WELCOME TO THE 19th MEETING
OF THE BRAIN NEUROETHICS WORKING
GROUP.
MY NAME IS ANDREA
BECKEL-MITCHENER, DEPUTY
DIRECTOR OF NIH BRAIN
INITIATIVE, RECENTLY NAMED
ACTING DIRECTOR OF THE NATIONAL
INSTITUTE OF MENTAL HEALTH,
WHICH CO-LEADS "BRAIN."
MY ROLE HERE TODAY IS DESIGNATED
FEDERAL OFFICIAL FOR TODAY'S
MEETING.
I WANT TO EXTEND A WARM WELCOME
TO OUR WORKING GROUP CO-CHAIRS,
DOCTORS FARAHANY AND DR. JIM
EBERWINE, ACTING CO-CHAIR FOR
THIS MEETING.
DR. CHRISTINE GRADY HAS
CO-CHAIRED THIS GROUP SINCE
2015, FIRST MEETING, I BELIEVE
IS JOINING US AS A PARTICIPANT
TODAY.
BUT WE DO THANK JIM FOR STEPPING
IN AS CO-CHAIR FOR THE MEETING
FOR TODAY.
I WANT TO WELCOME THE MEMBERS OF
THE WORKING GROUP, ALONG WITH
OUR INVITED SPEAKERS JOINING US
TODAY.
AS WE PROCEED WITH TODAY'S
MEETING, A FEW REMINDERS.
THE NEUROETHICS WORKING GROUP IS
NOT A FORMAL ADVISORY GROUP,
LIKE THE "BRAIN" MULTI-COUNCIL
WORKING GROUP THAT MET
YESTERDAY, THE NEWG IS A WORKING
GROUP OF THE ADVISORY COUNCILS
OF THE NIH INSTITUTES AND
CENTERS THAT PARTICIPATE IN
"BRAIN."
AND WAS ESTABLISHED BECAUSE OF
THE NEED FOR INPUT ON
NEUROETHICS CONSIDERATIONS
RELATED TO RESEARCH SUPPORTED
THROUGH THE BRAIN INITIATIVE.
THE NEWG DISCUSSIONS AND
DELIBERATES ETHICAL QUESTIONS
THAT COME UP IN THE CONTEXT OF
BRAIN INITIATIVE RESEARCH.
THE GROUP HAS CONSISTENTLY
RAISED HELPFUL PERSPECTIVES AND
OFFERED NEW NOVEL POINTS TO
CONSIDER, AROUND THE BRAIN
TECHNOLOGY, LEADING EDGE
APPROACHES THAT COMPRISE THE
BRAIN GRANT PORTFOLIO.
IN TODAY'S VIRTUAL MEETING WE'RE
USING TEAMS, NEW FOR US TODAY,
SO WE'RE GOING TO TRY TO MAKE
THAT AS SMOOTH AS POSSIBLE.
WE'VE RUN INTO SOME GLITCHES
ALREADY BUT HAVE A FEW ITEMS ON
THE AGENDA.
FIRST WE'LL HEAR AN UPDATE FROM
DR. JOHN NGAI, BRAIN DIRECTOR.
AND THEN WE'LL DO A ROUNDTABLE
HEARING UPDATES FROM THE NEWG
MEMBERS ABOUT HAPPENINGS SINCE
WE LAST MET IN ALL.
IN ALL.
WE'LL DEVOTE THE MEETING TO A
SESSION FOLLOWING ON DISCUSSIONS
AROUND BRAIN DATA SHARING, MORE
SPECIFICALLY WE'RE GOING TO
DELVE INTO THE POTENTIAL ETHICAL
CHALLENGES RELATED TO DIGITAL
BRAIN TWINS, TO INFORM THAT
DISCUSSION, WE'LL BE HEARING
FROM TECHNICAL EXPERTS AS WELL
AS BIOETHICISTS AROUND LARGE
SCALE BRAIN DATA TOWARDS
GENERATION OF SIMULATED DIGITAL
DUPLICATES OF BRAIN DATA AND
WHAT THAT COULD MEAN FOR
INDIVIDUALIZED MEDICINE.
WE'LL HAVE AN OVERVIEW FROM JEN
FRENCH, GIVING AN OVERVIEW OF
IBCI-CC.
THROUGHOUT THE DAY WE'LL HAVE
PLENTY OF TIME FOR QUESTIONS AND
DISCUSSION.
WE LOOK FORWARD TO A VERY RICH
DISCUSSION.
JUST A FEW HOUSEKEEPING NOTES
BEFORE WE GET STARTED.
THIS IS AN OPEN SESSION, IT'S A
LIVE VIDEOCAST IN THE PUBLIC
DOMAIN.
THE RECORDING WILL BE ARCHIVED
FOR LATER VIEWING ON THE NIH AND
BRAIN WEBSITE.
DURING DISCUSSION, NEWG MEMBERS
AND SPEAKERS PLEASE TURN ON YOUR
VIDEO AND USE THE RAISE HAND
OPTION, IF YOU HAVE QUESTIONS.
MODERATORS WILL CALL ON YOU TO
UNMUTE YOURSELF.
PLEASE DO OPT FOR THAT RAISE
HAND FEATURE RATHER THAN TYPING
QUESTIONS INTO THE TEAMS CHAT SO
THAT OUR VIDEOCAST ATTENDEES CAN
SEE OR HEAR THE QUESTION.
JUST TO LET YOU KNOW, I AM
GETTING CALLED OUT FOR A COUPLE
MEETINGS, SO DR. NINA HSU WILL
STEP IN DURING THOSE MEETINGS,
SO WE'RE TAG-TEAMING TODAY, IT
SHOULD BE SEAM SEAMLESS, I'LL
LET NINA KNOW WHEN I HAVE TO
STEP AWAY.
EVERYONE IS BUSY.
WE APPRECIATE YOUR TIME AND
INPUT ON THESE TOPICS.
NONE OF THIS CAN HAPPEN WITHOUT
OUR TIME.
I THINK DR. NINA HSU, SCIENCE
COMMITTEE SPECIALIST FOR THIS
WORKING GROUP, TODAY'S MEETING
IS MADE POSSIBLE BY THE TEAM
ALSO INCLUDES DR. SASKIA
HENDRIKS, DR. SHEN TON, DR.
LANTZ, AND THE TEAM FOR FULL
EFFECT.
LAST BUT NOT LEAST THANK YOU,
JOHN.
DR. JOHN NGAI IS UP NEXT, FOR
HIS SUPPORT OF NEUROETHICS.
I'LL TURN IT OVER TO YOU, JOHN.
>> THANKS, EVERYBODY.
THANK YOU FOR BEING HERE.
ALSO BIG SHOUT OUT TO ALL THE
FOLKS THAT ANDREA JUST
MENTIONED.
I COULDN'T GET THIS OUT WITHOUT
ANY OF YOU.
ANDREA IS WEARING HATS SO WELL,
WE'RE APPRECIATIVE OF WHAT SHE'S
DONE, NOW STEPPING UP TO HELP
LEAD NIMH DURING THIS TIME OF
TRANSITION.
SO THANK YOU, ANDREA.
THANKS TO OUR CO-CHAIRS OF NEWG,
NINA FARAHANY AND JIM FOR
STEPPING IN AT THE LAST MOMENT,
JIM EBERWINE AS OUR ACTING
CO-CHAIR.
CHRISTINE, WE MISS YOU.
WE REALLY APPRECIATE EVERYTHING
YOU'VE DONE WITH AND FOR US.
I'M DELIGHTED TO SEE YOU HERE
ATTENDING AS WELL.
NITA IS INVOLVED IN HER SCHOOL'S
EXCELLENCE. -- COMMENCEMENT
ACTIVITIES AND WILL BE JOINING
US LATER, I HAD HER PROMISE SHE
WOULD BE JOINING IN FULL
REGALIA.
BEFORE I TURN IT OVER TO THE
CHAIRS I WANT TO GIVE A FEW
QUICK UPDATES WITH "BRAIN" IN
THE AREA OF NEUROETHICS AND
RELATED AREAS.
TO DATE WE FUNDED 24 NEUROETHICS
PROJECTS, 24 PROJECTS, 24
SCHOLARLY PURSUITS IN THE AREA
OF NEUROETHICS.
$30 MILLION TO DATE, STILL HAVE
NINE ACTIVE PROJECTS, WE'LL BE
MAKING FUTURE INVESTMENTS, WE'RE
EXCITED ABOUT THAT.
THIS INCLUDES PRIMARY SITES IN
12 U.S. STATES AND ONE IN CANADA
TO OUR BENEFIT.
WE COMPLETED REVIEWS OF THE LAST
ROUND OF NEUROETHICS R01s AND
R21, SMALLER STARTER GRANTS.
FIRST TIME EVER.
WE'LL SEE HOW THAT SHAKES OUT.
WE'RE EXCITED ABOUT THAT.
THESE PROJECTS ARE ALL A
TESTAMENT TO THE VALUE THAT WE
PLACE ON A STRATEGIC
MULTI-PROJECTED NEUROETHICS
RESEARCH PROGRAM THAT EXAMINES
ETHICAL, LEGAL, SOCIETAL
IMPLICATIONS OF BRAIN-FUNDED
TECHNOLOGY.
WE'LL HEAR MORE ABOUT THAT WORK
TO COME.
I WANT TO HIGHLIGHT A FEW RECENT
EVENTS.
IT'S BEEN A WHILE SINCE WE MET.
WE PUSHED THE JANUARY MEETING
TILL NOW.
I WAS HAPPY TO SEE MANY OF YOU
IN PERSON AT SOCIETY
NEUROSCIENCE THIS FALL IN
CHICAGO.
GIVEN OUR BIG EMPHASIS IN
"BRAIN" ON A COLLABORATION IT
WAS GREAT TO SEE 50 TOOL MAKERS
SHOWING THEIR STUFF AT THE BRAIN
INITIATIVE SOCIAL, BUILDING
TOOLS AND TECH FOR INNOVATIVE
FUTURE.
AND THIS INFORMAL SOCIAL GAVE
ATTENDEES THE OPPORTUNITY TO
LEARN ABOUT A BROAD RANGE OF
TECHNICAL TOOLS DATA RESOURCES
SUPPORTED BY BRAIN.
IN ADDITION, BRAIN-FUNDED
INVESTIGATOR DR. MUNOZ GAVE A
LECTURE ON NEUROETHICS,
HIGHLIGHTING PRESSING CHALLENGES
AND OPPORTUNITIES OF THE NASCENT
BRAIN-COMPUTER INTERFACE, AND
WE'LL HEAR MORE ABOUT THAT LATER
TODAY.
IN NOVEMBER, WE ALSO HELD -- YOU
CAN SEE THE POSTER BEHIND ME,
THE BRAIN NEURO-A.I. WORKSHOP
LOOKING AT RECENT CONVERGENCE
BETWEEN NEUROSCIENCE AND
ARTIFICIAL INTELLIGENCE TO DRIVE
RECIPROCAL ADVANCES IN
UNDERSTANDING AND BEHAVIOR, THE
TWO-DAY WORKSHOP, FULL OF GREAT
DISCUSSIONS, WAS AN IMPORTANT
STEP IN IDENTIFYING PRIOR
PRIORITIES FOR HOW NEURO-A.I.
CAN ADVANCE NEUROTECHNOLOGY
WHILE INTEGRATING ETHICAL
CONSIDERATIONS FOR NEURO-A.I TO
PROVIDE FRAMEWORKS AND GUIDE
ADVANCES IN THIS SPACE, REALLY A
HOT AREA, ALL THE MORE REASON
FOR US TO BE CONSIDERING THESE
ETHICAL IMPLICATIONS AT THE
VERY, VERY BEGINNING.
LET'S SEE.
YESTERDAY'S MULTI-COUNCIL
WORKING GROUP, I HIGHLIGHTED
PUBLICATION BY BRAIN-SUPPORTED
INVESTIGATOR FRANCIS SHEN,
NAVIGATING ETHICAL ISSUES AROUND
PORTAL M.R. AT COMMUNITY
SETTINGS.
WE'RE STARTED TO SEE IN ADDITION
TO SCHOOL SNAZZY TOOLS IN THE
SPACE, THEY ARE GIVING GREATER
RESOLUTION, TEMPORAL AND SPATIAL
RESOLUTION, BUT ARE LIMITED TO
HEAVILY RESOURCED SCHOOLS AND
HOSPITALS, GETTING INTO
COMMUNITIES THAT DON'T HAVE
ACCESS INCLUDING RURAL
COMMUNITIES.
THERE'S BEEN A PUSH TO DEVELOP
PORTABLE M.R. MACHINES, GREAT,
BUT ALSO RAISES ETHICAL ISSUES.
AND DR. SHEN AND HIS
COLLABORATORS AT UNIVERSITY OF
MINNESOTA IDENTIFIED A NUMBER OF
CORE CHALLENGES AS WELL
ASPIRATIONAL GUIDANCE, WHICH
WOULD PROVIDE AN IMPORTANT
STARTING POINT FOR WORKING WITH
THIS TECHNOLOGY TO MAKE SURE
THAT WHEN FOLKS ARE GETTING
ACCESS TO IT THEY ARE NOT JUST
GETTING A LOWER GRADE ACCESS BUT
STILL ACHIEVING HIGH-QUALITY
CARE AND RESEARCH.
SO WITH THAT, I WILL TURN IT
BACK OVER TO THE CHAIRS.
I SEE PROFESSOR FARAHANY, YOU
MADE IT, YOU MADE IT AWAY FROM
THE FAMILIES, THE VERY PROUD
FAMILIES AND GRADUATES.
I DON'T SEE YOU IN THE GOWN BUT
THAT'S OKAY.
>> SORRY, IT WAS REALLY HOT.
MAYBE AT THE BREAK I'LL PUT IT
BACK ON SO YOU GET THE MOMENT.
>> GOOD TO SEE YOU.
>> GREAT TO SEE YOU.
LET ME HAND IT OVER TO MY
CO-CHAIR
WELCOME TO EVERYBODY, SO GLAD
WE'RE HERE.
BUT HAND IT OVER TO JIM EBERWIE
LEADING THIS PART OF THE
CONVERSATION.
>> THANKS.
I'M GLAD YOU WERE ABLE TO GET
HERE ON TIME.
I WANT TO THANK JOHN FOR THE
UPDATE.
THEY ARE WONDERFUL TO HEAR
UPDATES AND PROGRESS MADE BY
INVESTIGATORS OF THE BRAIN
INITIATIVE.
IN FACT IT'S THE REASON WE'RE
HERE.
IT'S THOSE -- THAT PROGRESS AND
ADVANCES THAT FUEL OUR INTEREST
IN TRYING TO UNDERSTAND THE
NEUROETHICS IMPLICATIONS OF NEW
TECHNOLOGIES BEING DEVELOPED.
I APPRECIATE THOSE UPDATES.
I WELCOME ALL THE MEMBERS,
INVITED SPEAKERS, AND THE
ATTENDEES TO THE MEETING, QUITE
INTERESTING IN TERMS OF TOPICS
DISCUSSED.
NORMALLY WE END WITH A
ROUNDTABLE UPDATE BUT STARTED TO
START WITH THESE UPDATES TODAY,
SO THAT WE GET TO HEAR WHAT
EVERYONE IS UP TO, WHAT PEOPLE
HAVE BEEN INTERESTED IN,
THINKING ABOUT OVER THE LAST
PERIOD OF TIME SINCE OUR LAST
MEETING.
WHY DON'T WE START WITH -- THIS
IS FOR THE MEMBERS OF THE
COMMITTEE, AND I'M JUST GOING TO
GO THROUGH THE MEMBERSHIP LIST
AND ASK EACH OF YOU TO GIVE US A
BRIEF UPDATE ON THE THINGS
YOU'VE BEEN INVOLVED WITH OR ARE
THINKING ABOUT WITH RESPECT TO
NEUROETHICS.
WHY DON'T WE START WITH WINSTON
CHUNG.
ARE YOU ON?
>> I'M HERE.
CAN YOU HEAR ME?
>> YES.
>> GREAT.
I THINK ONE BIG UPDATE IS THE
JUST-COMPLETED MEETING OF THE
INTERNATIONAL NEUROETHICS
SOCIETY WHICH MET IN MUNICH,
FIRST TIME OUT OF NORTH AMERICA,
THREE WEEKS AGO, GREAT TO MEET
WITH INTERNATIONAL
COLLABORATORS.
WANTED TO SAY WE'RE PLANTING
NEXT YEAR'S INTERNATIONAL
NEUROETHICS MEETING, WITH
DIFFERENT SITES AROUND THE WORLD
REFLECTING THE COMMUNITY, IN
STANFORD, CALIFORNIA, LOOK
FORWARD TO UPDATES ON THAT.
>> SHAMIR, ARE YOU ON?
I KNOW SHAMIR WAS TRAVELING,
PERHAPS NOT ON TODAY.
>> I THINK HE'S EN ROUTE.
>> YES.
>> YEAH, OKAY.
>> JENNIFER FRENCH, ARE YOU
AVAILABLE IN?
>> I AM.
HI, EVERYONE.
GREAT TO SEE YOU ALL.
YEAH, WE'VE BEEN UP TO A LOT BUT
I KNOW I'M TALKING LATER TODAY
ABOUT THE IMPLANTABLE
BRAIN-COMPUTER INTERFACE, WE'RE
ORGANIZING THE PUBLIC/PRIVATE
PARTNERSHIP OF THE NON-PROFIT
FORUM, JUNE 25th, WITH NINDS.
AND WE'LL ALSO BE CELEBRATING
THE 75th ANNIVERSARY OF NINDS
WITH A BRIEFING ON THE 24th,
BUT THE NON-PROFIT FORUM IS
ONGOING ON THE 25th.
WE'RE THRILLED TO TAKE PART IN
THAT EVENT AND MAKE SURE IT'S
ONGOING TO ENGAGE OUR
NON-PROFITS IN THE SPACE.
>> THANK YOU, JEN.
SYD?
>> I WAS RECENTLY PROMOTED TO
PROFESSOR, HAPPY TO SAY.
AND LET'S SEE, I HAD A BOOK COME
OUT A FEW MONTHS AGO ON THE
THREE PILLARS OF ETHICAL
RESEARCH WITH NON-HUMAN
PRIMATES.
I AM SERVING AS OBSERVER ON THE
UNIFORM LAW COMMITTEE STUDY
COMMISSION LED BY OUR OWN NITA
FARAHANY.
AND I GAVE A TALK AT THE KINGS
COLLEGE LONDON NEUROSCIENCE
SOCIETY ON PHILOSOPHY, ETHICS,
WINDING PATHS.
I THINK THAT'S IT.
>> QUITE BUSY, SYD.
THANK YOU.
IS AMY MAGUIRE ON, ARE YOU HERE?
>> YES.
CAN YOU HEAR ME?
>> YES.
>> HI, I'M HERE.
ALSO TRAVELING TODAY.
YEAH, IT'S GOOD TO SEE
EVERYBODY.
AND I DON'T HAVE MANY UPDATES.
WE'VE BEEN BUSY WORKING ON OUR
BRAIN-FUNDED PROJECT, BRAIN
SHARE, AND WE'RE TRYING TO GET
OUT SOME DATA RELATED TO THAT,
LOOKING AT DATA SHARING WITHIN
THE BRAIN INITIATIVE, AND OTHER
NEUROTECHNOLOGY RESEARCH.
BEEN WORKING WITH THE RESEARCH
ON HUMANS COMMITTEE FOR THE
BRAIN INITIATIVE THINKING ABOUT
ISSUES WITH RESEARCH DURING
NEUROSURGERY AND WE'RE WORKING
WITH SAMIR AND NEUROSURGEONS
THINKING THROUGH ETHICAL ISSUES
ASSOCIATED WITH THAT.
AND THAT'S IT.
I'VE BEEN WORKING, SITTING AT I
GUESS NOT OFFICIALLY A MEMBER
BUT AD HOC MEMBER TO NINDS
COUNCIL AND SO WE'VE BEEN
EXCITED THAT THEY HAVE BEEN
FUNDING SOME NEUROETHICS
RESEARCH AND MEETING AND GETTING
THINGS OUT THE DOOR SO THAT'S
GREAT.
>> THANK YOU, AMY.
KAREN ROMMELFANGER?
I'M NOT SURE KAREN IS ON.
>> HI!
GOOD TO SEE EVERYONE.
I CAN'T REMEMBER WHEN WE LAST
MET SO I DON'T KNOW WHEN THE
UPDATE SHOULD START.
LET'S SEE.
I'LL THING OF NEWISH THINGS THAT
MIGHT BE RELEVANT.
ONE INTERESTING THING, THE BRAIN
INITIATIVE AND A COUPLE OFFICES
HOSTED A NEURO-A.I. WORKSHOP
YEAR, THERE'S BEEN A LOT OF
MOMENTUM FROM THAT LOCALLY AND
KIND OF GLOBALLY IN THAT SPACE.
THERE WAS AN INTERESTING
CONFERENCE I HAD THE PLEASURE OF
BEING AT WITH JEN IN PERSON IN
D.C. RECENTLY, TRYING TO BRING
TOGETHER PEOPLE AND COMPUTING
WITH BCI DEVELOPERS, TRYING TO
GET THEM TO COLLABORATE EARLIER
ON WITH THE SCIENCE.
AND I'M HOPING THERE WILL BE
MORE CONNECTIONS FROM THAT.
I THINK ONE OF OUR BIGGER
PROJECTS IS WITH INSTITUTE OF
NEUROETHICS, THINK TANK, WORKING
THINKING ABOUT THE CHALLENGE OF
MAKING SURE THAT PEOPLE FROM
DIVERSITY OF COMMUNITIES ARE
TALKING ABOUT THE FUTURE OF
NEUROTECHNOLOGIES THEY WANT TO
HAVE IN A WAY THAT ISN'T LIMITED
TO TALKING ABOUT JUST RISK OR A
DYSTOPIAN OR UTOPIAN FUTURE BUT
MAYBE ONE IN THE MIDDLE THAT'S
MORE REAL.
AND SO WHAT WE'VE BEEN DOING TO
THAT END IS WORKING ON TWO
ELEMENTS.
ONE, ENGAGED TOOLS THAT FOSTER
MULTI-DIRECTIONAL DIALOGUE WITH
POLICY, ACADEMIA.
WE'VE BEEN WORKING WITH JAPAN'S
MOONSHOT PROJECTS, A SERIES OF
PROJECTS RELATED TO DIFFERENT
ELEMENTS OF UNDERSTANDING THE
BRAIN AND CONNECTING WITH IT.
AND WE'VE HAD THE PLEASURE OF
WORKING WITH THEIR
COMMUNICATIONS TEAM AND WE'LL BE
GOING BACK ACTUALLY NEXT WEEK TO
SET UP OUR NEXT SERIES OF
WORKSHOPS.
