of agentic AI marks a new phase in the digital transformation of healthcare. Distinct from conventional generative AI, agentic AI systems are capable of autonomous, goal-directed actions and complex task coordination. They promise to support or even collaborate with clinicians and patients in increasingly independent ways. While agentic AI raises familiar moral concerns regarding safety, accountability, and bias, this article focuses on a less explored dimension: its capacity to transform the moral fabric of healthcare itself. Drawing on the framework of techno-moral change and the three domains of decision, relation and perception, we investigate how agentic AI might reshape the patient-physician relationship and reconfigure core concepts of medical morality. We argue that these shifts, while not fully predictable, demand ethical attention before widespread deployment. Ultimately, the paper calls for integrating ethical foresight into the design and use of agentic AI.

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arXiv2025

From Everyday to Existential -- The ethics of shifting the boundaries of health and data with multimodal digital biomarkers

Multimodal digital biomarkers (MDBs) integrate diverse physiological, behavioral, and contextual data to provide continuous representations of health. This paper argues that MDBs expand the concept of digital biomarkers along the dimensions of variability, complexity and abstraction, producing an ontological shift that datafies health and an epistemic shift that redefines health relevance. These transformations entail ethical implications for knowledge, responsibility, and governance in data-driven, preventive medicine.

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arXiv2025

Ethical Aspects of the Use of Social Robots in Elderly Care -- A Systematic Qualitative Review

Background: The use of social robotics in elderly care is increasingly discussed as one way of meeting emerging care needs due to scarce resources. While many potential benefits are associated with robotic care technologies, there is a variety of ethical challenges. To support steps towards a responsible implementation and use, this review develops an overview on ethical aspects of the use of social robots in elderly care from a decision-makers' perspective. Methods: Electronic databases were queried using a comprehensive search strategy based on the key concepts of "ethical aspects", "social robotics" and "elderly care". Abstract and title screening was conducted by two authors independently. Full-text screening was conducted by one author following a joint consolidation phase. Data was extracted using MAXQDA24 by one author, based on a consolidated coding framework. Analysis was performed through modified qualitative content analysis. Results: A total of 1,518 publications were screened, and 248 publications were included. We have organized our analysis in a scheme of ethical hazards, ethical opportunities and unsettled questions, identifying at least 60 broad ethical aspects affecting three different stakeholder groups. While some ethical issues are well-known and broadly discussed our analysis shows a plethora of potentially relevant aspects, often only marginally recognized, that are worthy of consideration from a practical perspective. Discussion: The findings highlight the need for a contextual and detailed evaluation of implementation scenarios. To make use of the vast knowledge of the ethical discourse, we hypothesize that decision-makers need to understand the specific nature of this discourse to be able to engage in careful ethical deliberation.

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arXiv2024

The ethical landscape of robot-assisted surgery. A systematic review

Background: Robot-assisted surgery has been widely adopted in recent years. However, compared to other health technologies operating in close proximity to patients in a vulnerable state, ethical issues of robot-assisted surgery have received less attention. Against the background of increasing automation that are expected to raise new ethical issues, this systematic review aims to map the state of the ethical debate in this field. Methods: A protocol was registered in the international prospective register of systematic reviews (PROSPERO CRD42023397951). Medline via PubMed, EMBASE, CINHAL, Philosophers' Index, IEEE Xplorer, Web of Science (Core Collection), Scopus and Google Scholar were searched in January 2023. Screening, extraction, and analysis were conducted independently by two authors. A qualitative narrative synthesis was performed. Results: Out of 1,723 records, 66 records were included in the final dataset. Seven major strands of the ethical debate emerged during analysis. These include questions of harms and benefits, responsibility and control, professional-patient relationship, ethical issues in surgical training and learning, justice, translational questions, and economic considerations. Discussion: The identified themes testify to a broad range of different and differing ethical issues requiring careful deliberation and integration into the surgical ethos. Looking forward, we argue that a different perspective in addressing robotic surgical devices might be helpful to consider upcoming challenges of automation.

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arXiv2024

Rapid Integration of LLMs in Healthcare Raises Ethical Concerns: An Investigation into Deceptive Patterns in Social Robots

Conversational agents are increasingly used in healthcare, and the integration of Large Language Models (LLMs) has significantly enhanced their capabilities. When integrated into social robots, LLMs offer the potential for more natural interactions. However, while LLMs promise numerous benefits, they also raise critical ethical concerns, particularly around the issue of hallucinations and deceptive patterns. In this case study, we observed a critical pattern of deceptive behavior in commercially available LLM-based care software integrated into robots. The LLM-equipped robot falsely claimed to have medication reminder functionalities. Not only did these systems assure users of their ability to manage medication schedules, but they also proactively suggested this capability, despite lacking it. This deceptive behavior poses significant risks in healthcare environments, where reliability is paramount. Our findings highlights the ethical and safety concerns surrounding the deployment of LLM-integrated robots in healthcare, emphasizing the need for oversight to prevent potentially harmful consequences for vulnerable populations.

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arXiv2024

The Ethics of ChatGPT in Medicine and Healthcare: A Systematic Review on Large Language Models (LLMs)

With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.

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