SO EXCITED ABOUT THAT AND HAPPY
TO TALK ABOUT THAT MORE AS IT
EVOLVES.
I HOPE WE CAN SEE MORE OF THAT
CONNECTION WITHIN THE BRAIN
INITIATIVE AS WELL.
>> THANK YOU, KAREN.
CAROLINE?
>> GREAT TO SEE EVERYONE HERE.
I HOPE EVERYONE IS DOING OKAY.
WHEN WE LAST MET, HOPEFULLY I'M
NOT COVERING THINGS COVERED IN
THE PAST, THINKING ABOUT THE
FALL AND NOVEMBER, THE DANA
FOUNDATION, THE LAUNCH AT
BRIGHAM, JOINING TWO OTHER SITES
WE LAUNCHED UNDER THIS UMBRELLA
LAST YEAR.
OTHER SITES ARE UCLA TOGETHER
WITH CHARLES UNIVERSITY AND
LOYALA UNIVERSITY CHICAGO, LED
BY THERESA WILLIAMSON, FRANCES
CHEN AND GABRIELLA MUNOZ.
INTERDISCIPLINARY RESEARCH
TRAINING ON TRAINING OF
BENEFICIAL CLINICAL
NEUROTECHNOLOGIES, NEUROSCIENCE
AS EVIDENCE IN THE COURT AND IN
CRIMINAL JUSTICE REFORM.
AND ANOTHER AREA IS ON COMMUNITY
PARTNERSHIP AND ADVOCACY
TRAINING TO FACILITATE
BIDIRECTIONAL LEARNING BETWEEN
SCIENTISTS AND MEMBERS OF
COMMUNITIES IMPACTED OR COULD BE
IMPACTED BY NEUROTECHNOLOGY
ADVANCEMENTS, SO WE'RE VERY
EXCITED ABOUT THIS AND, YOU
KNOW, ALSO LOOK FORWARD TO
SEEING ALL THE WORK THAT THEY
COME WITH.
SO ANOTHER ANNOUNCEMENT IS
AROUND THE DANA FOUNDATION
ITSELF, CELEBRATING OUR 75th
ANNIVERSARY THIS YEAR, WE
STARTED OFF IN 1950 WITH A FOCUS
ON HIGH OFFER EDUCATION AND
HEALTH RESEARCH FIRST IN CANCER,
FOR EXAMPLE, WITH THE
DANA-FARBER CANCER INSTITUTE AND
NOW OUR FOCUS IS IN SPECIFICALLY
NEUROSCIENCE AND SOCIETY, I'LL
DROP IN A TIMELINE WE'VE CREATED
IN SOME OTHER COLLATERALS COMING
TO TELL THE STORY, IT'S EXCITING
TO HEAR NINDS IS CELEBRATING
THEIR 75th ANNIVERSARY THIS
YEAR, A GREAT TRIBUTE AND HONOR
FOR SCIENTISTS AND ENGINEERS
THAT CONTRIBUTED TO THE FIELD
OVER THIS TIME.
AND THEN THE FINAL MAYBE ONE OF
THE OTHERS THINGS I'LL SHARE
THIS COMING JUNE PUBLICLY
ANNOUNCING OUR INAUGURAL
AWARDEES OF THE DANA FOUNDATION
NEUROSCIENCE AND SOCIETY AWARDS,
VERY EXCITED ABOUT THIS, VERY
EXCITED ABOUT THE PROCESS OF
SEARCH AND SELECTION FOR THIS.
STAY TUNED FOR THAT.
THESE AWARDS AIM TO RECOGNIZE
INDIVIDUALS WHOSE INFLUENTIAL
WORK BRIDGED THE GAP BETWEEN
NEUROSCIENCE AND SOCIETY TO
DRIVE MEANINGFUL DIALOGUE AND
INNOVATION ACROSS DIVERSE FIELDS
SUCH AS LAW, POLICY, EDUCATION,
AND HEALTH CARE.
STAY TUNED FOR THAT.
THE LAST PIECE COMING FROM THE
SCIENCE PHILANTHROPY COMMUNITY,
I GOT OUT OF MEETINGS WITH THE
ALLIANCE, AND WITHIN THOSE
DISCUSSIONS WE'RE THINKING VERY,
VERY DEEPLY ABOUT HOW TO BEST
SUPPORT THE SCIENCE COMMUNITY,
ESPECIALLY EARLY CAREER TRAINEES
AND SCHOLARS TO ENSURE A
PROMISING AND VIBRANT COMMUNITY
FOR SCIENTISTS.
>> AS ALWAYS, VERY EXCITING.
I GUESS I WILL GO NEXT.
WHEN WE'RE DONE WITH THE
SESSION, NITA WILL START THE
PRESENTATIONS FROM OUR GUEST
LECTURERS.
I'LL GO NOW AND NITA CAN TELL US
ABOUT HER UPDATES.
AND SO RECENTLY I HAD THE GREAT
PLEASURE TO WORK WITH KAREN
ROMMELFANGER, ENGAGING
SCIENTISTS IN NEUROSCIENCE IN
SOUTHEAST ASIA, PUBLISHED LATE
LAST YEAR, KAREN AND I WERE BOTH
MEMBERS, ALWAYS A PLEASURE TO
WORK WITH KAREN.
THE REPORT IS AN INTERESTING
REPORT ON POTENTIAL INTERACTIONS
BETWEEN THE U.S. AND A VARIETY
OF SOUTHEAST ASIAN COUNTRIES.
AND MORE RECENTLY, I WAS
COORDINATOR FOR NATIONAL
ACADEMIES OF SCIENCES PAPER,
ELUCIDATING MOLECULAR AND
PATHWAY DETERMINANTS OF
COGNITIVE PERFORMANCE IN HUMANS
THROUGH MULTI-OMICS, THERE'S A
NEUROETHICS COMPONENT.
I'VE BEEN INTERESTED IN HOW
MULTI-OMICS USING MOLECULAR
APPROACHES, AND WITH THAT I WANT
TO TURN IT OVER TO CO-CHAIR NITA
TO HEAR ABOUT HER UPDATES WHICH
WILL BE QUITE EXTENSIVE, I'M
SURE.
>> THANKS, JIM.
I'LL KEEP MINE BRIEF.
I'M HAVING THE PLEASURE OF
INTRODUCING OUR SESSION ON
DIGITAL TWINS, BACKDROP ON IT.
FOR MY PART, I'LL TALK ABOUT A
FEW OF THE MAJOR INITIATIVES
THAT ARE UNDERWAY, SOME PEOPLE
HERE ARE INVOLVED IN THEM WHICH
IS TERRIFIC.
ONE OF THEM IS THAT THE UNIFORM
LAWS COMMISSION HAS LAUNCHED A
STUDY COMMITTEE ON MENTAL
PRIVACY, COGNITIVE BIOMETRICS,
NEURAL DATA TO TAKE UP THE
CHARGE TO LOOK AT POTENTIAL FOR
UNIFORM MODEL LAW IN THE UNITED
STATES, LAW COMMISSION IS THE
OLDEST LEGAL ORGANIZATION IN THE
UNITED STATES THAT HAS -- THAT
SERVES TO TRY TO DEVELOP
UNIFORMITY, BEST KNOWN FOR
UNIFORM COMMERCIAL CODE, AND WE
HAVE A WIDE VARIETY OF PEOPLE
WHO PARTICIPATED AS OBSERVES,
I'M HONORED TO BE CHAIRING THAT
AS COMMISSIONER FROM NORTH
CAROLINA.
THE SECONDS MAJOR UPDATE
AMERICAN LAW INSTITUTE AND
EUROPEAN LAW INSTITUTE HAVE
LAUNCHED PROJECT ON THE
PRINCIPLES OF BIOMETRICS TO TRY
TO FIND HARMONIZATION ACROSS
JURISDICTIONS AND THAT OF COURSE
INCLUDES A LOT THAT HAS TO DO
WITH BRAIN AS WELL FROM MORE
BROADLY THINKING ABOUT
INFERENCES THAT ARE BEING MADE
ABOUT BRAIN, POTENTIAL USE OF
BRAIN AND BIOMETRIC CONTEXT AS
WELL.
AND TO TRY TO HARMONIZE THE
PRINCIPLES THAT WOULD BE
VALUABLE FOR GOVERNANCE ACROSS
HOSE, -- THOSE, AND I'M SERVING
AS REPORTER WITH MY COUNTERPART
ON THE EUROPEAN SIDE, WITH
OPPORTUNITIES FOR ENGAGEMENT,
THE FIRST MEETING OF ADVISORS
THIS COMING FALL AND IT WILL BE
A MULTI-YEAR PROCESS.
THE THIRD IS THE WORLD ECONOMIC
FORUM HAS LAUNCHED A GLOBAL
FUTURES COUNCIL ON
NEUROTECHNOLOGY, WHICH I'M
CO-CHAIRING WITH TOM OXLEY FROM
SYNCHRON, THAT HAS A BROAD
INTERNATIONAL STAKEHOLDERS
AUDIENCE.
THE FUTURE OF THE GLOBAL COUNCIL
TO SEE WHETHER IT MIGHT BE
POSSIBLE TO DEVELOP INSTRUMENTS
FOR MEASURING TRUST IN
NEUROTECHNOLOGY COMPANIES, AND
IT'S A VERY DIFFERENT APPROACH
THAN OTHER INTERNATIONAL
ORGANIZATIONS HAVE TAKEN, AND
IT'S AN EXCITING OPPORTUNITY TO
ENGAGE WITH THAT.
THE LAST IS UNESCO HAS ITS DRAFT
RECOMMENDATIONS ON
NEUROTECHNOLOGY.
I WAS PLEASED TO BE REPRESENTING
THE UNITED STATES AS AN EXPERT.
THAT DRAFT IS NOW GOING TO BE
DEBATED NEXT WEEK IN PARIS BY
THE POLITICAL ENTITIES FROM THE
194 MEMBER COUNTRIES, SOME IN
PERSON, SOME REMOTE
WHAT SHOULD EMERGE WILL BE
CONSENSUS DRAFT IDEALLY, WHICH
WILL THEN GO THROUGH EDITS AND
BE PRESENTED THIS SUMMER TO THE
UNESCO COMMITTEES TO GET TO THE
BOARD IN OCTOBER AND BE VOTED ON
IN NOVEMBER OF 2025 BY THE
MEMBER COUNTRIES, IF THEY CHOOSE
TO RATIFY AT THAT TIME IT WILL
BECOME A GLOBAL STANDARD WITH
IMPLEMENTATION AND ENFORCEMENT
AND REPORTING REQUIREMENTS TO IT
SO IT'S EXCITING TO SEE THAT
PROGRESSING AND THE KIND OF WORK
THAT IT HAS HAD THE OPPORTUNITY
TO CULTIVATE AS WELL.
I'LL BE THERE NEXT WEEK IN A
DIFFERENT CAPACITY AS OBSERVER
FROM THE PRIOR BUREAU FROM THE
EXPERTS.
I'M NOT A POLITICIAN SO I'M NOT
NEGOTIATING ON BEHALF OF THE
U.S.
STILL UNCLEAR IF THERE WILL BE A
U.S. REPRESENTATIVE NEXT WEEK,
STAY TUNED FOR EXCITING UPDATES.
ALL RIGHT.
WITH THOSE UPDATES FROM ME I'M
GOING TO TRANSITION US TO OUR
CONVERSATION TODAY WHICH IS TO
REALLY FOCUS ON DIGITAL TWINS.
AND WHAT I WANT TO DO IS FRAME A
LITTLE BIT WHY WE CHOSE TO TAKE
ON THE ISSUE OF DIGITAL TWINS
TODAY AND HOW IT CONNECTS WITH
THE LAST MEETING WE HAD, WHERE
WE EXPLORED THE EMERGING FIELD
OF BRAIN FOUNDATION MODELS,
COMPUTATIONAL FRAMEWORKS THAT
LEARN AND REPRESENTATIONS OF
NEURAL ACTIVITY AND BRAIN
STRUCTURE THAT CAN BE USED TO
GENERATE PREDICTIONS ABOUT BRAIN
STATES AND FUNCTION.
TODAY WE'RE TURNING OUR
ATTENTION TO DIGITAL TWINS IN
NEUROSCIENCE AND
NEUROTECHNOLOGY, AND THERE'S A
LINE BETWEEN THESE, WE THOUGHT
IT WOULD BE THE NATURAL NEXT
STEP FOR THE CONVERSATION.
NICE TO HERE KAREN'S REMARKS
ABOUT A.I. CONVERGENCE.
MUCH LIKE LARGE LANGUAGE MODEL,
THAT LEARN STATISTICAL PATTERNS,
BRAIN FOUNDATION MODELS ARE
TRAINED ON VAST DATASETS OF
NEURAL RECORDINGS, BRAIN IMAGING
AND STRUCTURAL DATA TO CAPTURE
PATTERNS AND DYNAMICS OF BRAIN
FUNCTION.
AND SOME OF THE MODELS THAT WE
TALKED ABOUT PREVIOUSLY WERE
THINGS LIKE BRAIN BERT, THE
MODEL TRAINED ON MULTI-MODAL
NEUROIMAGING DATA FROM THOUSANDS
OF PARTICIPANTS, WHICH
DEMONSTRATED ABILITY TO PREDICT
NEURAL RESPONSES TO NOVEL
STIMULI WITH UNPRECEDENTED
ACCURACY.
THESE FOUNDATION MODELS ARE
REALLY AIMING TO ESTABLISH A
COMPUTATIONAL BASE THIS IS CAN
GENERALIZE ACROSS CONDITIONS,
COGNITIVE TASKS, SOME HAVE SHOWN
BY TRAINING A SINGLE MODEL ON
MULTIPLE DATASETS SPANNING THE
LIKES OF EEG, fMRI, INVASIVE
RECORDINGS, IT'S POSSIBLE TO
HAVE TRANSFER LEARNING
CAPABILITIES THAT REVOLUTIONIZE
OUR UNDERSTANDING OF CROSS-MODAL
NEURAL DYNAMICS.
DIGITAL TWAINS TAKE THIS A
CRUCIAL STEP FORWARD.
SO WHILE BRAIN FOUNDATION MODELS
GIVE GENERALIZED FRAMEWORKS
ABOUT BRAIN FUNCTION, DIGITAL
TWINS AIM TO CREATE PERSONALIZED
COMPUTATIONAL MODELS THAT
SIMULATE STRUCTURE, FUNCTION,
POTENTIALLY EMERGENT PROPERTIES
OF AN INDIVIDUAL'S BRAIN.
TAKE FOR EXAMPLE THE BLUE BRAIN
PROJECT, A DEMONSTRATION OF A
PARTIAL DIGITAL TWIN FOR
EPILEPSY PATIENTS THAT
DEMONSTRATES THIS SHIFT, CREATED
A PERSONALIZED SIMULATION THAT
INCORPORATE A INDIVIDUAL'S
UNIQUE NEURAL CONNECTIVITY
PATTERNS ALLOWING FOR
UNPRECEDENTED PREDICTION OF
FUTURE ONSET AND PROPAGATION
PATHS FORWARD SPECIFIC TO EACH
PATIENT.
SO, THE PROGRESSION HERE IS
LOGICAL, BUT ALSO PROFOUND,
WHICH MOVES FROM GENERAL MODELS
OF THE BRAIN TO INDIVIDUALIZED
SIMULATIONS THAT MIGHT ONE DAY
REPLICATE ASPECTS OF A PERSON'S
SPECIFIC NEURAL ARCHITECTURE,
CONNECTIVITY, THEIR PATTERNS,
EVEN COGNITIVE PROCESSES.
WHICH MEANS WHERE WE MIGHT BE IN
FIVE YEARS FROM NOW FROM PARTIAL
STIMULATIONS -- SIMULATIONS OF
SPECIFIC NEURAL SUBSTRATES, TO
POTENTIALLY WHOLE BRAIN MODELS
THAT CAN CAPTURE AN INDIVIDUAL'S
UNIQUE COGNITIVE SIGNATURE,
WHICH RAISINGS FUNDAMENTAL
ETHICAL QUESTIONS WE THOUGHT
WOULD BE GOOD FOR US TO ADDRESS
AND GRAPPLE WITH.
LIKE WHAT DOES IT MEAN TO CREATE
A COMPUTATIONAL TWIN OF AN
INDIVIDUAL'S BRAIN?
AT WHAT POINT MIGHT TWINS PLAN
FEST MANIFEST WITH PROPERTIES
LIKE PERSONHOOD OR IDENTITY?
HOW MIGHT THESE TECHNOLOGIES
RESHAPE OUR UNDERSTANDING OF THE
RELATIONSHIP BETWEEN BRAIN,
MIND, SELF?
AS WE DISCUSS DIGITAL TWINS I
WANT TO PROPOSE WE CONSIDER
SEVERAL ETHICAL DIMENSIONS WITH
DEPTH AS WE HEAR FROM SPEAKERS.
WE MIGHT START BY THINKING ABOUT
PRIVACY AND DATA GOVERNANCE.
SO DIGITAL TWINS REQUIRE
UNPRECEDENTED ACCESS TO NEURAL
DATA, NOT JUST SNAPSHOTS, BUT
POTENTIALLY CONTINUOUS STREAMS
OF NEURAL DATA THAT CAN REVEAL A
LOT ABOUT THE COGNITIVE AND
EFFECTIVE PROCESSES IN THE
BRAIN.
THIS RECOMMENDS A QUANTUM LEAP
BEYOND CURRENT PRIVACY CONCERNS.
IN PREVIOUS MEETINGS WE HAVE
REALLY FOCUSED ON NEURAL DATA,
THE IMPLICATIONS OF A DIGITAL
TWIN COULD BE EVEN MORE
PROFOUND.
SO TAKE FOR EXAMPLE A DIGITAL
TWIN OF A PATIENT WITH
ALZHEIMER'S, THAT MIGHT REQUIRE
CAPTURING LONGITUDINAL NEURAL
DATA THAT INADVERTENTLY CAPTURES
NOT JUST COGNITIVE DECLINE
MARKERS BUT PERSONAL MEMORIES,
EMOTIONAL RESPONSES TO FAMILY
MEMBERS, UNCONSCIOUS BIASES A
PERSON MIGHT PREFER TO KEEP
PRIVATE.
WHICH RAISES THE QUESTIONS ABOUT
DATA SOVEREIGNTY AND CONTROL,
INFORMED CONSENT FOR FUTURE
USES, VULNERABILITY AND
SURVEILLANCE, AND THE RIGHT
TO -- DIFFERENT HUMAN RIGHTS
WE'VE BEEN REALLY TALKING ABOUT
WHEN IT COMES TO THINGS LIKE
NEUROTECHNOLOGY.
THE SECOND IS AROUND IDENTITY
AND PERSONHOOD.
DIGITAL TWINS CHALLENGE IN MANY
WAYS NOTIONS OF SELF AND
IDENTITY, IN MANY WAYS THEY HAE
ENCOUNTERED DIGITAL TWINS, IN
THIS WAY AN A.I. REPRESENTATION
AND RECREATION RATHER THAN A
DIGITAL TWIN IN NEUROSCIENCE
SETTING WHICH RAISES PROFOUND
QUESTIONS LIKE DIGITAL TWINS
BECOME MORE ACCURATE, AT WHAT
POINT MIGHT THEY DESERVE LEGAL
AND MORE CONSIDERATION OR
POSTMORTEM EXISTENCE, HOW WE
DEFINE THE ENDS OF PERSONHOOD,
SHOULD FAMILIES HAVE THE RIGHT
TO RUN DIGITAL TWIN TO DISEASED
LOVED ONE, IMPLICATION FOR
GRIEVING OR LEGAL PROCEEDINGS?
WHAT ARE BOUNDARIES OF IDENTITY
IN THE PRESENT DAY?
WHEN PREDICTS TREATMENT
RESPONSES OR COGNITIVE
DEVELOPMENT HOW WE DISTINGUISH
BETWEEN PREDICTION AND
DETERMINISM?
THIRD MAJOR CATEGORY IS AROUND
AUTONOMY AND AGENCY, AS DIGITAL
TWINS BECOME SOPHISTICATED MAY
INFLUENCE DECISIONS ABOUT
PHYSICAL AND MENTAL HEALTH,
EDUCATION, EVEN LIFE CHOICES.
CONSIDER PREDICT-RX, A SYSTEM IN
TRIALS WHICH USES DIGITAL TWINS
TO SIMULATE RESPONSES TO
TREATMENT FOR TREATMENT, WHEN IT
RUNS ON A TWIN AND RECOMMENDS AN
INTERVENTION PATHWAY WHAT
HAPPENS TO THE PHYSICIAN'S
CLINICAL JUDGMENT OR PATIENT'S
SUBJECTIVE PREFERENCES, WHICH
RAISES CONCERNS ABOUT DECISION
MAKING AUTHORITY, WHO HAS THE
FINAL AUTHORITY WHEN A DIGITAL
TWIN'S PREDICTION CONTRADICTS AN
INDIVIDUAL'S STATED PREFERENCE,
RAISING QUESTIONS ABOUT
PREDICTSIVE GOVERNANCE WHERE
JURISDICTION, MIGHT INFORM
DECISIONS FROM EARLY
INTERVENTION TO MENTAL HEALTH,
MIGHT ONE DAY BE USED FOR THINGS
LIKE PAROLE DETERMINATION.
AND RAISES QUESTIONS ABOUT
COGNITIVE ENHANCEMENT AND
INEQUITY, INTRODUCING STARK
QUESTIONS WHO GETS BENEFITS TO
THESE TECHNOLOGIES AND WHETHER
THEY WILL EXACERBATE EXISTING
SOCIAL DIVIDES WHICH BRINGS ME
TO THE FOURTH CATEGORY, SOCIAL
JUSTICE AND ACCESS, CREATING
TECHNOLOGICAL DIVIDE RAISING
QUESTIONS ABOUT EQUITY, WHO HAS
ACCESS TO CUSTOMIZED TREATMENT
AND TREATMENT MODELS.
FINALLY, SECURITY AND DUAL USE
CONCERNS.
THE CAPABILITIES OF DIGITAL
TWINS RAISE QUESTIONS ABOUT
SECURITY AND EXTEND BEYOND
TRADITIONAL INFORMATION SECURITY
NETWORKS.
THIS INCLUDES QUESTIONS ABOUT
UNAUTHORIZED INFERENCE AND
INTERNATIONAL GOVERNANCE GAPS WE
NEED TO ADDRESS.
FORGIVE MY DOG IN THE
BACKGROUND.
IF YOU CAN HEAR HIM.
ALL RIGHT.
SO, I SUGGEST WE APPROACH
TODAY'S DISCUSSION WITH BOTH
SCIENTIFIC RIGOR AND ETHICAL
IMAGINATION.
DIGITAL TWINS REPRESENTATIVE
CONVERGENCE OF NEUROSCIENCE,
ARTIFICIAL INTELLIGENCES,
COMPUTATIONAL MODELING THAT MAY
TRANSFORM OUR RELATIONSHIP WITH
TECHNOLOGY AND OURSELVES.
OUR ROLE IN THE NEUROETHICS
WORKING GROUP IS NOT TO IMPEDE
SCIENTIFIC PROGRESS BUT ENSURE
THAT IT UNFOLDS IN WAYS THAT CAN
BE ETHICALLY ALIGNED AND SO I
LOOK FORWARD TO THE DISCUSSIONS
AND OUR INVITED SPEAKERS TO
SHARE -- WHO ARE GOING TO SHARE
INSIGHTS ON CURRENT STATES AND
FUTURE DIRECTIONS OF DIGITAL
TWINS IN NEUROSCIENCE.
WE'LL BEGIN WITH A PRESENTATION
BY DR. VIKTOR JIRSA, DIRECTOR F
NEUROSCIENCE, I HAVE TO PRACTICE
MY FRENCH HERE, THE UNIVERSITY,
WHO WILL BEGIN WITH A
CONVERSATION AROUND DIGITAL TWIN
TECHNOLOGIES FOR BRAIN MEDICINE.
>> THANK YOU.
THANK YOU FOR THE INTRODUCTION
AND THE FRENCH IS SUPERB.
I'D LIKE TO SHARE MY SCREEN WITH
YOU.
AND DO THIS RIGHT NOW.
I'M ASSUMING YOU CAN SEE MY
SCREEN?
SORRY, CAN YOU PLEASE CONFIRM?
>> YES, WE CAN SEE YOUR SCREEN.
>> EXCELLENT.
THANK YOU VERY MUCH.
SO, I'D LIKE TO GIVE YOU AN
OVERVIEW OF SOME OF THE WORK
THAT WE'RE DOING IN EUROPE,
SPECIFICALLY THE HUMAN BRAIN
PROJECT, AND IN THE DIGITAL
NEUROSCIENCE INFRASTRUCTURE,
INFRASTRUCTURE SUPPORTING ALL
DIGITAL ACTIVITIES IN
NEUROSCIENCE, SPECIFICALLY
INTEGRATING TOOLS, MODELS, AND
MANY OF THE CHALLENGES THAT NITA
JUST MENTIONED WE HAVE RUN INTO
BEFORE.
SO, DIGITAL TWINS IS A PRIORITY.
HERE I'M JUST HIGHLIGHTING ONE
OF THE INITIATIVES IN EUROPE,
EUROPEAN VIRTUAL HUMAN TWINS
THAT IS AN INITIATIVE BY THE
EUROPEAN COMMISSION ENHANCING
THE USE, DEVELOPMENT OF
INTEGRATED AND WELL VALIDATED
DIGITAL REPRESENTATION OF ORGANS
AND PARTS OF THE HUMAN BODY, IN
PARTICULAR THE DIGITAL BRAIN
TWIN.
ONE OF THE REASONS IT'S SO --
RECEIVING SO MUCH ATTENTION AT
THE MOMENT, SOME OBVIOUS PARTS
SUCH AS ESCALATING HEALTH CARE
COSTS AND NEED FOR EFFICIENCY,
SOME WE ALREADY MENTIONED.
BUT THERE IS ESPECIALLY IN
NEUROSCIENCE IMPERATIVE FOR
PERSONALIZED MEDICINE DUE TO THE
FACT THAT WE HAVE SO MUCH
VARIABILITY IN THE BRAIN FROM
ONE BRAIN TO THE OTHER, ON THE
STRUCTURAL LEVEL THAT DOES NOT
NECESSARILY ALWAYS CORRELATE
WITH THE FUNCTIONAL VARIABILITY.
AND THE FUNCTIONAL PERFORMANCE
OF INDIVIDUAL BRAINS.
AND ONE WAY TO APPROACH THIS IS
ACTUALLY THE BUILDING OF DIGITAL
TWINS, PERSONALIZED SUBJECT OR
PATIENT-SPECIFIC MODELS.
AND TO PROVIDE WITH YOU A
DEFINITION ON A HIGHER LEVEL OF
DIGITAL TWIN, SO THE TWIN IS A
REPRESENTATION OF THE PHYSICAL
OBJECT, OF COURSE ITS LIFE
CYCLE, FROM THE BEGINNING
CONCEPTION ALL THE WAY UNTIL ITS
EXIT OUT OF USAGE.
ONE ASPECT THAT DISTINGUISHES IT
FROM A SIMPLE MODEL IS THAT IT
USES REALTIME DATA OR REAL WORLD
DATA TO ENABLE THE USE OF THE
MODEL IN THE CONTEXT OF
ENVIRONMENT.
SPECIFICALLY, FOR BRAIN TWINS,
IN THE USING BRAIN TWIN, WHICH
WE DO, THIS IS REPRESENTED HERE
ON THE SKETCH ON THE LEFT-HAND
SIDE, IS WE'RE INTEGRATING DATA
FOR INDIVIDUALS, COMING FROM
MULTIPLE LEVELS, COMING FROM
MULTIPLE MODALITIES, INTEGRATING
ACROSS MULTIPLE TIME SCALES,
COULD BE A LIFESTYLE DATA, FOR
INSTANCE, IN THE SAME SHARED
ECOSYSTEM.
AND THAT ALLOWS US TO LINKAGE TO
MATHEMATICS, IN THIS DIGITAL
SHARED ECOSYSTEM AND PLEASE
INVITING YOU TO THINK OF
MATHEMATICS, OUR MODEL IS A
REPRESENTATION OF THE KNOWLEDGE
THAT WE HAVE GOTTEN IN
NEUROSCIENCE, CAN BE
MATHEMATICAL, COMPUTATIONAL, CAN
BE SYMBOLIC, ALGORITHMIC,
SOCIETIES A REPRESENTATION OF
THE KNOWLEDGE THAT WE HAVE THAT
IS BEING LINKED TO THE DATA,
IMPORTANTLY RENDERED
INTEROPERABLE IN THE SAME
ECOSYSTEM, IN THE SAME REFERENCE
SYSTEM WHICH ALLOWS US THEN TO
RUN SIMULATIONS AND TO MAKE
PREDICTIONS, TEST HYPOTHESES,
MANY, MANY TIMES WAY BEYOND THE
WAY WE CAN TYPICALLY DO IT IN
THE PATIENT'S SITUATIONS WHEN
THEY OFTEN A SINGLE REALIZATION
OR SINGLE INTERVENTION CAN ONLY
BE PERFORMED ONCE.
SO, IN THE TYPE OF MODELS THAT
WE USE IN THE CONTEXT OF DIGITAL
TWIN ARE EITHER DATA DRIVEN
MODELS, FOUNDATION MODELS, OFTEN
KNOWN ALSO AS THEMEOLOGICAL
MODELS THAT ARE BASED ON
GENERATIVE SYSTEM, AND ARE
DRIVEN COMPLETELY BY THE DATA,
SO LOTS OF DATA.
ON THE OTHER HAND, WE HAVE
KNOWLEDGE-DRIVEN MODELS, ALSO
KNOWN AS MECHANISTIC MODELS THAT
ARE BASED ON SOME MATHEMATICAL
OR COMPUTATIONAL REPRESENTATION
OF OUR KNOWLEDGE, THAT CAN BE
OPERATED.
TYPICALLY WHAT WE USE IN DIGITAL
TWINS ARE HYBRID APPROACHES, IN
WHICH THE DATA DRIVE THE MODEL
AND ARE BEING INTEGRATED IN THE
MODEL IN ORDER TO OBTAIN
DATA-DRIVEN MODEL-SPECIFIC
REALIZATION THAT ALLOWS US THEN
TO -- AS DATA ARE COMING FROM
INDIVIDUALS, IT ALLOWS US TO RUN
INDIVIDUALIZED SIMULATIONS.
I WILL GIVE A CLEAR EXAMPLE WITH
REGARD TO THIS.
HERE IN THIS CARTOON I PUT A
WORKFLOW FOR YOU TO GET IT.
IMAGINE YOU HAVE A PATIENT, A
SUBJECT, INDIVIDUAL WORKFLOW,
THE DATA ARE BEING RECORDED THAT
ARE STRUCTURAL DATA AND
FUNCTIONAL DATA, SO FUNCTIONAL
DATA ARE ALL-TIME RESULT DATA
SUCH AS EEG AND fMRI.
THEY ARE BEING SENT AND
INTEGRATED IN THE SAME ECOSYSTEM
WHICH MEANS THEY NEED TO BE
ANCHORED IN A PARTICULAR ATLAS
THAT ALLOWS US TO REPRESENT AND
HAVE THE DATA COMMUNICATE WITH
EACH OTHER.
THIS TYPE OF COMMUNICATION IS A
FORM OF TRANSLATION,
ACCOMPLISHED THROUGH THE TYPE OF
MECHANISTIC MODELS THAT NEED TO
BE IMPLEMENTED IN THE SAME
SPACE.
AND ANOTHER MEANS OF INTEGRATION
IN THE RENDERING FURTHER PATIENT
SPECIFIC IS USE OF A.I.
TECHNOLOGY, IN PARTICULAR
INFERENCE THAT IN PARTICULAR
CAUSAL INFERENCE THAT ALLOWS US
TO USE THE DIGITAL TWIN, AS A
CAUSAL HYPOTHESIS AND THEN USING
CERTAIN TECHNIQUES SUCH AS
INFERENCE, BAYESIAN INFERENCE IN
PARTICULAR, WE WITH ESTIMATE THE
PARAMETERS FOR THIS PARTICULAR
PATIENT.
SO THE DIGITAL TWIN IS NOT ONLY
CONTAINED BY BRAIN IMAGING DATA,
STRUCTURAL, IN ORDER TO CREATE A
SCAFFOLD SPANNING THE DIGITAL
TWIN BUT ALSO WITH A FUNCTIONAL
DATA, CONFRONTED WITH
MATHEMATICS, AND THEN ALLOWING
US TO ESTIMATE PARAMETERS
SPECIFIC FOR THE PATIENT.
THAT'S VERY IMPORTANT BECAUSE
PARAMETERS ARE THE INTERFACE OF
THE CAUSAL HYPOTHESIS ON ONE
HAND SIDE, THE MODEL, AND THE
DATA ON THE OTHER HAND.
THINK OF THE PARAMETERS THAT
COULD BE ILLUSION, FOR INSTANCE,
OR I WILL GIVE AN EXAMPLE OF
EPILEPSY, WHETHER IS THE ZONE
LOCATED?
HOW MUCH A-BETA HAS BEEN
DEPOSITED IN CERTAIN BRAIN
ATLAS, THE TYPE OF PARAMETERS
I'M TALKING ABOUT.
THAT ALLOWS US TO USE THE
DIGITAL TWIN, EITHER AS
AUTONOMOUS SIMULATION ENGINE, OR
AS A TARGET FOR ESTIMATION OF
THIS TYPE OF PARAMETERS, FOR
INSTANCE IN DIAGNOSTIC
APPROACHES.
I'LL GIVE AN EXAMPLE IN A
SECOND.
THE INFORMATION IS BEING SENT
BACK TO THE CLINICIAN THAT THEN
INTEGRATES IT INTO HIS OR HER
WORKFLOW, CLINICAL DECISION
MAKING, ADDITIONAL MEANS, SO
ADDITIONAL MODALITY INFORMING
THE DECISION MAKING.
IF I MAY, AT THE END OF THE DAY
THE FINAL DECISION ALWAYS STAYS
WITH THE CLINICIAN USING THIS
PARTICULAR TOOL AND THAT LINKS
BACK TO THE PATIENT.
SO, THIS IS THE GENERAL
FRAMEWORK THAT IS BEING USED IN
THE CONTEXT OF DIGITAL TWIN USE,
IN PARTICULAR WHEN WE'RE USING
THE NON-INVASIVE BRAIN IMAGING
DATA CUSTOMARY IN CLINICAL
ROUTINE, THEN THIS TYPE OF
DIGITAL TWIN IS REFERRED TO AS
VIRTUAL BRAIN TWIN.
THERE ONE OF THE DRIVING
PARADIGMS THAT WE USED IN EUROPE
WAS EPILEPSY.
1% ARE EPILEPTIC, 2/3 CAN BE
TREATED CORRECTLY USING
MEDICATION BUT WHICH MEANS A
THIRD OF THEM, OF THE PATIENTS,
PHARMACEUTICALLY RESISTANT.
AND FOR THOSE OPTIONS ARE -- ONE
AT THE MOMENT IS STIMULATION,
ONE MORE ESTABLISHED OPTION IS
EPILEPSY SURGERY.
YOU NEED TO IDENTIFY A TARGET
FOR EPILEPSY SURGERY, AND FOR
THIS EXPLORATIONS ARE PERFORMED,
INITIALLY NON-INVASIVE SUCH AS
EEG, PET, INTERPRETATION OF THE
EVOLUTION OF THE CLINICAL
BEHAVIORAL DYNAMICS DURING THE
SEIZURE AND ALSO PRIOR TO THE
SEIZURE BUT VERY IMPORTANTLY AS
PRE-SURGICAL EXPLORATION SEEG IS
USED, STEREOTACTIC, ELECTRODES
IMPLANTED BASED ON A PARTICULAR
HYPOTHESIS, AND THEN THE DATA
ARE BEING RECORDED, HOLOGRAPHIC
INVASIVE DATA RECORDED, ON THE
BASIS THERE OF THE CLINICIAN HAS
TO MAKE A DECISION ABOUT WHERE
AND HOW EPILEPTOGENIC ZONE IS,
THAT TRANSLATES INTO A DECISION
OF WHAT TYPE OF SURGERY TO
PERFORM IN ORDER TO REMOVE THE
EPILEPTOGENIC ZONE.
NOTABLE IT IS THAT THE SURGERY
SUCCESS RATE IS IN TEMPORAL LOBE
EPILEPSY 70%, CAN DROP DOWN TO
25, 30%, IN FRONT LOBE EPILEPSY.
AND THAT SURGERY SUCCESS RATE
HAS NOT REALLY SIGNIFICANTLY
IMPROVED OVER THE LAST 50 YEARS,
AND THAT TELLS YOU ALREADY
SOMETHING THAT THERE'S A PART
THAT WE'RE MISSING.
AND THE HOPE IS THAT DIGITAL
TWINS, SPECIFICALLY THE VIRTUAL
BRAIN TWINS, USING THE TYPE OF
HYBRID MODELS I EXPLAINED TO
YOU, CAN BE USED IN THIS
PARTICULAR CONTEXT.
SO THIS IS A WORKFLOW THAT IS
BEING USED IN EPILEPSY, YOU
RECORD THE DATA, STRUCTURAL
DATA, AND FUNCTIONAL DATA, INTY
PARTICULAR CASE SEEG RECORDINGS,
RECONSTRUCT IN THREE DIMENSIONS
AND USE PATIENT-SPECIFIC
IMPLANTATION SCHEMES AS
REPRESENTED HERE.
AND THEN WITH THE SEEG DATA YOU
CAN ESTIMATE THE PARAMETERS AND
IN THIS PARTICULAR CASE THE
PARAMETERS ARE THE EPILEPTOGENIC
ZONE REGIONS BECAUSE YOU CAN USE
THE PATIENT'S OWN TWIN AS A
TARGET FOR INFERENCE TO OPTIMIZE
YOUR EXPLOREATIVE IDENTIFIABLE,
IDENTIFIABLE OF THE
EPILEPTOGENIC ZONE, AND THIS
INFORMATION IS SENT BACK TO THE
PATIENT.
ESSENTIALLY IN THIS TYPE OF
APPROACH THE VIRTUAL BRAIN TWIN
OF THE PATIENT CAN BE USED IN
TWO WAYS.
DIRECT OR SO-CALLED FORWARD
PROBLEM, WHICH MEANS YOU CAN USE
IT AS A PLATFORM TO RUN
SIMULATIONS, AND TO TEST
HYPOTHESIS WHERE IS THE
EPILEPTOGENIC ZONE, WHAT DOES
MEASURED DATA LOOK LIKE IF THE
EPILEPTOGENIC ZONE IS A
PARTICULAR LOCATION.
HERE I'M SHOWING SIMULATION OF A
PATIENT THAT YOU SEE THE BLUE
DOTS REPRESENT THE DIFFERENT
NEURAL SOURCES, THE BRAIN
REGIONS.
IT'S A PATIENT-SPECIFIC
IMPLANTATION SCHEME.
ONCE LINKED TO THE MATHEMATICS
YOU CAN ACTUALLY RUN IT AS LIKE
A FLIGHT SIMULATOR, YOU'RE
RUNNING AND FLYING AN AIRPLANE,
FLIGHT SIMULATOR, HERE YOU CAN
ONE AS BRAIN SIMULATOR AND TEST
YOUR HYPOTHESIS AND ACTUALLY RUN
EPILEPTIC SEIZURES PROPAGATING
THROUGH THE BRAIN AND YOU SEE
THE ENERGY DURING A SEIZURE IS
HIGHLIGHTED IN RED, AND INVOLVES
EMERGING AS THE SEIZURE
PROPAGATES THROUGH THE BRAIN.
WHAT YOU SEE HERE IS THE TIME
SERIES THAT CORRESPONDS TO WHAT
THE TREATING CLINICIAN WOULD
MEASURE IN THE SEEG DATA.
YOU CAN CONSIDER AND TEST WHAT
THE CONSEQUENCES ARE, DIFFERENT
TIMES OF SURGICAL PROJECTORIES,
THIS IS THE DIRECT PROBLEM.
INVERSE PROBLEM IS WHEN YOU USE
THE DIGITAL TWIN OF THE PATIENT
AS A TARGET FOR PARAMETER
ESTIMATION, AND THIS IS
ESSENTIALLY WHAT IS BEING FED
BACK TO THE CLINICIAN.
WHAT YOU SEE HERE IS THE
PATIENT, WHERE THE EPILEPTOGENIC
ZONE HAS BEEN ESTIMATED AND THE
RETURN TO THE CLINICIAN IS BEING
AS A HEAT MAP, TYPICALLY IN
THREE DIMENSIONAL MRI, OVERLAID
WITH POST-SURGICAL YOU SEE
REPRESENTED HERE IN RED, HEAT
MAP, LIKELIHOOD FOR PARTICULAR
EPILEPTOGENIC ZONE AND
CORRESPONDS TO THE SURGERY
PERFORMED.
YOU SEE THIS IS A WAY HOW WE
COMMUNICATE WITH CLINICIANS,
GIVEN A REPORT ON THE RIGHT-HAND
SIDE, THE EPILEPTOGENICITY
PROBABILITY DISTRIBUTION WHICH
ESTIMATES LIKELIHOOD, THERE MAY
BE MODALITIES BECAUSE SOMETIMES
THE ZONE IS NOT IDENTIFIABLE, AS
YOU SEE HERE IN THIS PARTICULAR
AREA.
SO, THIS IS WHAT CAN BE DONE AND
HAS BEEN DONE IN DIFFERENT
COHORTS, DIFFERENT LABORATORIES.
AND CURRENTLY RUN IN A CLINICAL
TRIAL TESTING IT ACROSS 13
REFERENCE CENTERS.
WHAT IS THE ADDED VALUE OF THE
DIGITAL TWIN?
THAT'S WHAT I WANT TO SHOW ON
THIS PARTICULAR PICTURE, LET'S
ME GO BACK.
YOU SEE HERE THE HEAT MAP HAS
BEEN ESTIMATED, OVERLAID WITH
POST-SURGICAL MRI.
YOU CAN ACTUALLY DO THIS AND
TEST IN RETROSPECTIVE DATA.
AND PERFORMING SURGERY THAT'S
BEEN PERFORMED, CLINICAL
HYPOTHESIS, AGAINST WHAT IS
COMING OUT OF THE PREDICTION OF
THE VIRTUAL BRAIN TWIN.
AND THIS YOU SEE ON THE
RIGHT-HAND SIDE, YOU RECOGNIZE
THE NEEDLES, YELLOW BALLS
REPRESENTING THE SEEG NEEDLES.
WHAT A CLINICIAN WOULD TYPICALLY
DO HE/SHE WOULD INTERPRET THE
DATA MEASURED BY SEEG, AND THEN
BASED ON THIS A DECISION COULD
BE MADE OF THE BRAIN AREAS WHICH
BECOME SURGICAL TARGETS INVOLVED
HERE INTO THE EPILEPSY
REPRESENTED IN BLUE HERE.
SO THAT'S THE SITUATION.
WHAT WE'RE DOING WITH THE
VIRTUAL BRAIN TWINS, WE'RE
MODELING THE ENTIRE BRAIN, NOT
JUST THE BRAIN PARTS THAT ARE
LOCATED THERE, WHERE THE SEEG
HAS BEEN MEASURED BUT IN THE
POSTERIOR REGIONS OF THE BRAIN,
SUBCORTEX ET CETERA WHERE NO
MEASUREMENTS HAVE BEEN
PERFORMED, STANDARD CHALLENGE
THAT IS ENCOUNTERED, IF WE
COMPARE WHAT YOU SEE REPRESENTED
HERE ON THE LEFT-HAND SIDE, FROM
ZERO TO 1.0, 100%
CORRESPONDENCE, YOU SEE FOR THIS
COHORT THAT WE USED HERE, 25
POST-SURGICAL PATIENTS, SO THE
PREDICTION OVERLAID WITH
POST-SURGICAL MRI, WHAT YOU SEE
FOR THE SEIZURE-FREE PATIENTS
THERE'S ALMOST A PERFECT
CORRESPONDENCE BETWEEN WHAT CAME
OUT OF THE VIRTUAL BRAIN TWIN
BUT FOR THE NOT SEIZURE FREE,
HALF OF THEM, IT DROPS DOWN
SIGNIFICANTLY AND THIS HOLDS
ACROSS MANY STATISTICAL
EVALUATIONS.
THE POINT I WANT TO MAKE IS THE
FOLLOWING.
YOU SEE THESE ARE THE ONES THAT
HAVE FAILED.
SO PATIENTS ARE NOT SEIZURE
FREE.
WHEN YOU EVALUATE BRAIN REGIONS
INVOLVED IN THIS, 29% OF ALL
THESE CASES FALL INTO THE FACT
INTO THE AREAS, INTO THE CASES,
WHERE THE PREDICTED
EPILEPTOGENIC ZONES WERE NOT
ACCESSIBLE BY THE DATA, BUT WERE
IDENTIFIED BY THE VIRTUAL BRAIN
TWINS THAT HAVE ACTUALLY ALSO
TAKEN CONNECTIVITY AND ALL THE
OTHER INFORMATION AVAILABLE IN
THE ACCOUNT BECAUSE IT WAS
INTEGRATED IN THE TWIN BUT NOT
MEASURED BY THE DATA.
I WANT TO EMPHASIZE THIS POINT
HERE THAT WHAT THE VIRTUAL BRAIN
TWIN DOES IT GOES OUTSIDE OF THE
DATA SPACE AND USES THE
MATHEMATICS, MECHANISTIC MODELS,
TO PROVIDE THE TYPE OF KNOWLEDGE
THAT HAS NOT BEEN MEASURED.
SAID DIFFERENTLY IF YOU USE
FOUNDATION MODELS OR, YEAH, IF
YOU USE FOUNDATION MOD THAT
MODELS
TRAINED ON DATA SPACE YOU WILL
NOT GET OUTSIDE THIS DATA SPACE
SO YOU HAVE TO TAKE THE APPROACH
USING MECHANISTIC MODELS.
THIS IS BEING TESTED
SYSTEMATICALLY IN PROSPECTIVE
CLINICAL TRIALS, THE TRIALS
STARTED IN 2019.
HAS BEEN JUST FINISHED IN 2023,
AND THE DATA ARE UNDER
EVALUATION, WHERE HALF OF THE
PATIENTS IS RECEIVING THIS
INFORMATION OF THE VIRTUAL BRAIN
TWIN ENTERS INTO CLINICAL
DECISION MAKING, THE OTHER SIDE
HAS NOT, WITH 356 PROSPECTIVE
PATIENTS, FINISHED IN SEPTEMBER,
RANDOMIZATION UNDER RECENTLY,
LAST PATIENT OPERATED.
WE HAVE TO WAIT ONE YEAR AFTER
THIS SURGERY HAS BEEN PERFORMED.
SO THIS IS THE CURRENT SITUATION
WITH REGARD TO THE EPILEPSY.
YOU CAN TRANSFER TO OTHER
DISEASES, IN EPILEPSY THERE,
DATA FEATURES ARE MORE EVIDENT,
WE DEAL WITH SEIZURES, HERE WE
HAVE SPIKES.
OTHER CHALLENGES CAN BE FOUND,
FOR INSTANCE, IN DEEP BRAIN
STIMULATION, WHICH YOU CAN USE
TWINS TO TEST AND OPTIMIZE
STRATEGIES.
THIS PROJECT STARTED TWO YEARS
AGO USING VIRTUAL BRAIN TWINS IN
THE CONTEXT OF TREATMENT OF
PSYCHIATRIC DISORDERS, ACTUALLY
PERSONALIZING THE TWIN FOR
INDIVIDUAL SCHIZOPHRENIA
PATIENTS, SO EARLY PSYCHOTIC
EPISODES THAT NEED THEIR
MEDICATION TO BE EITHER CHANGED,
ALTERED, GO FROM ONE MEDICATION
TO ANOTHER SO WE'RE FOCUSING ON
DIFFERENT MEDICATION
CONCENTRATIONS PREDICTED BASED
ON DATA RECORDED, fMRI DATA IN
THIS PARTICULAR CASE, AND HELP
THE BRAIN TWIN AND PREDICT BASED
ON SIMULATIONS THAT BEST USES OF
THE MEDICATION.
THIS IS WHERE WE STAND WITH THE
USE OF THE VIRTUAL BRAIN TWINS.
WE HAVE -- WHEN YOU GO THROUGH
THIS, I HAVE TRIED TO LIST SOME
BENEFITS, SOME OF THE
CHALLENGES, SO I WANTED TO SHOW
YOU HOW ACTUALLY ENHANCED
INDIVIDUAL PRECISION IS ALLOWING
US TO ADDRESS ONE OF THE BIGGEST
BARRIERS TO PROGRESS IN
NEUROSCIENCE, INTERINTEREST
VARIABILITY, THE THE BRAIN IS A
COMPLEX SYSTEM,
INDIVIDUALIZATION IS NECESSARY.
WITH USE OF MECHANISTIC MODELS
WE CAN TEN ACTUALLY -- THEY WERE
ACTUALLY ADDRESS SOME ASPECTS
NOT OTHERWISE ACCEPTABLE.
I'M MENTIONING INCREASED
ACCEPTANCE IN THE COMMUNITY,
THEY ARE JUST WITNESSING A
REPORT OF MINE WHEN I WAS
TALKING ABOUT IN THE PAST ABOUT
THE CLINICAL TRIAL IN EPILEPSY,
THE FIRST FEW YEARS GOT COMMENTS
THAT THIS IS VERY DIFFICULT, HOW
CAN YOU ACTUALLY USE SUCH A
MODEL IN CLINICAL SURGERY, MUST
BE BECAUSE IT'S ACTUALLY
CONSEQUENTIAL FOR THE PATIENT.
SO, THERE IS RISK FOR THE
PATIENT.
WHERE IS THIS COURAGE OR YOU A
DAWES I CAN THY -- AUDACITY, IT
CHANGED OVER TIME, MORE COMMENTS
STARTED COMING UP HOW CAN YOU
ACTUALLY WITHHOLD THIS
INFORMATION FOR THE BRANCH IN
THE CLINICAL TRIAL FROM THE
PATIENTS, FROM THE TREATING
CLINICIANS, IF YOU HAVE
ADDITIONAL INFORMATION THAT
COULD BE TO THE BENEFIT OF THE
PATIENT, SO THERE IS A DIFFERENT
PERCEPTION AND ACCEPTANCE IN THE
COMMUNITY THAT WE'RE
EXPERIENCING NOW.
THE VIRTUAL BRAIN TWIN CAN HELP
TO REDUCE COSTS, AND IN
PARTICULAR TO HELP TO PERFORM
TESTING DIFFERENT HYPOTHESES.
AVOID TRIAL AND ERROR APPROACHES
IN TREATMENT AND IT'S NOT JUST A
COST REDUCTION BUT YOU CAN TEST
OUT THE VARIOUS PAUCITY AND
BUILD UP AN APPROACH THAT ALLOWS
TO ACCELERATE THE TREATMENT
DECISION OR IN CLINICAL TRIALS
ACTUALLY ACCELERATE THE TESTING
OF MANY DIFFERENT VARIABLE
PATHWAYS.
I WANT TO EMPHASIZE NITA
MENTIONED EARLIER IT'S ALSO THE
IMPROVED HEALTH CARE FOR MANY
BUT I WANT TO EMPHASIZE ANOTHER
ELEMENT.
IT'S NOT JUST PREFERRED
TREATMENT OF A PARTICULAR
PATIENT OR IMPROVED TREATMENT OF
THE PARTICULAR PATIENT.
HOWEVER, THINK OF IT THIS WAY.
THERE ARE MANY UNDERRESOURCED
GROUPS.
VERY OFTEN THERE ARE SOME
IMAGING TECHNIQUES NOT
AVAILABLE, OR SEEG INVASIVE,
PRE-SURGICAL EXPLORATION CANNOT
BE PERFORMED.
YOU NEED EXCELLENCE CENTERS,
REFERENCE CENTERS, IN ORDER TO
DO THIS.
WITH THAT VIRTUAL BRAIN TWIN OF
A PARTICULAR PATIENT, THIS TYPE
OF TECHNOLOGY CAN LEAD TO NOT
100%, CANNOT REPLACE INVASIVE
APPROACHES, HOWEVER IT CAN
ACTUALLY INCREASE THE
PERFORMANCE IN ABSENCE OF
HIGH-QUALITY APPROACHES, YOU CAN
ACTUALLY UNDERRESOURCED
INSTITUTIONS OR GROUPS YOU CAN
ACTUALLY APPROXIMATE 70%, 80%,
BECAUSE ALTERNATIVE WOULD HAVE
BEEN THIS INFORMATION IS
COMPLETELY MISSING, THE PERSON
NEEDS TO BE TREATED ANYWAY.
I WANT TO EMPHASIZE THIS
PARTICULAR ASPECT IN THIS
CONTEXT.
CHALLENGES HAVE BEEN MENTIONED
BEFORE.
DATA PRIVACY AND SECURITY IS
OBVIOUSLY AN ENORMOUS ONE.
BUT THERE ARE OTHER DATA-RELATED
CHALLENGES.
YOU NEED DATA.
YOU NEED MULTI-MODAL DATA, IN
ORDER TO BUILD ONE OF THESE
TWINS.
THIS REQUIRES TIME.
MODEL VALIDATION IS DIFFICULT.
VERY COMPLEX.
THE TWIN VALIDATION.
AGAIN, WE NEED THE TYPE OF DATA
TO VALIDATE IT.
AND THERE ARE AT THE MOMENT A
LACK OF CONSOLIDATED REGULATORY
PATHWAYS OF USING TWINS IN
CLINICAL ROUTINES SO THESE
THINGS NEED TO BE ESTABLISHED.
AND PATHS FOR THIS TYPE OF USE
NEED TO BE PUT IN PLACE.
AND OBVIOUSLY COMPUTATIONAL
RESOURCES NEED TO BE PUT IN
PLACE IN ORDER TO RUN THIS TYPE
OF VIRTUAL BRAIN TWINS FOR
INDIVIDUAL PATIENTS.
IF YOU WANT TO SCALE IT UP.
LET
LET ME STOP HERE AND THANK YOU
FOR YOUR ATTENTION.
>> WE HAVE FIVE MINUTES FOR
QUESTIONS BEFORE THE NEXT
PRESENTATION.
LET ME SEE IF ARE THERE ARE ANY
QUESTIONS.
JIM?
>> I HAVE A COUPLE QUESTIONS.
ONE IS, IS THERE DATA, CLINICAL
DATA, THAT YOU HAVE CHOSEN NOT
TO POPULATE THE MODEL WITH, TOO
SENSITIVE OR UNINFORMATIVE OR IS
THERE A TYPE OF DATA THAT YOU DO
NOT PUT INTO THESE MODELS?
>> WE HAVE NOT ASKED THIS TYPE
OF QUESTION.
NOT INFORMATIVE, YOU MEAN -- AT
THE MOMENT WHEN WORKING WITH THE
VIRTUAL BRAIN TWINS, THE ONES
BASED ON BRAIN IMAGING DATA
WE'RE USING DATA ACROSS SCALES.
SO, ALL THE WAY FROM THE
MOLECULAR TYPICALLY PROTEOMIC
SCALE OF THE INDIVIDUAL ALL THE
WAY TO MILLIMETER, CENTIMETER
DATA.
WE'VE WORKED WITH BEHAVIORAL
DATA, EXAMPLE WOULD BE COGNITIVE
PERFORMANCE DATA.
BUT THERE WHERE WE ARE RUNNING
INTO, I USE THE EXPRESSION
CAUSAL HYPOTHESIS, IN ORDER TO
RUN SUCH A TWIN IN A MEANINGFUL
MANNER, YOU NEED TO HAVE A
CAUSAL HYPOTHESIS, HOW ACTUALLY
THE DATA THAT YOU PUT IN RELATE
TO ALL THE OTHER DATA, IN A
MEANINGFUL MANNER.
AND THERE FOR INSTANCE WE'VE
HAVE NOT MANAGED TO DO THIS
SYSTEMATICALLY FOR COGNITIVE
PERFORMANCE DATA.
WE DON'T KNOW HOW TO DO THIS.
I DON'T THINK ANYONE KNOWS HOW
TO DO THIS AT THE MOMENT,
CAUSALLY, SO IT CAN BE DONE ONLY
CORRELATIONALLY, SO STATISTICS
ENTERS IN THIS PARTICULAR
REGARD.
IN THE SCHIZOPHRENIA EXAMPLE,
WITH MEDICATION DATA, WE ARE --
THERE ARE SO MANY POSSIBILITIES
SO WE'RE OUTSOURCING MUCH OF THE
WORK ON SUPERCOMPUTERS, WHICH
WHERE THE SIGNALING PATHWAY AND
MEDICATION IMPACTS ARE BEING RUN
IN A GENERIC FASHION AND THEN
ONLY THE RESULTS NAMELY THE
BEHAVIOR OF THE INDIVIDUAL BRAIN
REGIONS IS BEING INTEGRATED IN
THE VIRTUAL BRAIN TWIN BECAUSE
YOU CANNOT RUN THIS TYPE OF
MODEL, PERSONALIZED MODELS, ON
SUPERCOMPUTERS.
SO, WHAT I'M TRYING TO SAY IS WE
HAVE NOT EXCLUDED ANY DATA PER
SE.
HOWEVER, WE'RE STRUGGLING WITH
CHALLENGES AND BARRIERS WHEN THE
CAUSALITY IS NOT EVIDENT AND WE
HAVE TO FIND WAYS OF DEALING
WITH THIS.
THERE, BY THE WAY, FOUNDATIONAL
GROUPS MAY PLAY A VERY IMPORTANT
ROLE.
IF YOU CANNOT MECHANISTICALLY
FORMULATE IT YOU CAN STILL LEARN
THE RELATIONSHIPS.
>> THANK YOU.
>> WE HAVE TIME FOR ONE MORE
BRIEF QUESTION, AND I'M GOING TO
GIVE IT TO ARLEEN SALLES WHO
WILL KEEP MINDFUL OF TIME SINCE
SHE'S UP NEXT.
>> YES, HI, VIKTOR.
SUCH A PLEASURE AS USUAL.
CAN YOU HEAR ME?
OKAY, A QUICK QUESTION.
YOU TALKED ABOUT THE VIRTUAL
BRAIN TWIN, MY QUESTION IS IT
REALLY A TWIN?
IS IT REALLY THERE'S CONSTANT
REALTIME INTEGRATION OF
INFORMATION FROM THE PHYSICAL
ENTITY TO THE TWIN AND BACK?
SO IS IT REALLY, REALLY A TWIN
AS WE UNDERSTAND THE DEFINITION
OF DIGITAL TWIN?
>> IN THE EXAMPLE THAT I SHOWED
YOU, NOT, I WANTED TO SHOW YOU
HOW WE ACTUALLY GO TO THE
CLINICAL TRIAL AND BECAUSE THERE
WE HAVE HAD THE BIGGEST IMPACT
AT THE MOMENT USING THE VIRTUAL
BRAIN TWINS, IN THIS SENSE YOU
HAVE NOT REAL TIME BUT REAL
WORLD DATA THAT ARE ENTERING, IN
THE EXAMPLE OF STIMULATION, YOU
CAN TAKE A HYBRID APPROACHES
WHERE RESPONSES OF BRAIN REGIONS
ARE BEING DIRECTLY, SO
FUNCTIONAL DATA, SO TIME RESULT
DATA BEING INTRODUCED INTO THE
VIRTUAL BRAIN TWIN.
THERE THE ANSWER IS YES, IT'S
BEEN SO RECORDED DATA ARE BEING
INJECTED TO THE BRAIN TWIN TO
BIAS CERTAIN CERTAIN BEHAVIORS,
OTHER BEHAVIORS OPEN.
THESE EXAMPLES EXIST IN THE
CONTEXT OF BRAIN STIMULATION, IN
PARTICULAR WHEN GUIDING
TECHNIQUES FOR NON-INVASIVE
BRAIN STIMULATION WHERE IT'S
BECOMING VERY IMPORTANT
ACTUALLY.
>> THANK YOU.
WE'LL HAVE TIME FOR MORE
QUESTIONS WHEN WE HAVE A
CONVERSATION WITH EVERYONE AFTER
THE BREAK.
SO LET ME TURN IT TO OUR NEXT
SPEAKER WHICH IS DR. ARLEEN
SALLES, WHO IS GOING TO SPEAK
ABOUT THE ETHICAL CONSIDERATIONS
IN DIGITAL TWIN MODELS.
SHE'S A SENIOR RESEARCHER AT
INSTITUTE OF NEUROETHICS.
LET ME HAND IT OVER TO HER
PLEASE.
>> CAN YOU SEE MY PRESENTATION?
CAN YOU SEE MY PRESENTATION NOW?
>> YES, WE CAN SEE YOUR
PRESENTATION.
>> GOOD.
THANK YOU FOR THE NICE
INTRODUCTION AND AGAIN IT'S A
PLEASURE TO BE HERE AND TO SHARE
SOME OF MY THOUGHTS ON DIGITAL
TWINS AND HAVE THE OPPORTUNITY
TO FOLLOW VIKTOR BECAUSE PART OF
THE BRAIN PROJECT I WAS IN A
GROUP WITH VIKTOR, A PLEASURE TO
HAVE THIS CONVERSATION.
WHAT I'M GOING TO BE DOING HERE
ACTUALLY IS I WANT TO OFFER A
NON-EXHAUSTIVE BRIEF OVERVIEW IN
PERSONALIZED BRAIN MODELING AND
ENCOURAGE CONVERSATIONS
REGARDING CHALLENGES.
BUT ALSO WHAT IS NEEDED TO
ENHANCE IN THE SPACE.
SO I WILL START ACTUALLY WITH
THIS CATEGORIZE OF BRAIN MODELS,
I WAS INCLUDED IN A PAPER
RECENTLY PUBLISHED BY SEVERAL
RESEARCHERS FROM THE HUMAN BRAIN
PROJECT, BY KATRINA, THE
DISTINCTION MADE BETWEEN BRAIN
MODELS, PERSONALIZED BRAIN
MODELS, DIGITAL TWINS, AND OF
COURSE INTEREST IS BRAIN MODELS
AND DIGITAL TWINS.
WHAT THE PERSONALIZED BRAIN
MODEL WHICH WE CALL THE VIRTUAL
BRAIN IN THE HUMAN BRAIN PROJECT
AGAIN PERSONALIZED DIGITAL MODEL
OF THE BRAIN THAT COMBINES
DETAILED BRAIN SCANS WITH
MATHEMATICAL MODELS TO SIMULATE
HOW THE PERSON'S BRAIN
FUNCTIONS.
PRIMARY VALUE THAT IS ALLOWED TO
STUDY UNDERSTANDING OF THE BRAIN
AND IMPROVE DIAGNOSIS AND
TREATMENT OF CONDITION.
ADDITIONAL VALUE, FOR THE
DEVELOPMENT OF DIGITAL TWINS OF
THE BRAIN AS DYNAMIC
STIMULATION, ABLE TO PRESENT
STATSES IN REALTIME, IN THE
CLINICAL CONTEXT PREDICT
PROGRESSION.
THAT SENSE SHIFTS FROM THE
PERSONALIZED BRAIN MODEL TO TWIN
WOULD BE SHAPED FROM MORE STATIC
SIMULATION TO MORE REALTIME
PREDICTED.
IT'S BEEN SUGGESTED ETHICISTS
SOMETIMES HAVE A TENDENCY -- OUR
ATTENTION FROM ISSUES THAT WE
FACE, AND AT THE SAME TIME
IMPLICATIONS, MISGUIDED CHOICES,
AND SO ON.
MY GOAL IS MY OVERVIEW, ACTUALLY
THIS MEANS ENGAGING WITH HOW
MODELS ARE DESCRIBED,
CONSTRUCTED, INTERPRETED.
I WANT TO MAKE A DISTINCTION
WITH FOUR MAIN THEMES AND NOTE
THAT HAVING A LOT TO DO WITH
STUDY INTRODUCTION AND WHAT
VIKTOR MADE IN HIS PRESENTATION,
TERMINOLOGYICAL, HOW WE TALK
ABOUT THESE MODELS.
SECOND HAS TO DO WITH DESIGN AND
FORMULATION OF THE COMPUTATIONAL
MODEL BASICALLY HOW ARE THEY
BUILT.
THIRD WHAT I CALL PHILOSOPHICAL
CONUNDRUMS, WHAT CERTAINTY CAN
THEY PROVIDE?
FOURTH IS SOCIETAL IMPACT AND
USE, IMPLICATION IN SPECIFIC
CONTEXT.
SO, LET ME MOVE TO THE NEXT
SLIDE.
WHAT ARE THE TERMINOLOGYICAL
CONCEPTIONS?
WE KNOW AS WE CONSIDER THE
MODELS IN NEUROTECHNOLOGY, THE
POWER OF LANGUAGE AND THEY ARE
NOT NEUTRAL.
THEY SHAPE HOW WE UNDERSTAND
THINGS.
SO, ONE OF THE QUESTIONS THAT
CAME UP AT THE BEGINNING WHEN WE
STARTED WORKING, WHEN THE
NEUROETHICS GROUP STARTED
WORKING WHAT DO WE MEAN WHEN WE
TALK ABOUT THIS?
AS I SAID IT WAS A POPULAR TERM
BUT OUR CONCERN
AT THE TIME THE VIRTUAL BRAIN IS
LIMITED, SPECIFIC BRAIN NETWORK
OR FUNCTION, NOT A GOOD DIGITAL
REPLICA OF THE BRAIN, AND ARE
THERE MORE ACCURATE ALTERNATIVES
TO USE SUCH AS COMPUTATIONAL
BRAIN MODEL, IT'S POSSIBILITY
MORE ACCURATE AND BETTER TERMS
TO USE BUT WE HAVE TO
UNDERSTAND, THE SAME PROBLEM WE
THOUGHT ARISE WHEN WE WERE
TALKING ABOUT THE TERM DIGITAL
TWIN.
IT'S TRUE THE MODEL COMPRISES
THREE MAIN COMPONENTS,
COUNTERPARTS, DYNAMIC REALTIME
DATA CHANGE BETWEEN THEM, THE
QUESTION FOR US WAS IS IT CLEAR,
WHEN WE TALK ABOUT DIGITAL TWINS
OF THE BRAIN, SO IT SEEMS THAT
TERMINOLOGYIC CAN HAVE A
PRAGMATIC VALUE, CAN HELP GET
FUNDING, WHEN ONE INCLUDES THIS
TERM IN PROPOSALS.
HOWEVER, IT CARRIES RISK, WHEN
NON-EXPERTS HEAR TERMS LIKE
BRAIN, DIGITAL TWIN -- SOMEBODY
TALKED TO ME?
>> ARE THE SLIDES ADVANCING FOR
YOU?
>> SOMEBODY IS TALKING TO ME
AGAIN.
>> YES, I THINK -- THERE WE GO.
OKAY.
NOW THEY ARE ADVANCING.
GREAT.
THANK YOU.
>> OKAY.
>> SORRY, I MUTED THAT PERSON.
>> THE POINT IS THAT WHY THIS
MAY HAVE VALUE WE HAVE TO BE
CAREFUL WHEN WE PRESENT TERMS
AND DISCUSS THIS DEVELOPMENT IN
PARTICULAR WAY, BECAUSE WE HAVE
TO BE MINDFUL OF WHAT DIFFERENT
AUDIENCES MIGHT BE INTERPRETING.
AND THIS IS RELEVANT.
WELL, ACCURATE TERMINOLOGY IS
ESSENTIAL.
SO THE WAY WE DESCRIBE,
INCLUDING VIRTUAL BRAIN, DIGITAL
TWIN, SHAPES PERCEPTION.
SO WE HAVE TO BE MINDFUL OF THE
POSSIBILITY OF CONFUSION,
PARTICULARLY AT PRESENT,
ESPECIALLY IN MORE
INTERDISCIPLINARY AND APPLIED
CONTEXT.
SO ONE OF THE ISSUES I WANT TO
UNDERLINE IS THE EXTENT TO WHICH
WE NEED TO BE CONCEPTUAL PRECISE
WHILE REMAINING RESPONSIBLE WHEN
IT COMES TO COMMUNICATION.
NITA, THERE'S SOMEBODY TALKING,
THERE'S A VOICE I HEAR.
>> I HEAR IT AS WELL.
I'M TRYING TO SEE WHO IS
UNMUTED.
I APOLOGIZE.
>> OKAY.
>> I'M NOT SEEING WHO IS UNMUTED
AT THIS POINT.
>> OKAY, YES.
SO LET ME MOVE ON TO THE SECOND
THEME THAT I THINK IS IMPORTANT,
VIKTOR EXPLAINED REALLY
BRILLIANTLY, VIRTUAL BRAIN TWIN
ENTAILS.
I WANT TO TALK ABOUT SOME OF THE
ISSUES THAT ARE ETHICALLY
RELEVANT EVEN WHEN USUALLY
EXPLORED FROM A TECHNICAL
PERSPECTIVE.
PREDICTABILITY, FOR EXAMPLE,
BOTTOM LINE, THESE MODELS ARE
GOING TO GUIDE, IT IS IMPORTANT
TO ENSURE THEIR RELIABLE,
ETHICALLY SOUND.
THIS REQUIRES FOR EXAMPLE INPUTS
RELIED UPON WHICH ALLOW US TO
UNDERSTAND EVALUATING MODELS, SO
LACK OF TRANSPARENCY IS GOING TO
AFFECT THE DECISION-MAKING
PROCESS.
SAME FOR REPRODUCIBILITY.
THEY CAN UNDERMINE.
VERIFICATION IS KEY.
ENSURING SOFTWARE UNDERLINING
MATHEMATICS, MODEL THAT FUNCTION
THAT PRODUCE OUTPUT.
VALIDATION, VIKTOR MENTIONED
VALIDATION BECOMES AN ISSUE.
THIS MEANS WHAT IS SUPPOSED TO
DO IN THE REAL WORLD.
A MODEL CAN BE MATHEMATICALLY
SOUND, PROVIDE USEFUL
PREDICTION, VALIDATION IS KEY.
DATA INTEGRITY AND UNCERTAINTY,
IMPORTANT TO RECOGNIZE TO
ACKNOWLEDGE AND MANAGE
APPROXIMATION ERRORS,
UNCERTAINTIES HAVE TO BE
COMMUNICATED.
INACCURATE, INCOMPLETE, CAN LEAD
TO MISUSE.
COMMUNICATION AND
ACCOUNTABILITY, OVERSTATING
ACCURACY, FOR EXAMPLE, I WILL
TALK ABOUT THIS IN A MINUTE, CAN
MISLEAD STAKEHOLDERS.
SO TOGETHER THOSE ASPECTS WE CAN
SEE THESE HAVE IMPORTANT ETHICAL
IMPLICATIONS.
AND WITH THIS I WOULD LIKE TO
MOVE TO THE OBJECTIVITY BECAUSE
THIS IS IMPORTANT.
THE MODEL APPEARS PRECISE, THEY
APPEAR TO BE OBJECTIVE.
YET THEY ARE SHAPED BY SEVERAL
DECISIONS INCLUDING SELECTION OF
ALGORITHMS, HARDWARE,
MEASUREMENT UNITS, DATA
INCLUSION, IT'S INTERESTING JIM
ASKED IS THERE INFORMATION YOU
DO NOT INCLUDE, DECISIONS GUIDED
BY DOMINANT SCIENTIFIC
PARADIGMS, INSTITUTIONAL GOALS,
RESOURCE CONSTRAINTS,
DISCIPLINARY UNDERSTANDING COME
TO MIND.
SO THIS FRAMING AFFECTS NOT JUST
HOW THE MODEL IS STRUCTURED BUT
ALSO WHAT IS EXPRESSED, OR
EXCLUDE.
SO, THIS MEANS THAT THIS IS A
MODEL, EVEN FOR ANALYSIS
PREDICTION AND DECISION MAKING,
CAN EMBED ASSUMPTION, BIASES,
AND MAY LEAD TO ACTUALLY
UNJUSTIFIED TRUST, TREATED AT
MUTUAL REPRESENTATION.
OBVIOUSLY THERE'S ETHICAL RISK
IN TREATING THESE PRESENTATIONS
AS NEUTRAL BECAUSE THEY ARE NOT.
THEY ARE IMPORTANT BUT PARTIAL
AND MUST BE INTERPRETED
CAREFULLY.
SO, IN SOME WAY THIS LEADS TO
SCIENTIFIC PHILOSOPHICAL
CONUNDRUM.
DIGITAL REPRESENTATIONS ARE NOT
JUST TECHNICAL ARTIFACTS, THEY
ARE EMBEDDED.
I THINK DIRECTLY TO A FEW
QUESTIONS, WHAT KIND OF REALITY
DO THEY REALLY REPRESENT?
AND WHAT KIND OF KNOWLEDGE CAN
THEY PROVIDE?
SO LET'S START WITH THE
ONTOLOGIC ISSUE, AND FOLLOWING
CLOSELY THEY DO MAKE A
DISTINCTION BETWEEN THE
DIMENSION, IF YOU WISH, OF
DIGITAL TWIN AND DIGITAL BRAIN
MODEL.
ONE IS THE REPRESENTATION, BRAIN
MODEL, DIGITAL TWIN, STUDIED FOR
SPECIFIC ASPECTS, THEY REPRESENT
CERTAIN FUNCTIONS OR STRUCTURES.
THEN WE HAVE FUNCTIONAL DAMAGE,
SUPPOSED TO SEE ACTIVITY IN REAL
TIME, DYNAMIC, PREDICTIVE,
INTERACTIVE, RECEIVE DATA FROM
THE BRAIN, INFORM DECISIONS.
THIS MAKES THEM POWERFUL TOOLS
FOR ANALYSIS FOR PREDICTION AND
PERSONALIZED CARE.
BUT FINALLY WHICH HAVE ENORMOUS
DIMENSION, HERE IS PHILOSOPHICAL
AND ETHICAL IMPLICATION MAY
BECOME MORE APPARENT.
THESE MODELS ARE NOT JUST
PREDICTIVE, THEY ARE NORMATIVE,
EMBED CERTAIN ASSUMPTIONS ABOUT
WHAT MATTERS, WHAT SHOULD BE
MEASURED, HOW THE BRAIN SHOULD
BE UNDERSTOOD, WHICH FEATURES
ARE PRIORITIZED, NOT REALLY
TECHNICAL DECISIONS OR TECHNICAL
OBJECTS.
THEY ARE ETHICAL DEVELOPMENT.
THE QUESTION OR SOME OF THE
QUESTIONS THAT I THINK, IS THERE
A POSSIBILITY THESE MODELS CAN
SHIFT ATTENTION AWAY FROM THE
PERSON TOWARDS THE MODEL?
PARTICULARLY TREATED AS
OBJECTIVE OR AUTHORITATIVE?
AND THIS IS PART OF WHAT NITA
STARTED INTRODUCING.
NOW, IF THEY SHIFT AWAY FROM THE
PERSON THAT'S NOT NECESSARILY
WRONG.
IT'S SYSTEM RISK BECAUSE
PATIENTS MAY BE REDUCED TO DATA
PATTERNS AND COMPLEXITY OF THE
PATIENT MAY BE SOMEHOW SKEWED.
ON THE OTHER HAND, WHO BUILDS
THE MODEL?
IT MATTERS BECAUSE WHO OWNS THE
DATA, HOW -- WHICH DATA WAS
SELECTED, HOW TRANSPARENT, AND
WHAT CLINICIAN FEEL EMPOWERED TO
QUESTION THE MODEL'S OUTPUT.
FINALLY THEY SHAPE THE
BEHAVIORS, EXPECTATIONS, SO WE
HAVE TO ASK AT SOME POINT HOW DO
USERS INTERACT WITH THE MODEL?
WHO IS ACCOUNTABLE?
AND WHEN IT COMES TO DECISIONS,
I WILL GO BACK TO THIS TOWARD
THE END.
WHAT KIND OF RELATIONSHIP IS
EMERGING BETWEEN PATIENTS,
PRACTITIONERS, AND THE DIGITAL
TWIN?
SO, LET'S BRIEFLY ADDRESS THE
SECOND PHILOSOPHICAL CONUNDRUM,
REAL WORLD BEHAVIOR, COMPLEX,
CONTEXT DEPENDENT, MUCH MORE SO
THAT CAN BE CAPTURED IN CONTROL
LABORATORY.
THRB THERE ARE -- THERE ARE A
NUMBER OF FACTORS, MAY BE
DIFFICULT WITH PRE-DIGS.
NEUROSCIENTISTS ARE GRAPPLING
WITH UNKNOWNS, WE DON'T FULLY
UNDERSTAND HOW BRAIN FUNCTIONS,
TRANSLATED TO COMMISSION OR
BEHAVIOR.
THIS UNCERTAINTY COULD CARRY
OVER INTO MODELS AND RAISES
ISSUES ABOUT HOW ACCURATE OR
PREDICTIVE THIS THESE DIGITAL
TWINS CAN BE.
SO WHY IS THIS ETHICAL RELEVANT?
MODELS CARRY CERTAIN DEGREE OF
UNCERTAINTY, HOW SHOULD THEY BE
USED TO GUIDE DECISIONS?
HOW MUCH UNCERTAINTY IS
ACCEPTABLE BEFORE A MODEL IS
UNRELIABLE OR HARMFUL?
WHEN IS IT OR HOW DO WE
DETERMINE THAT?
SO, I WOULD LIKE TO NEXT TALK
ABOUT SOME PROBLEM, BROADER
ETHICAL AND SOCIAL IMPLICATIONS
ON COMPUTATIONAL MODELS AND
DIGITAL TWIN.
FIRST BARRIER, A CONCERN THIS
TECHNOLOGY COULD WIDEN QUALITY
WITHIN THE SYSTEM AND EVEN
BETWEEN COUNTRIES.
MODELS BEING USED IN LIMIT FOR
BIASED DATASETS, DISCRIMINATION
OR PROVIDE LESS ACCURATE OUTPUT
FOR UNDERSERVED POPULATIONS
WHICH OF COURSE WOULD BE A
PROBLEM.
I WANT TO BRING UP ANOTHER
ISSUE, WHETHER THEY COULD
PRODUCE INJUSTICE?
THE NOTION REFERS TO HARM DONE
TO PEOPLE IN THEIR CAPACITY, FOR
EXAMPLE ABILITY TO ACCESS,
CONTRIBUTE TO KNOWLEDGE,
PRODUCTION AND COMMUNICATION OF
KNOWLEDGE IS UNDERMINED.
THE QUESTION IS COULD THESE
DIGITAL TWINS PRODUCE HARM
PARTICULARLY FOR PATIENTS,
PARTICULARLY IN THE CONTEXT OF
PATIENT RELATIONSHIP AND SO ON.
IT SEEMS THEY COULD.
DON'T SAY NECESSARILY WILL.
COULD.
FOR EXAMPLE IF THE PATIENT LIVED
EXPERIENCE IS A MYTH,
UNDERVALUED BECAUSE SEEN AS MORE
OBJECTIVE, IF THE PATIENT FEELS
COMPARED TO THE OUTPUT EVEN WHEN
THEY CONTRADICT HIS OR HER OWN
EXPERIENCE IT COULD BE SAID THIS
REPRESENTS INJUSTICE, HARM DONE
TO THE PATIENT.
ON THE OTHER HAND, IF
INDIVIDUALS, PATIENTS, LACK
CONCEPTUAL TOOLS, FOR EXAMPLE,
IF PREDICTIONS ARE FRAMED
THROUGH ALGORITHMS THAT THEY CAN
NOT INTERPRET, AND THESE AFFECT
ABILITY TO UNDERSTAND AND EVEN
NAVIGATE THEIR CONDITION, AGAIN
IT WOULD BE -- THERE'S ANOTHER
FORM OF SYSTEMIC INJUSTICE.
COMPUTATIONAL MODELS OF COURSE
CAN EMPOWER OFFERING INSIGHTS, I
DON'T THINK IT'S CONTROVERSIAL
AT ALL.
THE QUESTION THAT I'M RAISING
AND LEADS TO TOPICAL DISCUSSION
CAN THEY ALSO BE EMPOWERED,
SHIFTING AUTHORITY, RISKING
REDUCING PATIENTS -- REDUCING
QUALITY OF THE CLINICAL
ENCOUNTER?
SO, THIS RAISES THE ISSUE OF
WHOSE KNOWLEDGE TO BE
PRIORITIZED?
WHOSE VOICE SHOULD BE AMPLIFIED
OR SILENT?
THESE TECHNOLOGIES, ARE THESE
AMPLIFYING VOICES, WHICH?
ALSO THE ISSUE OF THE POTENTIAL
OF DIMINISHING HUMAN CONTACT,
DIGITAL TWINS BECOME MORE
EFFICIENT TO CONSULT, THEN
EXPECTATIONS WE DESERVE WHEN IT
COMES TO CARE.
WILL WE LOSE WHEN THE CLINICAL
ENCOUNTER BECOMES EVEN MEDIATED
BY THIS PREDICTED METRIC TO A
CERTAIN EXTENT.
AND FINALLY WE HAVE THE ISSUE OF
CLINICAL RESPONSIBILITY.
AND THESE ARE MADE CLEAR WHEN IT
COMES TO CLINICAL
RESPONSIBILITY, RESPONSIBILITY
IS ON THE CLINICIAN,
RESPONSIBILITY IS ON THE
SURGEON.
SO, THAT IS CLEAR.
HOWEVER, ONE QUESTION I THINK
THAT BECOMES WORTH DISCUSSING
ALSO IS WITH CLINICIANS WILL
SURGEONS BE PRESSURED TO DID DR
TO THE MODEL, TO BE FOLLOWED?
SO I THINK THIS IS ANOTHER THING
TO CONSIDER.
I WANT TO FINISH ARE A POINT
THAT THE REPORT BY THE NATIONAL
ACADEMIES MAKES WHEN THEY TALK
ABOUT DIGITAL TWINS.
HIGHLIGHTING INTERDISCIPLINARY
COLLABORATION AND INVESTMENT IN
INFRASTRUCTURE ARE ESSENTIAL,
NOT OPTIONAL, FOR DIGITAL TWINS.
I AGREE A HUNDRED PERCENT.
I WOULD LIKE TO GO FURTHER AND
STRESS THE NEED TO EXPLICITLY
INTEGRATE ETHICS AT THE
FOUNDATIONAL ELEMENT IN THIS
RESEARCH.
I BELIEVE TO TRULY REALIZE
BENEFITS OF DIGITAL TWINS WE
MUST BE INTENTIONAL, KNOW ABOUT
TECHNICAL COLLABORATION BUT ALSO
WHAT ARE THE ETHICAL FRAMEWORKS
USED, HOW ARE WE PROMOTING A
MORE ETHICAL UNDERSTANDING OF
THE ISSUE?
SO, FOR ME THE QUESTION
CONTINUES TO BE HOW DO WE DEAL
ETHICAL REFLECTION AS THE CORE
COMPONENT OF THE COLLABORATION,
HOW DO WE VIEW, AND WHAT
MECHANISM SHOULD WE TRY TO
BUILD, CREATE, TO MAKE THIS
INTEGRATION MUCH MORE CONCRETE
AND ACTIONABLE?
SO, I THINK WE HAVE TO -- I WANT
TO BE FAIR THAT ETHICAL CONCERNS
AROUND MODELING ARE NOT NEW,
SINCE THE 1980s OR SO CALLS
FOR GREATER ETHICAL
RESPONSIBILITY AMONG MODELS.
THESE SCHOOLS, OFTEN
UNDERADDRESSED.
MANY TIMES PEOPLE DO NOT KNOW
THEY FIT OR THEY FIND IT IS
DIFFICULT MANY TIMES TO REALLY
FOLLOW THEM.
SO IN ADDITION TO THAT WE HAVE
THE VIEW THAT MODELING IS
OBJECTIVE AND VALUE FREE SO
THEREFORE ETHICAL REFLECTION
MIGHT BE GOOD, BUT IS OPTIONAL
RATHER THAN INTENTIONAL.
FOUNDATIONAL TRAINING I THINK
REALLY EQUIPS SCIENTISTS TO
LEAD, TO NAVIGATE SOME OF THESE
QUESTIONS, HUMAN BRAIN PROJECT
IN PARTICULAR, QUITE A BIT,
ATTEMPTED TO CREATE EDUCATIONAL
MODELS, DESIGNED NOT TO IMPOSE
RULES, TO FOSTER COMPLIANCE BUT
RATHER TO PROMOTE REFLECTION AND
EXAMINATION.
HOWEVER, THOUGH, I DON'T THINK
THAT'S ENOUGH.
WITH THE GROUP OF SCIENTISTS
ACTUALLY WE'RE WORKING ON THIS
IDEA THAT ETHICAL CAPACITY
BUILDING MUST BE EMBEDDED IN THE
LAB, NOT BE A AFTERTHOUGHT,
CREATING SAFE SPACES FOR
REFLECTION, COLLABORATION, IN
THE LAB.
WHEN PEOPLE ARE MODELING, FREE
TO DISCUSS AND REFLECT ON THIS
ISSUE.
ULTIMATELY IT'S CLEAR THIS IS A
SHIFT TOWARDS VIEWING ETHICS AND
ETHICAL REFLECTION AS KEY
COMPONENT OF SCIENTIFIC
EXCELLENCE BUT I THINK THAT'S
EXACTLY THE KIND OF THING WE
HAVE TO BE CONCERNED WITH.
THESE ARE ADDITIONAL TEXTS AND
BIBLIOGRAPHY.
THANK YOU VERY MUCH.
>> WONDERFUL.
THANK YOU SO MUCH.
WE HAVE TIME FOR ONE QUESTION
BEFORE WE TRANSITION TO OUR
FINAL SPEAKER BEFORE THE BREAK
AND THEN WE'LL HAVE TIME FOR
DISCUSSION WITH ALL OF OUR
SPEAKERS FOLLOWING THE BREAK.
JIM HAS JUMPED IN.
PLEASE ASK THE QUESTION.
>> ARLEEN, THANK YOU FOR THE
TALK.
IT'S ALWAYS NICE TO SEE HOW YOU
THINK ABOUT THESE THINGS FROM
YOUR PERSPECTIVE.
IT DID RAISE AN INTERESTING
QUESTION FOR ME THOUGH.
IF THE IDEA IS THAT YOU HAVE TO
HAVE A CAUSAL HYPOTHESIS TO MOVE
INTO THIS VIRTUAL TWIN AREA, ONE
OF THE AREAS OF ACTIVE RESEARCH
IN NEUROSCIENCE IS ORGANOIDS,
THE GOAL TO TAKE TISSUE, ALLOW
IT TO GROW AND CREATE MODEL
SYSTEMS TO TEST HYPOTHESES.
WHAT WOULD BE THE ETHICAL
DISTINCTION IN TWEETING A
DIGITAL ORGANOID OR ASSEMBLIOD,
ARE THERE DISTINCTIONS?
>> I THINK THE QUESTION IS
POINTING TO THE ISSUE OF MORAL
STATUS, DIFFERENT ENTITIES,
DIFFERENT MORAL STATUS?
>> I'M SORRY, WHY WOULD THEY
HAVE DIFFERENT MORAL STATUS?
>> I THINK THAT'S A FANTASTIC
QUESTION.
WOULD YOU TREAT THEM
DIFFERENTLY, RIGHT?
THAT'S WHAT YOU'RE ASKING, DO
THEY HAVE DIFFERENT MORAL
STATUS?
AND I THINK -- I DON'T KNOW THAT
I WOULD WANT TO STATE THEY HAVE
DIFFERENT MORAL STATUS BUT
HONESTLY WHAT WE NEED TO BE
AWARE OF IS THAT THESE DIFFERENT
SCHOOLS BEING DEVELOPED CANNOT
BE TAKEN TO BE AS OBJECTIVE AND
REPRESENTATIVE AS WE MIGHT THINK
THEY ARE.
AND IN THAT RESPECT WE HAVE TO
BE MUCH MORE CAREFUL.
SO I WOULD HAVE TO THINK MUCH
LONGER ABOUT WHETHER THERE'S
DIFFERENCE STATUS OF ORGANOID OR
DIGITAL TWIN BUT THEY ARE
BOTH -- BOTH CASES ISSUES ARE
BEING RAISED REGARDING HOW THEY
ARE BEING MENTIONED, ORGANOIDS
INTELLIGENCE, DIGITAL TWIN,
VIRTUAL BRAIN.
WE HAVE TO BE QUITE AWARE THAT
THESE TOOLS ARE MUCH MORE
EMBEDDED IN A NUMBER THAT WE
USUALLY DON'T PAY ATTENTION TO.
THAT FOR ME WHAT IS THE MORAL
STATUS OF EACH AND WHAT ARE WE
OWED TO EACH OF THEM?
I THINK WE REALLY HAVE TO START
PRIORITIZING WHAT ARE THEY DOING
REGARDING AND HOW ARE WE TAKING
WHAT THEY GIVE, HOW ARE WE
RATING THE KIND OF KNOWLEDGE
THEY ARE PROVIDING?
>> THANK YOU.
>> TERRIFIC.
THAT LEAVES US WITH ONE MORE
QUESTION BEFORE WE SHIFT.
LET ME SEE IF THERE ARE ANY
OTHER QUESTIONS BEFORE WE SHIFT
TO THE FINAL SPEAKER BEFORE THE
BREAK.
I'M SURE THERE ARE A LOT OF
QUESTIONS BECAUSE THAT
WONDERFULLY FRAMES THE
QUESTION -- SORRY, KAREN, DID
YOU HAVE A QUESTION?
PLEASE GO AHEAD.
>> I THINK IT'S QUICK.
ARLEEN WAS ONE OF THE DEPUTY
LEADS OF THE HUMAN BRAIN PROJECT
ENGAGEMENT EFFORTS, ALSO.
SO I'M CURIOUS, ARLEEN,
SOMETHING I COULD LOOK UP BUT
HAVING THE EXPERT I CAN ASK YOU,
WERE THERE PUBLIC ENGAGEMENT
PROJECT ASKING SOME OF THESE
QUESTIONS, CONCEPTUAL QUESTIONS,
ABOUT DIGITAL TWINS OR THE
DISTINCTION OF THE VIRTUAL
BRAIN, YOU KNOW, VERSUS DIGITAL
TWIN?
YOU WROTE AN EXCELLENT PAPER BUT
I'M CURIOUS WAS THERE ANY
PUBLISHED --
>> YEAH, THIS IS INTERESTING.
WE DID WRITE QUITE A BIT.
THE PAPER I MENTIONED AT THE
BEGINNING, BY KATRINA MUNZ AT
FIRST SPECIFIC EFFORTS TO ENGAGE
CITIZENS ON THE ISSUE, DIGITAL
TWIN VERSUS BRAIN, SO ENGAGED IN
A NUMBER OF ACTIVITIES BUT NOT
SPECIFICALLY ON THAT ONE, AS FAR
AS I REMEMBER.
BY THE WAY, I HAVE TO SAY THAT,
I MEAN NOT GIVING A TALK, BY
ENGAGE AM.
WE GAVE MANY TALKS ABOUT THIS.
I'M TALKING ABOUT ENGAGEMENT
UNDERSTOOD BIDIRECTIONAL WAY,
ENGAGED, DIALOGUE WITH PUBLIC.
I HAVEN'T SEEN THAT ASKED IN THE
LAST FEW MONTHS IN THE HUMAN
PROJECT BUT VIKTOR PROBABLY HAS.
>> OKAY.
>> QUICKLY, VIKTOR, TO GET TO
THE FINAL SPEAKER AND MORE TIME
FOR CONVERSATION.
PLEASE GO AHEAD.
YOU CAN MAKE YOUR BRIEF
INTERVENTION.
NO?
OKAY.
I'M GOING TO TAKE THAT SIGN
LANGUAGE TO BE MOVE AHEAD AND
WE'LL TALK ABOUT IT AFTER THE
BREAK.
SO, LET ME INTRODUCE THE FINAL
SPEAKERS DR. JANA SCHAICH BORG,
WALTER SINNOTT-ARMSTRONG AND
VINCENT CONITZER TO SHARE
ETHICAL CONVERSATIONS RELATED TO
MORAL DIGITAL, HOW TO THINK
ABOUT THESE ISSUES AND SO I'M
NOT QUITE SURE HOW THEY ARE
DIVIDING.
THERE'S JANA.
SO LET ME TURN IT OVER
PRESUMABLY TO JANA TO KICK US
OFF.
IF I'M WRONG YOU'LL CORRECT ME
WITH OUR GRATITUDE.
SO THANKS.
>> THAT'S RIGHT.
THANKS FOR THE INVITATION.
IT'S A PLEASURE AND FASCINATING
TO BE HERE.
WE DECIDED I WOULD TALK.
THREE OF US HERE FOR QUESTIONS.
I'M TRYING TO SHARE MY SLIDES.
ARE YOU SEEING MY SLIDES?
OKAY.
JUST YELL IF THAT'S NOT THE CASE
AT SOME POINT.
I CAN'T SEE EVERYTHING ON THE
SCREEN AT THE SAME TIME.
THANK YOU FOR THE INVITATION.
I'M SPEAKING ON BEHALF OF ALL
THESE ARE OF US, MYSELF, A
NEUROSCIENTIST WHO I LIKE TO SAY
ADAPTED, WALTER AND VINCENT, MO
IS A COMPUTER SCIENCE
SPECIALIZING IN A.I.
IN OTHER AUDIENCES PERHAPS NOT
THIS ONE THEY OFTEN WONDER WHAT
ON EARTH BROUGHT THE THREE OF
YOU TOGETHER?
DIVERSE BACKGROUNDS.
THE ANSWER IS OUR ENTHUSIASM FOR
A.I.
WE'VE BEEN WORKING TOGETHER
SINCE 2016, ALMOST A DECADE.
AND WHAT BROUGHT US TOGETHER,
AGAIN, WAS AT THAT TIME OUR
ENTHUSIASM FOR A.I.
THAT'S CUTE THESE DAYS BECAUSE
HALF THE WORLD WOULD SAY THEY
ARE AN A.I. ENTHUSIAST BUT MOST
PEOPLE DIDN'T KNOW WHAT A.I. WAS
AT THAT TIME.
YET VINCE DEDICATED HIS CAREER
TO A.I.
I AS A NEUROSCIENTIST HAVE BEEN
USING IT FOR A LONG TIME IN MY
WORK IN BRAIN IMAGING AND
POSTDOCTORAL WORK, INTERFACE,
PSYCHIATRIC DISEASE, AND WALTER
WRITING ABOUT IT FOR A WHILE.
WE WERE ALL REALLY EXCITED ABOUT
ALL OF THE POTENTIAL A.I. HAD TO
DO ESPECIALLY IN MEDICINE.
AND IN HELPING PEOPLE IN THOSE
TYPES OF DOMAINS.
WE ALSO REALIZED A.I. HAD
POTENTIAL TO DO TREMENDOUS HARM
IF NOT CAREFUL OR RESPONSIBLE.
NOW WE'RE SEEING LOTS OF HARMS
PLAY OUT, THEY ARE NOT
HYPOTHETICAL ANYMORE, THESE ARE
SOME EXAMPLES.
SO OUR GROUP HAS BEEN DEDICATED
TO MORAL A.I.
THE FIELD OF BUILDING A.I. THAT
CAN BEHAVE IN WAYS CONSISTENT
WITH MORAL VALUES, ALSO HELPING
HUMANS LEARN HOW TO USE A.I. IN
ETHICAL WAYS AND WE FEEL
STRONGLY ENOUGH THAT WE WROTE A
BOOK ON IT, HERE I'M SHOWING
YOU, FOR THIS GROUP WE WOULD
LOVE YOUR FEEDBACK ON THE BOOK.
A REASON I PUT IT UP TO MAKE
SURE YOU KNOW IN THE BOOK WE GO
OVER AT LEAST FIVE PIECES OF THE
PUZZLE WE NEED TO PURSUE
SIMULTANEOUSLY TO MAKE MORAL
A.I. A REALITY.
PUBLIC POLICY, TECHNICAL TOOLS,
EDUCATIONAL, MORAL A.I.,
STAKEHOLDER FEEDBACK
INFRASTRUCTURE.
WE THINK ALL OF THESE PIECES ARE
NECESSARY AND IMPORTANT BUT
TODAY GIVEN THE TIME AND FOR
THIS GROUP WE'RE GOING TO FOCUS
ON TELLING YOU ABOUT THE WORK
OUR GROUP IS WORKING ON FOR ONE
OF THESE PUZZLE PIECES,
TECHNICAL TOOLS.
HOW DO YOU BUILD TOOLS TO HELP
A.I. BEHAVE CONSISTENT WITH
MORAL VALUES? THERE ARE MANY
THINGS TO TRY.
BUT HERE IS ONE APPROACH WE'VE
BEEN WORKING ON WE HAD SOME
SUCCESS WITH, WE THINK SHOWS
PROMISE.
THE OVERALL IDEA WHICH MAY NOW
SEEM FAMILIAR SINCE PEOPLE ARE
USING A.I. IN MANY CASES IS THAT
WE ACT AN INDIVIDUAL PERSON,
PRESENT MANY MORAL SCENARIOS AND
ASK THEM TO MAKE JUDGMENTS ABOUT
WHAT'S RIGHT OR WRONG.
WE MAY CHOOSE THOSE CAREFULLY SO
THEY ARE MAXIMALLY INFORMATIVE,
WE USE THAT TO MAKE PREDICTIONS
ABOUT WHAT PERSON WOULD SAY IS
RIGHT OR WRONG AND FOR MANY
INDIVIDUAL PEOPLE AND GET
PREDICTIONS ABOUT WHAT EACH ONE
WOULD SAY IS RIGHT OR WRONG.
WE CAN USE MANY TYPES OF
STRATEGIES TO AGGREGATE INTO AN
A.I.
WE'LL HAPPY TO TALK ABOUT THOSE
BUT THERE ARE MANY OUT THERE.
AND SO WE CAN USE THAT
INTEGRATION IN A.I. TO SERVE AS
ETHICAL GUARD RAIL ON THE A.I.
BEHAVIOR AND CONSTRAINED WHAT
THE A.I. DOES AND JUDGMENT IT
MAKES.
AND SO WE CAN DO THIS WITH --
WE'VE BEEN MORE SUCCESSFUL THAN
ANTICIPATED FROM THE BEGINNING.
THERE ARE OTHER GROUPS WORKING
ON THIS TOO ESPECIALLY IN A
DATA-DRIVEN WAY.
ALL ARE FINDING LEAST IN SOME
SCENARIOS CAN PREDICT WITH 90%
ACCURACY, ENOUGH TO GIVE
OPTIMISM THIS IS A TOOL THAT
COULD BE USEFUL.
I ALLUDED TO THE FACT OTHER
GROUPS ARE WORKING ON THIS TOO.
I THINK THE REASON WE WERE
INVITED TO TALK THERE'S
SOMETHING THAT MAKES US UNIQUE
AMONG THOSE GROUPS.
I THINK WE'RE THE ONLY ONE
FOCUSED ON THIS.
THAT'S AT LEAST IN A A GOOD PAT
OF OUR WORK WE'RE INTERESTED IN
UNDERSTANDING WHY THEY SAY IT'S
RIGHT OR WRONG, FOR EACH
INDIVIDUAL WHAT FEATURES ARE
THEY PAYING ATTENTION TO?
HOW ARE THEY WEIGHING FEATURES
AGAINST EACH OTHER?
ARE THEY USING PRINCIPLES,
RULES, HOW ARE THEY WORKING THIS
OUT?
COLLECTIVELY THE MORAL MODEL.
WHAT IS THEIR MORAL MODEL TO
MAKE THEIR MORAL DECISION.
YOU MIGHT WONDER WHY EVEN BOTHER
DOING THIS?
WHY EVEN BOTHER WORRYING ABOUT A
MORAL MODEL AS OPPOSED TO
PREDICTION?
I'LL TELL YOU AT LEAST ONE
REASON IS ETHICAL.
WE FEEL IF YOU'RE GOING TO BE
APPLYING A.I. TO MORAL
SITUATIONS, ESPECIALLY LIFE OR
DEATH, YOU SHOULD BE ABLE TO
EXPLAIN HOW A.I. IS MAKING
DECISION SO PEOPLE CAN EVALUATE
WHETHER THEY AGREE.
IT ALSO SEEMS LIKE IF WE CONS
CAN
UNDERSTAND, WE'LL BE IN A BETTER
PLACE TO PREDICT WHEN IT WILL
MAKE MISTAKES AS OPPOSED TO
BLACK BOX MODEL WHERE YOU HAVE
NO IDEA EVEN FIT SEEMS ACCURATE.
YOU MIGHT WONDER DO WE NEED TO
KNOW AN INDIVIDUAL'S MORAL
MODEL? COULDN'T WE HAVE A MODEL
OF A GROUP OVERALL, AGGREGATE
MORAL MODEL?
HERE IS ONE REASON WHY WE THINK
HAVING INDIVIDUAL MORAL MODELS
WOULD BE USEFUL.
I TOLD YOU FIRST GENERATION
ASKED PEOPLE TO MAKE MORAL
JUDGMENTS AND WE USED THOSE TO
HELP TRAIN THE A.I. TO PREDICT
NEW MORAL JUDGMENTS.
SECOND GENERATION MODELS THAT
WE'RE WORKING ON WE'RE TAKING
THIS IN A NEW DIRECTION.
NOW WE'RE EXPLORING BENEFIT OF
WHAT HAPPENS WHEN A.I. TELLS YOU
WHAT MODEL IT THINKS YOU'RE
USING.
IN THE CONTEXT OF KIDNEY
EXCHANGES, IT MIGHT SAY, I THINK
YOU ARE WEIGHING HOW MANY
DEPENDENTS WHEN DECIDE DECIDINO
SHOULD GET AND HOW MUCH TIME ON
THE WAIT THAT SEEMS RIGHT.
DO YOU THINK THAT'S RIGHT?
FIRST STEP, YES OR NO,
TRADITIONAL WAY.
WE'RE WORKING ON ASKING FOR
DEEPER FEEDBACK, BECAUSE WE HAVE
THESE MORAL MODELS AND WE'RE
BEING ABLE TO SAY EXACTLY WHAT
WE THINK IT IS, WHAT FEATURES
YOU'RE PAYING ATTENTION TO, WHAT
RULES YOU'RE PAYING ATTENTION TO
CAN PROVIDE WAYS FOR THE USER TO
CHANGE THE MODEL DIRECTLY SO I'M
SHOWING EXAMPLE HERE, A CONCEPT,
AND EXAMPLE I SHOWED BEFORE,
IMAGINE WE PUT SLIDER BARS UP
THERE, INDIVIDUALIZATION, OKAY,
HERE IS HOW MUCH WE THINK YOU'RE
WEARING FEATURES, COULD YOU
SLIDE THE BARS YOURSELF AND SAY
THIS IS ACTUALLY MORE ACCURATELY
REFLECTING HOW I WANT TO MAKE MY
DECISION.
AND SO THE PROCESS WE'RE
EXPLORING AND WORKING ON, OKAY,
MODEL TAKES THAT FEEDBACK, ASKS
MORE SCENARIOS, TAKES YOUR
CHOICES AND COMPARES TO THE
MODEL THAT YOU SAID YOU WANTED
TO USE, AND TELLS YOU AGAIN WHAT
KIND OF MODEL IT THINKS YOU'RE
USING, AGAIN YOU GIVE IT
FEEDBACK.
THE IDEA IS YOU CAN GO THROUGH
ITERATIVE COLLABORATIVE CYCLE,
UNTIL EVENTUALLY USER SAYS YES,
NOW I THINK YOU'VE GOT THIS
RIGHT.
I THINK THIS MODEL UNDERSTANDS
HOW I'M MAKING MY MORAL
JUDGMENT, MY MORAL A.I.,
REPRESENT WHAT IS I THINK.
MULTIPLE REASONS WE'RE EXPLORING
THIS DEEP A.I. HUMAN TEAMING
APPROACH, AND THE FIRST IS THAT
WE THINK IT WILL BE A MORE
EFFICIENT WAY TO TRAIN UP A.I.
RIGHT NOW DATA DRIVEN A.I.
REQUIRES TREMENDOUS AMOUNT OF
DATA.
THIS MIGHT BE A WAY TO CUT DOWN
ON AMOUNT OF DATA WE NEED TO
TRAIN UP A MODEL TO BECOME
ACCURATE.
WE PREDICT THIS SHOULD LEAD TO
INCREASED ACCURACY, AND THAT
BECAUSE YOU'RE BEING ABLE TO
TAKE ADVANTAGE OF WHAT PEOPLE
SAY THEY ARE DOING AND WANT TO
DO IN THEIR MORAL JUDGMENT, THAT
WE CAN ACTUALLY USE THAT
INFORMATION TO LEAD TO MORE
ACCURATE MODELS.
MOST IMPORTANTLY PERHAPS WE
THINK THIS IS REALLY IMPORTANT
FOR USER TRUST, IF WE WANT TO
HAVE THESE A.I.S STAND IN FOR
PEOPLE THEY HAVE TO TRUST THAT
THIS THING IS REPRESENTING THEM
AND WE THINK THIS ITERATIVE
COLLABORATIVE APPROACH MIGHT BE
A GOOD WAY FOR DOING THAT.
IF WE'RE RIGHT THAT THIS
APPROACH WILL INTRODUCE THESE
THINGS IT OPENS OPPORTUNITIES
FOR THINGS.
I'M GOING TO MENTION ONE OF
THOSE WE'VE BEEN WORKING ON, ONE
WE CALL MORAL GPS.
THE SAME WAY GEOGRAPHIC TELLS
YOU STEPS TO TAKE FOR A
GEOGRAPHIC LOCATION, THE MORAL
COULD PROVIDE YOU WITH STEPS TO
TAKE TO GET TO MORAL OR ETHICAL
DESTINATION YOU CHOOSE.
WE CONCEIVE THAT YOU TRAIN UP
THESE GPSs OVER TIME WHEN
YOU'RE RESTED, CAN CORRECT
MISTAKES AND THINK ABOUT IT.
SO THESE ARE AVAILABLE FOR YOU
IN TIMES UNCERTAIN, STRESSFUL,
TIME CONSTRAINED LIKE A WHEN
KIDNEY TRANSPLANT SURGEON GETS A
CALL IN THE MIDDLE OF THE NIGHT,
TIRED, HAVE TO DECIDE IN 20
MINUTES WHETHER TO ACCEPT A
KIDNEY.
MORAL GPS COULD TELL THEM WHAT
THEIR CALM AND RESTED SELF WOULD
THINK IS THE BEST COURSE OF
ACTION AND GIVE A SENSE OF IF
THEY ARE PLANNING ON MAKING
DECISION WHETHER THAT DECISION
IS IN LINE WITH WHAT THEY SAID
THEY WANTED TO DO.
IF NOT, WHY?
SO THAT SOUNDS ABSTRACT BUT I
PROMISE YOU WE'RE WORKING ON IT
IN CONCRETE APPLICATIONS, THESE
ARE SOME OF THE APPLICATIONS
WE'RE WORKING ON.
I MENTIONED KIDNEY TRANSPLANT
ALLOCATION, THAT'S ONE OF THE
MAIN ONES WE'VE WORKED ON.
WE'RE EXTENDING THAT INTO NEW
CONCEPTS, ENDS OF LIFE
DECISIONS, WALTER IS WORKING ON
THIS, CAN YOU TRAIN A.I. BEFORE
DEMENTIA TO STAND IN FOR YOU
AFTER YOU HAVE THE DEMENTIA, TO
SAY WHAT KIND OF END OF LIFE
DECISION YOU WOULD HAVE WHEN IT
COMES UNDER DIFFERENT
CIRCUMSTANCES.
WE'VE BEEN CONTACTED BY
COMPANIES INTERESTED IN USING
THIS APPROACH TO MAKE TRIAGE
DECISIONS, MEDICAL TRIAGE
DECISIONS IN THE FIELD OF THE
MILITARY.
THESE ARE SOME OF THE IDEAS AND
TYPE OF THING WE'RE WORKING ON.
I WANT TO OPEN UP TO QUESTIONS,
BUT I WANT TO CALL ATTENTION TO
THINGS WORTH DISCUSSING BEFORE
WE GO INTO THE QUESTIONS.
FIRST IS THE MOST FUNDAMENTAL
QUESTION, ARE WE TRYING TO
CREATE YOUR DIGITAL MORAL TWIN?
I'LL SUBMIT THAT CONCEPT OR
QUESTION WASN'T ON THE RADAR
BEFORE NITA INVITED US.
WE STARTED THINKING BIT.
WELL, DEPENDING ON YOUR DEAF
NATION -- DEFINITION MAYBE WE
ARE.
ONE THING YOU MIGHT WONDER WHEN
THINKING ABOUT THAT QUESTION, SO
FAR WE'VE ONLY DESCRIBED HOW
WE'RE APPLYING THIS METHODOLOGY
TO SPECIFIC CIRCUMSTANCES, SOME
NOTIONS OF DIGITAL TWINS WOULD
EXPECT THE DIGITAL VERSION OF
YOU TO MIRROR YOU IN MANY
CONTEXT, NOT JUST ONE.
TOWARDS THAT END I WANT TO CALL
OUT THAT IN THE SAME WAY THAT
NEUROSCIENCE USES MODEL SYSTEMS
AND TESTS TO UNDERSTAND THE
BRAIN AT LARGE, TO MAKE
HYPOTHESES AT LARGE, HOW THE
BRAIN WORKS, OFTEN QUITE
CORRECT, AT LEAST ONE OF OUR
IDEAS IS BY STUDYING HOW CAN
TRAIN VERY SPECIFIC CONTAINED
CONTEXT THAT WE EVENTUALLY
UNDERSTAND VERY WELL BUT WILL
HELP US GENERATE HYPOTHESES AND
THEORIES HOW MORAL REASONING
WORKS IN GENERAL THAT WE CAN
EVENTUALLY USE TO BUILD A.I.s
TO REPRESENT MORALITIES WHETHER
INDIVIDUAL OR GROUP MORALITIES.
WE'RE NOT THE ONLY ONES WHO
THINK THAT.
I'M PUTTING UP THE PAPER FROM
COMPUTATIONAL ETHICS, WE'RE ALL
CO-AUTHORS WITH SOME OTHERS IN
THE FIELD, THAT'S WHAT THIS
FIELD IS ABOUT.
DESCRIBING THIS IDEA IF WE CAN
UNDERSTAND HOW WE MAKE MORAL
JUDGMENT FROM INDIVIDUAL CONTEXT
CAN HELP US THEN MAKE MORE
GENERAL MODELS THAT COULD BE
INVOLVED IN A.I.
OR GUIDE A.I.
THE OTHER THING I WANTED TO
MENTION IS ALTHOUGH WE HAVE NOT
INCORPORATED DATA, THERE'S
NOTHING STOPPING US OTHER THAN
FUNDING.
THERE'S SPECIFIC ASPECT WHERE IS
NEUROSCIENCE DATA COULD BE
INFORMATIVE WITH EEG, ONE OF THE
EASIEST WAY TO INCORPORATE THIS.
AND I THINK EVEN IF WE DON'T DO
THIS AS ACADEMICS, I THINK
COMPANIES WILL BE STARTING TO
USE EEG DATA FOR THESE TYPES OF
APPLICATIONS.
ALL THESE THINGS SUPPORT THIS
STATEMENT.
I THINK IT IS REALISTIC TO
ENVISION A FUTURE WHERE WE'RE
LEARNING PEOPLE'S GENERAL MORAL
MODELS, IN OTHER WORDS WHAT
VALUES AND PRINCIPLES THEY CARE
ABOUT AND HOW THEY APPLY THEM
SOMEWHAT SUCCESSFULLY PERHAPS
WITH THE USE OF BRAIN DATA.
I DON'T KNOW HOW FAR THAT IS BUT
IT'S A PLAUSIBLE THING AND
SOMETHING THAT SOME COMPANIES
WILL BE COMING INCREASINGLY
INTERESTED IN RAISING ETHICAL
OPPORTUNITIES AND CONCERNS.
MANY WILL HAVE PLENTY TO SAY BUT
TO GET THE CONVERSATION STARTED
WE WANTED TO THROW OUT A COUPLE.
IS IT APPROPRIATE TO HAVE A.I.
MAKE DECISIONS ABOUT HUMAN LIFE
IN THE FIRST PLACE?
DO WE WANT TO HAVE OR DO WE
REALLY WANT TO BASE A.I.
BEHAVIOR ON HUMAN MORAL MODELS
GIVEN WE KNOW HUMAN MORAL MODELS
ARE BIASED, IMPERFECT AND ILL
INFORMED, DOES IT DESERVE
ETHICAL PROTECTION, IS THERE
SOMETHING UNIQUE THAT MAKES US
"US," ABOUT OUR MORAL MODELS,
DIFFERENT THAN, SAY, PREFERENCES
FOR WHAT VIDEO TO WATCH NEXT,
THAT DESERVES SPECIAL
PROTECTION.
SO WE LOOK FORWARD TO HEARING
YOUR QUESTIONS, AND ALL YOUR
COMMENTS.
THANK YOU VERY MUCH.
>> THAT WAS TERRIFIC.
THANK YOU, JANA.
THANKS ALSO TO VINCE AND WALTER
FOR BEING HERE.
ONE QUESTION FROM JEN AND WE'LL
HAVE A BRIEF BREAK TO GIVE
EVERYTHING A CHANCE FOR A
BIO-BREAK TO COME BACK AND HAVE
A FULL CONVERSATION.
WE'LL START WITH QUESTIONS FOR
VINCE AND WALTER AND JANA AND
MOVE INTO A BROADER DISCUSSION
ABOUT TOPICS AND NEXT STEPS TO
TAKE AS NEWG TOGETHER.
>> A GREAT PRESENTATION.
I ALWAYS LEARN A LOT EVERY TIME
I SEE YOU TALK.
MY QUESTION IS MORE PRACTICAL.
WHEN YOU TALK ABOUT YOUR MODEL
OF BUILDING YOUR A.I. MODEL AND
HAVING SLIDERS TO CHANGE HOW IT
MAKES A DECISION, HAVE YOU
THOUGHT ABOUT THE CONCEPT OF
WHERE YOU HAVE KIND OF A
STANDING CLINICAL TEAM WHERE
THEY MIGHT WORK TOGETHER, YOU
HAVE A TEAM BUILDING SLIDERS BUT
FOR EVERY TIME THEY APPLY IT
THERE'S A NEW PATIENT THAT MIGHT
HAVE DIFFERENT DECISION
CRITERIA?
HAVE YOU THOUGHT ABOUT A MODEL
LIKE THAT, WHERE YOU CONSTANTLY
HAVE A PERSON OR DIFFERENT
PATIENT COMING IN AND MAKING A
DIFFERENT DECISION?
>> GREAT QUESTION, I'LL START
AND LET VINCE AND WALTER JUMP
IN, PARTICULARLY VINCE SINCE
HE'S OUR -- GOOD AT AGGREGATING
THESE THINGS.
SO, WHAT I HEARD YOU DESCRIBE IS
A MODEL A TEAM IS WORKING ON,
WHAT HAPPENS IF YOU HAVE AN
INDIVIDUAL CHANGING, NEW
INDIVIDUAL OR INDIVIDUAL
CHANGING THEIR MIND FOR THAT
TEAM REPRESENTATION, DID I
UNDERSTAND CORRECTLY?
>> YES, CORRECT, BUT ALSO
WHETHER THE PATIENT NEEDS TO
HELP MAKE THAT DECISION, LIKE A
HUMAN LIFE DECISION, A TEAM
MAKING A DECISION THIS IS OUR
MODEL.
HOWEVER, I HAVE A NEW PATIENT
COMING IN, THERE MIGHT BE
DIFFERENT CULTURALLY OR SOCIALLY
OR ALL OF THESE OTHER ASPECTS
THAT MIGHT PLAY INTO THE
DECISION MAKING.
>> TERRIFIC.
MY VISION IS EVERYONE SHOULD
HAVE THEIR OWN.
IN THAT CONTEXT THE PATIENT
SHOULD HAVE THEIR OWN MORAL A.I.
MODEL THAT'S TRAINED UP THAT CAN
REPRESENT THEM IN A COLLECTIVE
DECISION.
THE PARTICIPANTS IN THE TEAM,
SAY THE CLINICAL TEAM, WOULD
HAVE THEIR A.I. THAT CONTRIBUTES
TO THE DECISION, AND THEN THAT'S
THE FIRST LAYER.
SO YOU CAN ALWAYS CHANGE YOUR
MODEL.
IT'S CONSTANTLY ASKING QUESTIONS
AND UPDATING, YOU CAN CHANGE
YOUR MIND.
THE IDEA THE WAY I THINK, THEN
YOU HAVE A SECOND LAYER WHERE
YOU AGGREGATE, WITH MANY WAYS TO
PRIORITIZE THE PATIENT,
PRIORITIZE CLINICAL EXPERTISE,
DIFFERENT WAYS TO HANDLE IT.
BUT SO IN THAT WAY, TO ME, IT
SEEMS CONSIST WENT WHAT YOU'RE
SAYING.
VINCE, DO YOU WANT TO -- WHAT DO
YOU THINK ABOUT THAT?
I KNOW HE WAS THERE SOMEPLACE.
IF NOT, I'LL CHECK MY E-MAIL TO
SEE IF HE HAD A TECHNICAL
PROBLEM AND HE WILL BE ABLE TO
ANSWER AFTER THE BREAK.
DID THAT ANSWER YOUR QUESTION,
JEN?
>> VINCENT'S HERE, JANA.
WE JUST CAN'T HEAR HIM.
>> CAN YOU HEAR ME NOW?
OKAY, GOOD.
WRONG MIC.
I THINK, AGAIN, WE'VE BEEN
THINKING MORE ABOUT REPRESENTING
ONE PERSON, BUT COULD BE
INTERESTING IF WE HAVE A RICH
SET OF DECISIONS, THAT WE CAN'T
REALLY PREDICT EVERY ONE OF
THOSE DECISIONS, MAYBE THERE'S
CONTEXT FROM THE MEDICAL TEAM
THAT NEEDS TO BE TAKEN INTO
ACCOUNT ABOUT WHAT'S FEASIBLE
AND WHAT ISN'T.
IN PRINCIPLE THERE ARE DIFFERENT
THINGS THAT YOU COULD DO, YOU
COULD TRY TO PREDICT IN VERY
RICH SETTINGS WITH LOTS OF
FEATURES ABOUT WHAT'S GOING ON,
WHAT THE PATIENT WOULD HAVE
WANTED, AS JANA SAID ALSO, MAYBE
IN SOME CASES YOU WANT TO TAKE
THE TEAM'S PREFERENCES INTO
ACCOUNT, ESPECIALLY IF IT
INVOLVES OTHER PATIENTS AT THE
SAME TIME AS WELL BECAUSE
THERE'S LIMITED RESOURCES AND
WHILE THE PATIENT MIGHT WANT ALL
THE RESOURCES, THAT MAY NOT BE
OKAY WITH THE MEDICAL TEAM.
I THINK THOSE ARE INTERESTING
QUESTIONS, DEPENDS ON WHAT THE
SPECIFIC SCENARIO IS AND WHOSE
REFERENCES AND VALUES ARE BEING
TRADED OFF, IT COULD ALSO BE
MEANWHILE THE MEDICAL TEAM IS
GUIDED BY ITS OWN A.I. WHICH
THEN TAKES THE PATIENT'S
PREFERENCES, MAYBE MULTIPLE
PATIENT PREFERENCES AS INPUT AS
FEATURES.
YEAH, MANY WAYS YOU COULD TRY TO
SET THAT UP.
BUT IT'S A GOOD QUESTION.
>> ALL RIGHT.
LET ME PAUSE.
WE'LL TAKE A BRIEF BREAK, TO
3:15, AN 8-MINUTE BREAK AND COME
BACK TOGETHER TO DO SOME DEEPER
DIVES INTO BOTH THIS
PRESENTATION AND THE OTHER ONE.
TAKE A QUICK BREAK.
SEE YOU ALL AT 3:15.
WITH VINCE AND JANA AND
WALTER, FEEL FREE TO RAISE YOUR
HAND, THEN A BROADER
CONVERSATION TO THINK ABOUT HOW
CAN WE INTEGRATE ACROSS ISSUES
AND DIVE DOWN DEEPLY.
I'LL START WITH JANA, YOU SAID
YOU HADN'T BEEN THINKING ABOUT
THE DIGITAL TWINS WHEN I SAID
THIS IS THE PERFECT DIGITAL TWIN
CASE STUDY.
AND I'M GLAD YOU CAME AROUND TO
SEEING IT AS POTENTIAL DIGITAL
TWIN MODEL BUT IN THINKING ABOUT
IT, I'M CURIOUS, YOU MENTIONED
THE WAYS WHICH PEOPLE CUSTOMIZE
IT.
LAST MEETING WAS BRAIN
FOUNDATIONAL MODELS, ONE AREA OF
INTEREST TO ME IS THINKING ABOUT
MODEL DESIGN FOR ETHICS IN THIS
PARTICULAR SPACE.
IN PARTICULAR ENTROPIC APPROACH,
BASE LAYER AND GUARDIAN LAYER,
GUARDIAN LAYER CUSTOMIZED TO
HAVE ETHICAL DUTIES TO THE USER.
I WONDER IF YOU COULD TALK ABOUT
TWO RELATED THINGS, I SEE YOU
NODDING, SEEMS LIKE YOU'RE
THINKING ABOUT THIS, OR YOU'VE
BEEN THINKING ABOUT THIS.
COULD THE MODEL BE DESIGNED IN
WAYS TO EMBED ETHICAL DUTIES TO
THE USER AND THEN A SECOND
QUESTION ON THAT IS, AS YOU
TALKED ABOUT CUSTOMIZATION COULD
SOMEBODY CUSTOMIZE THEIR MODEL
TO ACT ON THEIR BEHALF AT ODDS
WITH WHAT THEIR ETHICAL DECISION
MAKING IS BUT ASPIRATIONAL
DECISION MAKING MIGHT BE AND HOW
MIGHT WE THINK ABOUT THAT?
ARE YOU ABLE TO UNMUTE, JANA?
>> YES.
>> GREAT.
>> GREAT QUESTIONS.
VINCE, WHY DON'T YOU START OFF
AND I'LL JUMP IN.
YOU'LL BE MORE EFFICIENT
ANSWERING SOME OF THOSE
QUESTIONS.
>> THE SECOND ONE WE'VE TALKED
ABOUT, THIS IDEA OF, WELL, JUST
PREDICTING WHAT MY JUDGMENTS
WOULD BE, MAYBE NOT WHAT I WANT.
I WANT MY IDEAL JUDGMENTS TO BE
PRO -- PREDICTIVE.
THERE'S WAYS, ONE IS WHAT JANA
TALKED ABOUT GOING BACK TO THE
PERSON AND LET'S SAY FOR EXAMPLE
COULD BE THE PERSON MAKES
DECISIONS MAYBE NOT ABOUT THEIR
OWN LIFE AS A PATIENT BUT IN
OTHER CONTEXTS IN A WAY THAT'S
RACIST, EVEN THOUGH THE PERSON
DOESN'T WANT TO BE RACIST, IN
PRINCIPLE YOU WOULD OF COULD
POINT THIS OUT SEEMS LIKE YOU'RE
USING RACE AS A FEATURE, AND
WORK TOWARDS A BETTER PLACE.
FIRST THING YOU SAID ABOUT GUARD
RAILS IS INTERESTING.
THAT COULD BE APPLIED IN A
SIMILAR WAY.
MAYBE SAID OF GOING BACK TO THE
USER DECIDE THE MODEL SHOULD NOT
MAKE DECISIONS IN A RACIST WAY,
MORE DIFFICULT QUESTIONS TO
ENGAGE WITH BUT COLLECTIVELY WE
SOMEHOW DECIDED ONE PARTICULAR
FEATURE SUCH AS RACE SHOULD NOT
MATTER AND TRY TO GET INDIVIDUAL
PEOPLE'S MODELS BUT CORRECTED IN
THIS WAY, RIGHT?
MAYBE FROM THE DATA WE HAVE, WE
REALIZE THIS PERSON WOULD MAKE
DECISIONS IN A RACIST MANNER.
ONE THING WOULD BE TO
COMMUNICATE BACK WITH THEM BUT
IN ANOTHER CONTEXT MAYBE WE
CAN'T.
AND IN THAT CASE MIGHT SAY
REGARDLESS OF WHETHER THE USER
MEANT TO DO THAT WE'RE GOING TO
ADJUST IN A WAY THAT THAT ASPECT
IS TAKEN OUT WHILE STAYING CLOSE
OTHERWISE TO WHAT THE PERSON
WOVE WANTED COULD BE ONE
INTERPRETATION OF WHAT YOU SAID.
I DON'T KNOW IF THAT WAS IN LINE
WITH WHAT YOU HAD IN MIND.
>> I'M GOING TO OPEN IT UP,
THERE ARE OTHER QUESTIONS.
I WAS THINKING SOMETHING
DIFFERENT, NOT EMBEDDING OR
ENCODING WHAT A PREFERRED SET OF
NORMATIVE DECISIONS WOULD BE BY
THE DESIGNER BUT INSTEAD
ENSURING -- IT'S A TRICKY AREA
TO MAKE SURE MODELS ARE
FAITHFULLY APPLYING WHATEVER A
PERSON'S MORAL DECISION MAKING
WOULD BE SO TO HAVE ALIGNMENT
BETWEEN THE MODEL WHICH COULD
STAND IN THE PLACE OF DECISION
MAKING FOR AN INDIVIDUAL AND THE
INDIVIDUAL, YOU COULD HAVE A
CONSTITUTIONAL LAYER ACTING LIKE
A FIDUCIARY, RATHER THAN IT
BEING NORMATIVE JUDGMENTS THAT
WOULD OVERRIDE THE USERS.
WE CAN TALK MORE ABOUT THAT.
I SEE A LOT OF QUESTIONS, OPEN
TO EVERYONE.
LET ME LET WALTER JUMP IN AND
THEN THE QUESTIONS THAT ARE
FOLLOWING SYD, KAREN, JOHN, ARE
OPEN TO ALL OF OUR PRESENTERS.
WALTER?
>> ONE OF THE INTERESTING CASES
OF THE DEVICE POTENTIALLY
OVERRIDING WHAT THE PERSON
THEMSELVES SAYS IS THE CASE OF
DEMENTIA, BECAUSE YOU GATHERED
DATA ABOUT THE PERSON, WHAT THE
PERSON WOULD WANT IF THEY
UNDERSTOOD THEIR SITUATION BUT
NOW THEIR DEMENTIA IS SO FAR
ADVANCED THEY DON'T REALLY
UNDERSTAND WHAT'S GOING ON.
MYSELF, I WOULD RATHER HAVE THE
MACHINE SAY WHAT I WOULD WANT IF
I DID UNDERSTAND THAN HAVE MY
DOCTOR AND MY FAMILY FOLLOW WHAT
I SAY I WANT WHEN I DON'T REALLY
UNDERSTAND WHAT'S GOING ON.
AND NOT EVERYBODY IS GOING TO
FEEL THAT WAY BUT ENOUGH PEOPLE
WILL THAT THAT WOULD BE A CASE
WHERE WE MIGHT ALLOW THE MACHINE
TO OVERRIDE WHAT THE PERSON AT
THE MOMENT SAYS THEY WANT.
>> GREAT.
THANK YOU.
OKAY.
SO LET ME TURN TO SYD.
NOW LET ME MAKE SURE ARLEEN AND
VIKTOR ARE ALSO AVAILABLE AND
READY TO JUMP IN.
ARLEEN, IF YOU COULD REJOIN US
BY VIDEO AND EVERYBODY REJOIN BY
VIDEO.
IF YOU'RE HAVING DIFFICULTIES
WITH BEING ABLE TO UNMUTE PLEASE
DON'T HESITATE TO LET US KNOW IN
THE CHAT.
SYD, PLEASE.
>> THANK YOU FOR THAT.
I WANTED TO CONTINUE ON ABOUT
THIS NOTION OF CREATING A
PERSONALIZED DIGITAL AVATAR
MODEL TO MAKE DECISIONS FOR YOU
AND I'M A CLINICAL ETHICS
CONSULTANT, I WORK IN A
HOSPITAL.
THE QUESTIONS WE'RE CONFRONTED
WITH ARE MOSTLY REALLY NOT MORAL
QUESTIONS.
I MEAN, THEY ARE QUESTIONS ABOUT
WHAT PEOPLE WANT, BUT THEY ARE
OFTEN MADE MORE DIFFICULT
BECAUSE PEOPLE REALLY WANT TO
THINK ABOUT THE HORRIBLE THINGS
THAT MIGHT HAPPEN TO THEM IF
THEY GET SICK OR IF THEY GET
OLDER.
PEOPLE TEND TO BE VAGUE EVEN
WHEN FILL OUT THINGS LIKE
ADVANCED DIRECTIVES AND
PHYSICIAN ORDERS FOR TREATMENT
AND SO ON.
SO I'M SKEPTICAL THAT SOMEONE
COULD FULLY TRAIN AN A.I. MODEL
TO ADEQUATELY MAKE DECISIONS
THAT WOULD REQUIRE A TREMENDOUS
AMOUNT OF INFERENCE, AND
CONSIDERATION OF CURRENT
CIRCUMSTANCES THAT THIS PERSON
NEVER ANTICIPATED IN THE PAST.
SO, I'M CURIOUS ABOUT -- I GUESS
YOUR THOUGHTS ABOUT HOW THAT
WOULD ACTUALLY WORK AND WHY
SOMEONE WOULD WANT THIS
INFERENCE MACHINE TO MAKE
INFERENCES AS OPPOSED TO THEIR
SPOUSE OR THEIR OTHER FAMILY
MEMBERS WHO ACTUALLY CARE ABOUT
THEM TO MAKE THOSE CHOICES FOR
THEM.
>> MAYBE I'LL START.
I KNOW WALTER IN PARTICULAR HAS
A LOT TO SAY ABOUT THIS AS WELL.
I THINK PART OF THE REASON THAT
WE ARE FIRST -- OUR FIRST TEST
CASE IN KIDNEY ALLOCATION, A.I.
IS ALREADY BEING USED, REALLY
HELPING TO GET MORE PEOPLE
ORGANS WHEN THEY BECOME
AVAILABLE BUT THINGS TO HAVE CAN
BE CONSIDERED ARE PRACTICAL.
ENDS UP HAVING ETHICAL
CONSIDERATIONS BUT HOW CLOSE IS
THE KIDNEY?
OR JUST PRACTICAL
CONSIDERATIONS, MAYBE LEGAL
CONSIDERATIONS OR SOMETHING.
SO THE FIRST THING I WANT TO SAY
IS THAT PART OF THE VISION OR
PART OF WHY WE DO IT THERE IS TO
SEE HOW CAN WE INCORPORATE
ETHICAL CONSIDERATIONS, CAN YOU
EMBED IT IN DECISIONS THAT HAVE
TO TAKE DIFFERENT THINGS INTO
ACCOUNT INCLUDING THINGS WE DO
NOT THINK OF AS RELEVANT.
THAT DOESN'T SEEM -- YOUR
CONCERNS DON'T SEEM OUT OF THE
ELM
EL REALM WE'RE WORKING ON.
WHAT SCENARIOS TO ASK ABOUT, FOR
ME I THOUGHT IT WAS IMPORTANT TO
START WITH A SINGLE TEST CASE AS
OPPOSED TO FIGURING OUT HOW
PEOPLE MAKE ETHICAL DECISIONS IN
EVERY POSSIBLE SITUATION.
AND WE CAN TELL YOU APPROACHES
WE'VE USED TO FIGURE OUT, WE CAN
TALK TO CLINICIANS, TO PATIENTS,
TO INDIVIDUAL PEOPLE TO GET IDEA
WHAT KINDS OF FEATURES WILL
IMPACT YOUR DECISION.
YOU SAID THESE THINGS PEOPLE
DON'T WANT TO THINK ABOUT.
WE CAN FIGURE OUT WHAT THOSE
FEATURES ARE AND PRESENT WITH
SCENARIOS, THAT MAKES US HAVE
THAT INFORMATION INCLUDED.
IT DOESN'T SEEM TO ME LIKE THE
APPROACH IS INCAPABLE MUCH
HANDLING THE THINGS YOU'RE
CONCERNED ABOUT OTHER THAN HOW
COULD YOU POSSIBLY GENERALIZE
THAT, AND THEN THAT GOES BACK TO
AT LEAST TO ME A PROBLEM IN ALL
TYPES OF UNDERSTANDING ANYTHING,
AND THE HOPE IS THAT IF WE
UNDERSTAND IN A MODEL SYSTEM WE
CAN INCREMENTALLY HAVE THEORIES
TO ENCOMPASS EVERYTHING MORE
GENERAL.
>> I'LL JUST COMMENT ON THE --
WHY NOT HAND OVER TO THE SPOUSE,
I THINK THERE ARE A NUMBER OF
REASONS ON STUDIES DONE WHEN
SOMEONE NAMES A SURROGATE TO
MAKE A JUDGMENT FOR THEM, A
NUMBER OF STUDIES HAVE BEEN
DONE, NONE HAVE FOUND THEY MAKE
LESS THAN ONE OUT OF THREE
MISTAKES, SOMETIMES MORE THAN
THAT.
SO, THEY ARE NOT VERY ACCURATE.
THERE ARE A NUMBER OF REASONS.
SPOUSES OFTEN DIDN'T TALK ABOUT
IT IN DEPTH.
THEY'VE GOT A LOT OF
SELF-INTEREST INVOLVED.
AND SO ON.
WHEREAS THE DEVICES WE'VE
ALREADY ACHIEVED, YOU KNOW, ONLY
ONE MISTAKE OUT OF TEN SO 90%
ACCURACY, WHERE THEY ARE GETTING
65% ACCURACY.
BUT THE OTHER -- IN PREDICTING
PATIENT PREFERENCES.
BUT THE OTHER PROBLEM IS THE
SPOUSE OFTEN SUFFERS TREMENDOUS
GUILT AFTERWARDS.
WE'RE TALKING PTSD SYMPTOMS IN
OVER 50% OF THE CASES WHERE YOU
HAVE TO MAKE LIFE AND DEATH
DECISION FOR A LOVED ONE.
BY HAVING DEVICE COME IN, AND
CONFIRM, YES, THAT'S WHAT THEY
WOULD WANT, CAN MAKE THEM FEEL A
LOT BETTER.
SOMETIMES THEY DON'T EVEN WANT
TO MAKE THE DECISION BUT THEY
HAVE TO BECAUSE THEY ARE A
SURROGATE.
AND SO THEY ARE GLAD TO HAND IT
OVER.
WE INTERVIEWED A NUMBER OF
PEOPLE AND FOUND OVER 50% WOULD
WANT TO SEEK HELP FROM AN
AUTOMATED DIGITAL TWIN IF YOU
WANT TO CALL IT THAT, OVER 50%
WOULD WANT TO USE THAT IF THEY
WERE A SURROGATE, AS LONG AS THE
DIGITAL TWIN WAS 90% ACCURATE OR
MORE, OBVIOUSLY IF IT'S NOT
50/50 FLIP A COIN BUT IF IT
WORKS PEOPLE SEEM TO BE HAPPY TO
HAND OVER THE DECISION AND HAVE
IT USED FOR THEMSELVES.
>> I WANT TO ADD THAT'S A
SCENARIO WHERE YOU'RE LIKELY TO
BE ABLE TO GET INPUT FROM A
FAMILY MEMBER.
THAT IDEA IS A.I. IS BEING USED
IN MEDICAL DOMAIN IN MANY
SITUATIONS WHERE YOU WON'T GET
INPUT.
DECISIONS, TRIAGE DECISIONS WILL
BE MADE WITHOUT THE PATIENT'S
INPUT SO THE IDEA IS CAN WE
BUILD THE A.I. IN SUCH A WAY IT
ACTUALLY CAN TAKE MORE INPUT,
CAN REPRESENT MORE THAN IF YOU
DIDN'T HAVE INPUT AT ALL.
SO DID THAT MAKE SENSE?
>> LET ME OPEN TO THE NEXT
QUESTION.
WE HAVE A BIG QUEUE OF QUESTIONS
NOW, WHICH IS TERRIFIC.
AS PEOPLE START TO ASK
QUESTIONS, I WOULD REALLY
ENCOURAGE US TO THINK ABOUT WHAT
MIGHT WE DO IN NEWG AS A NEXT
STEP IN THINKING ABOUT BOTH
CONVERGENCE OF DIGITAL TWINS AS
WELL AS BRAIN FOUNDATION MODELS
WHICH WE HAD IN PREVIOUS
MEETING, AND THINK ABOUT A
PATHWAY FORWARD THAT WOULD BE
USEFUL.
KAREN?
>> I WASN'T READY BUT I'LL --
>> YOU DON'T HAVE TO.
IT WAS TO ENCOURAGE EVERYBODY TO
THINK ABOUT FRAMING THAT AS
WELL.
>> GREAT ENCOURAGEMENT.
WALTER, YOU MENTIONED THIS, AND
JANA, THE LAST TALK ALWAYS GETS
THE MOST QUESTIONS.
YOU TALKED ABOUT OVER 50% OF
FAMILIES SAID THEY WANTED THIS,
WALTER, AND YOU'RE TALKING ABOUT
WHO MIGHT BE THE DESIRABLE
CANDIDATE IN CONTEXT.
CAN YOU SHARE MORE, APOLOGIES
BECAUSE I SHOULD HAVE READ YOUR
PAPERS, WHO DOES WANT THIS?
IN WHAT CONTEXT DO THEY WANT IT?
OF THE PEOPLE YOU ASKED, WHERE
ARE THEY FROM?
ARE THEY YOUR STUDENTS, TYPICAL
STUDENT POPULATION, LIKE
ACTUALLY FAMILIES IN THE
HOSPITAL, OR JUST AMERICANS,
KIND OF CURIOUS ABOUT WHO WANTS
THIS, HOW DO YOU KNOW THAT?
>> SURVEY RESULTS WERE BASED ON
REPRESENTATIVE SAMPLE OF 900
AMERICANS, ALL AGED 60 OR OVER.
BECAUSE WE THOUGHT THAT WAS THE
GROUP THAT WOULD BE MOST
RELEVANT TO.
AND THEN WE ASKED THEM, WELL,
YOU KNOW, IF THE DEVICE WERE
ACCURATE, ARE 80% OF THE TIME
WOULD YOU WANT TO USE IT, 90%,
95% OF THE TIME WOULD YOU WANT
TO USE IT?
WE IN A FOLLOW-UP STUDY
MANIPULATED WHAT THEY KNOW ABOUT
THE SITUATION, THAT PEOPLE WHO
ACT AS SURROGATES OFTEN HAVE
PTSD SYMPTOMS, WE WOULD CHANGE
THAT KNOWLEDGE AND WE WOULD ALSO
CHANGE THEIR KNOWLEDGE OF HOW
ACCURATE SURROGATES ARE.
SURROGATES ARE NOT SUPPOSED TO
TELL YOU WHAT THEY THINK THE
RIGHT THING TO DO IS.
THEY ARE SUPPOSED TO BE
PREDICTING WHAT THE PATIENT
WOULD WANT.
AND SO WE ASKED HOW GOOD DO YOU
THINK SURROGATES ARE AT THAT?
AND SO IT'S MUCH MORE COMPLEX
RESULTS THAT I'D BE HAPPY TO
SHARE IN DETAIL LATER BUT THAT'S
THE SAMPLE, 900 REPRESENTATIVES
SAMPLE OF THE U.S.
>> I SHOULD HAVE BEEN CLEAR,
WHEN YOU TALK ABOUT WHEN I SAID
WHAT THEY WANT, AND YOU'RE
TALKING ABOUT DEVICE ACCURACY,
ACCURATE IN WHAT DIMENSION,
MORAL DIMENSION?
THE CONSTELLATION, HOW ARE YOU
DEFINING ACCURATE?
ACCURATELY PREDICTING WHAT THE
PATIENT WOULD WANT.
WE CAN ASK THE POTENTIAL PATIENT
WHAT WOULD YOU WANT IN THIS
SCENARIO, AND ASK THE SURROGATE,
WHAT DO YOU THINK THEY WOULD
WANT IN THIS SCENARIO?
ACCURACY IS GETTING THAT RIGHT.
NOW, I WOULD BE THE FIRST TO
ADMIT THAT'S NOT GETTING
ACCURATE -- WHAT THEY WANT LATER
ON, RIGHT, WHILE THEY ARE
INCAPABLE OF MAKING THAT
DECISION BECAUSE THEY DON'T
UNDERSTAND SITUATION, BUT IT'S
OUR BEST EVIDENCE OF WHAT THEY
WOULD WANT IF THEY STILL WERE
CAPABLE OF UNDERSTANDING THE
DECISION.
>> JOHN?
>> YEAH, THIS IS FASCINATING.
I GUESS FOLLOWING UP ON THAT, MY
GENERAL QUESTION IS, WOULD THESE
MODELS BE ABLE TO TAKE INTO
ACCOUNT LEARNING WITH FEEDBACK?
THIS IS WHERE MY SKEPTICISM
COMES IN BECAUSE THINGS -- I
MAKE THINK THINGS THROUGH IN A
CERTAIN WAY WHEN PERFECTLY
HEALTHY, BUT AS MY EXPERIENCE
CHANGES WITH FEEDBACK, YOU KNOW,
I'M GOING TO HAVE AGENCY TO BE
EVOLVING MY DECISION MAKING, AND
WHEN YOU MAKE THE MODEL ARE YOU
TAKING INTO ACCOUNT THOSE
CHANGES?
LIKE YOU SAY, THINGS LOOK
DIFFERENT WHEN YOU'RE CLOSE INTO
SOMETHING, THAT'S MY SENSE OF
AGENCY.
IT'S NOT CLEAR TO ME WHETHER OR
HOW YOU'D BE ABLE TO MODEL THAT
IN, INTO THIS WHOLE THING, THE
OTHER ISSUE IS, YOU KNOW, AGAIN,
IT FOLLOWS UP ON KAREN'S
QUESTION ABOUT HOW DO YOU DEFINE
ACCURACY AND UNDER WHAT CONTEXT
AND CIRCUMSTANCE?
I'M JUST GUESSING IF SOMEBODY'S
GOING TO SELL OR MARKET A DEVICE
90% IS NOT GOING TO MAKE IT.
SOMEBODY IS GOING TO FIND FAULT
WITH THAT 10%.
I'M A LITTLE BIT QUESTIONS HOW
WE'LL GET IT TO A POINT WHERE IT
CAN ACTUALLY FUNCTION AS NITA
BROUGHT UP THE ISSUE OF
FIDUCIARY A.I., HOW DO WE
PROTECT A PERSON'S INTERESTS
THAT WILL EVOLVE OVER TIME AS
THEY AGE IN THE DIFFERENT
CIRCUMSTANCE AND HOW DOES ONE
TAKE THAT INTO ACCOUNT?
RIGHT NOW A.I. APPROACHES, WE
DON'T HAVE THE EMBODIMENT OF THE
ACTUAL PHYSICAL EXPERIENCE.
>> I'M GOING TO FORGET SOME OF
THE POINTS.
ONE PART THAT I'M PARTICULARLY
PASSIONATE ABOUT, THE LEARNING
PART YOU DESCRIBED.
THAT'S ACTUALLY VERY MUCH WHAT
WE'RE FOCUSING, A LOT OF WHAT
WE'RE FOCUSING ON NOW.
I DIDN'T TALK ABOUT THIS BUT ONE
REASON I'M EXCITED ABOUT THIS,
WHAT WE'VE BEEN BUILDING, I
DIDN'T REALIZE THIS CAN BE A
TOOL FOR HELPING US DO THAT MORE
LEARNING.
YOU SPENT A LOT OF TIME THINKING
ABOUT THESE THINGS, YOU'RE
ETHICIST, BUT PEOPLE HAVEN'T
THOUGHT ABOUT THIS.
LIKE A MORAL PHILOSOPHY CLASS IF
YOU DESIGN QUESTIONS IN THE
RIGHT WAY, IT MAKES THEM THINK
ABOUT CONSIDERATIONS THAT THEY
HADN'T THOUGHT ABOUT BEFORE, CAN
HELP PEOPLE FIGURE OUT WHAT THEY
THINK IS RIGHT OR WRONG.
SO I THINK IT'S A REALLY -- I'M
EXCITED ABOUT POTENTIAL OF
TAKING ADVANTAGE OF THAT.
NOW THE FLIP SIDE HOW DO YOU
MAKE SURE THAT LEARNING GETS
INCORPORATED INTO THE MODEL?
AND SO WE'RE WORKING ON
TECHNICAL TOOLS FOR THAT,
MULTIPLE CASE.
CAN WE FIND PATTERNS, COME UP
WITH A COMPUTATIONAL THEORY OF
MORAL LEARNING THAT DESCRIBES --
THAT DOES A GOOD JOB DESCRIBING
HOW THIS HAPPENS OVERALL?
AND ALGORITHMS MORE RESILIENT TO
CHANGING YOUR MIND OR YOU MADE A
MISTAKE BECAUSE YOU'RE HUNGRY
TODAY COMPARED TO WHAT YOU WOULD
HAVE SAID LAST TIME, WE DO
STUDIES ON CONSISTENCY, FOR
EXAMPLE, ASKING YOU THE SAME
QUESTIONS OVER TIME, SEEING IF
YOU CHANGE YOUR RESPONSE.
AND SO WE'RE WORKING ON A LOT OF
PARTS OF THAT NOW.
THAT'S ALL IN THE REALM OF
WHAT'S GOING TO HAPPEN IN THE
NEAR FUTURE IS BEING ABLE TO
ACTUALLY ACCOUNT FOR THIS MORE
LEARNING AND THAT'S ALSO WHY I
THINK THE INTERACTIVE PART IS
NECESSARY BECAUSE YOU DO CHANGE
YOUR MIND, DO YOU LEARN THINGS,
MAYBE YOU WANT TO TAKE NEW
THINGS INTO ACCOUNT SO I THINK
THE IDEA WOULD BE IT WOULD HAVE
TO BE SOMETHING, MY VISION, YOU
CONTINUOUSLY UPDATE OR AT LEAST
WANT TO CHECK IN AND UPDATE.
I THINK VINCE RAISED HIS HAND.
>> AMY?
I ENCOURAGE EVERYBODY TO THINK
ABOUT IN CONTEXT WHAT WE MIGHT
DO TOGETHER IN NEWG, THIS IS
LEADING TO A SPIRITED SET OF
QUESTIONS.
>> OKAY.
YES, THANK YOU FOR THIS.
THIS IS REALLY FASCINATING.
I HAD TWO-PART QUESTION.
ONE HAS TO DO WITH HOW WE MAKE
DECISIONS, RIGHT?
WE WERE TALKING ABOUT LIKE DO WE
WANT PEOPLE TO MAKE DECISIONS
BASED ON HOW THEY NORMALLY MAKE
DECISIONS OR GOOD DECISIONS, HOW
DO WE DEFINE GOOD DECISIONS, SO
I THINK ONE WAY THIS COULD BE
USED IS WE KNOW PEOPLE MAKE
DECISIONS BASED ON ALL KINDS OF
COGNITIVE BIASES AND HUERISTICS,
HEY, YOU SEEM TO BE TAKING X
INTO ACCOUNT, LIKE RACE OR THE
LAST THING YOU SAW OR THE LAST
THING SAID TO YOU OR WHATEVER.
AND BY JUST MAKING EXPLICIT WHAT
THOSE BIASES ARE IT COULD, YOU
KNOW, POTENTIALLY OVERRIDE
BIASES AND HELP PEOPLE MAKE MORE
QUOTE/UNQUOTE RATIONAL
DECISIONS.
I GUESS THE FIRST PART OF MY
QUESTION HOW DO YOU ACCOUNT FOR
THOSE TYPES OF IMPLICIT BIAS IN
TRAINING OF THE MODEL IN THE
FIRST PLACE?
AND IN ORDER TO KIND OF LIKE
KNOW WHAT SOMEBODY LET'S SAY
AUTHENTICALLY WOULD WANT BASED
ON VALUES AND BELIEFS, INSTEAD
OF BASED ON SORT EVER ALL OF
THESE DIFFERENT HUERISTICS THAT
TYPICALLY GO INTO DECISION
MAKING AND CAN THE MODEL CORRECT
FOR THAT, AND THE SECOND PART IS
AROUND I WAS THINKING THIS IS
THE BRAIN EQUIVALENT OR MORAL
EQUIVALENT OF THE AURA RING,
I'VE HEARD PEOPLE TALK RECENTLY
ABOUT I WAKE UP IN THE MORNING,
I DON'T KNOW HOW I FEEL UNTIL MY
AURA RING TELLS ME.
DID I SLEEP WELL?
DO I FEEL GOOD?
WHAT'S THE RISK OF GENERALLY
UNDERMINING PEOPLE'S AGENCY AND
AUTONOMY SAYING I DON'T KNOW
WHAT I WANT UNTIL MY DIGITAL
TWIN TELLS ME, WHO OF HAVE YOU
THOUGHT ABOUT THAT AND
PROTECTING AGAINST THAT LONG
TERM?
>> WALTER, DO YOU WANT TO TALK
ABOUT THE CORRECTING PART?
>> SURE.
SO, I THINK WHAT WE -- FIRST
WHEN WE GIVE THEM FOR EXAMPLE
THE KIDNEY CASE WE DON'T TELL
THEM WHAT THE RACE OF THE
PATIENT IS.
WE DON'T TELL THEM WHAT THE
GENDER IS.
WE JUST DON'T GIVE THEM
INFORMATION ABOUT THE FACTORS
THAT THEY THINK SHOULD NOT
AFFECT THEIR JUDGMENT.
SO THAT CAN REDUCE.
THAT'S NOT GOING TO GET RID OF
IT ALL BECAUSE THERE ARE
PROXIES, SO FOR EXAMPLE IF YOU
TENDS TO GIVE A KIDNEY, ALLOCAE
A KIDNEY TO SOMEBODY WHO DOESN'T
HAVE DIABETES OVER SOMEBODY WHO
DOES, THAT'S GOING TO
DISADVANTAGE AFRICAN AMERICANS
BECAUSE THEY HAVE HIGHER RATES
OF DIABETES.
AND SO NOW WE CAN ASK, OKAY, IF
HAVE YOU THAT INFORMATION, AND
YOU KNOW THAT THAT'S GOING TO
BIAS THIS, NOW, YOU KNOW, HOW
DOES THAT AFFECT HOW MUCH WEIGHT
YOU PUT ON THE FACT THAT THEY
HAVE DIABETES AND THE ALLOCATION
OF THE KIDNEYS?
AND SO WHAT WE TRY TO DO IS TO
STUDY THOSE BIASES, AND IF WE
CAN FIND OUT, YOU KNOW, THE WAYS
IN WHICH THEY ARE AFFECTING
PEOPLE'S MORAL JUDGMENTS,
HOPEFULLY WE'LL BE ABLE TO
CORRECT FOR THOSE BIASES IN
THEIR MORAL JUDGMENTS.
YOU'RE ABSOLUTELY RIGHT.
THOSE CREEP IN AT THE BEGINNING,
AND THE HOPE IS THAT WE'LL BE
ABLE TO CORRECT FOR THEM IN WAYS
PEOPLE WOULD WANT THEM
CORRECTED.
WE'RE FINDING ALMOST EVERYBODY,
I MEAN, WELL OVER 95% ARE
SAYING, NO, I DON'T WANT RACE TO
AFFECT ALLOCATION OF KIDNEYS.
AND THEN WE CAN CORRECT TO TRY
TO MINIMIZE THE EFFECT.
WE'LL NEVER MAKE IT PERFECT.
WE WANT TO MAKE IT BETTER THAN
THE CURRENT SYSTEM.
>> IF I COULD JUMP IN.
WE HAVE A PAPER ON THIS PRECISE
QUESTION OF THE FEEDBACK FROM
THE A.I., THEN CHANGING HOW
PEOPLE THINK ABOUT THESE TYPES
OF QUESTIONS, TRYING TO GET
AROUND THAT.
I THINK WALTER IS RIGHT.
MOST OF THESE CASES WE CAN TRY
TO PREDICT WHAT THE GROUND TRUTH
WOULD BE IF THEY WERE BETTER
THEY
INFORMED.
SOME CASES IT'S HARD TO SAY WHAT
IS THE DECISION WE WANT TO MAKE.
LET'S SAY I TELL MY ALEXA OR
SOMETHING TO WAKE ME UP IN THE
MORNING TO GO TO THE GYM, DON'T
TAKE NO FOR AN ANSWER, THAT'S
WHAT I INSTRUCT IT TO DO.
IN THE MORNING, NO, I DON'T WANT
TO GO TO THE GYM, TURN OFF.
WHAT'S THE RIGHT DECISION?
THERE'S SOME INTERESTING
QUESTIONS THERE AS WELL.
IT DOES SEEM TO MAKE SENSE TO GO
WITH WHAT THE PERSON REALLY
WANTS IN THE MOMENT AND
SOMETIMES MAYBE NOT.
TO THE EXTENT WE THINK ABOUT THE
GROUND TRUTH, WHAT WE WONT TO
HAVE AS OUTPUT, WE CAN PREDICT
THAT AS WELL AS WE CAN.
>> I'M GOING TO NUDGE EVERYBODY
AGAIN TO BE THINKING ABOUT THE
CONVERGENCE HERE.
I SAY THAT, WHICH IS WE HAVE
BRAIN FOUNDATION MODELS, THESE
REALLY INCREDIBLE PRESENTATIONS
ALSO BY VIKTOR AND ARLEEN THAT
HELP US THINK MORE BROADLY ABOUT
BOTH MEDICAL BASE MODELS FOR
DIGITAL TWINS, THE BROAD ETHICAL
ISSUES AND VERY USEFUL TAXONOMY,
THAT RAISES IT'S INTERESTING
POINT THAT JANA RAISED, SHE
HADN'T BEEN THINKING ABOUT THIS
WITHIN THE DIGITAL TWINS, ARLEEN
FRAMED THAT FOR WHAT ARE WE
THINKING ABOUT.
AND, YOU KNOW, TO KAREN'S POINT
EARLIER AS WELL, JUST THIS PAST
WEEK I WAS TALKING TO A COMPANY
THAT'S REALLY FOCUSED ON
BUILDING PSYCHOLOGICAL PROFILE
OF INDIVIDUALS THROUGH
PSYCHOLOGICAL FOUNDATION MODELS,
AND THE BRAIN DATA THAT JANA WAS
TALKING ABOUT, COMPANIES ARE
GOING TO DO, THE IDEA IS WHETHER
IT'S FOR MORAL DECISION MAKING
OR ANY OTHER CONTEXT,
INCREASINGLY PEOPLE ARE MOVING
FORWARD TO TRY TO DEVELOP
DIGITAL TWIN MODS ALSO, FOR ALL
KINDS.
THERE MAY BE SOMETHING FRUITFUL
GIVEN INTEREST BROADLY AND USE
CASES WE'VE IDENTIFIED HERE
TODAY.
THE QUESTION IS TO WHOM, WOULD
IT BE USEFUL TO DEVELOP GUIDANCE
FOR RESEARCHES, TO THINK ABOUT
WHAT, YOU KNOW, THE BROAD SET OF
ETHICAL PRINCIPLES ARE THAT WE
MIGHT THINK ABOUT IN THIS SPACE,
WHAT IS THE KIND OF SPACE?
BECAUSE THERE'S NOT A LOT OF
WORK THAT'S BEEN DONE HERE.
ARLEEN HAS DONE SOME BRILLIANT
WORK BUT SEARCHING FOR PEOPLE
DOING ETHICS IN THE SPACE NOT
MUCH IS PUBLISHED AS OF YET.
IT'S A SPACE RIPE FOR US TO
THINK ABOUT COLLABORATING
TOGETHER ON.
JIM?
>> THANK, NITA.
ARLEEN OR VICTOR, GETTING TO
VALIDATION, THE CRUX IS HOW DO
YOU VALIDATE YOUR MODEL?
AND SO IT CAN BE PREDICTIVE?
AND SO WHAT ARE SOME BEST
PRACTICES, IN TERMS OF THINKING
ABOUT VALUE SEDATION?
VIKTOR MENTIONED IT'S HARD TO DO
VALIDATION.
WHAT ARE SOME OF THOSE ISSUES?
AND DO YOU HAVE THOUGHTS ON
THAT?
>> CAN I START?
>> SURE.
>> OKAY.
YES, VALIDATION IS HARD BECAUSE
YOU ESSENTIALLY NEED TO -- SO IN
CLINICAL APPLICATIONS BECAUSE
YOU NEED TO ACTUALLY USE THE
MODEL IN ORDER TO BIAS YOUR
DECISION-MAKING AND WHAT IF IT'S
WRONG?
BUT THERE ARE DIFFERENT WAYS OF
DOING THE VALIDATION, WHERE YOU
ACTUALLY ARE ON THE SAFER SIDE.
I'LL GIVE AN EXAMPLE.
THE VALIDATION OF THE
PATIENT-SPECIFIC PREDICTIVE
POWER CAN BE TESTED THROUGH
TRANSFER PAR SOMETIMES.
IN BRAIN STIMULATION, ONE OF THE
CHALLENGES IS WHEN YOU WANT TO
STIMULATE FOR PARTICULAR
DIAGNOSTIC OR THERAPEUTIC EFFECT
IN THE BRAIN GENERALLY THERE ARE
NO GUIDELINES OF HOW TO
STIMULATE, WITH WHICH AMPLITUDE,
WHICH FREQUENCY, AT WHAT
LOCATION, AT MULTIPLE LOCATIONS,
ET CETERA.
AND THESE ARE ASPECTS VERY
DIFFICULT TO TEST SYSTEMATICALLY
IN THE PATIENT.
SO, BUT SEVERAL LABORATORIES BY
NOW HAVE DEMONSTRATED THAT YOU
CAN ACTUALLY ACCELERATE THIS
ENORMOUSLY WITH PATIENTS'
VIRTUAL BRAIN TWIN BUT HOW DO
YOU FIT IN THE PARAMETERS?
THIS IS ESSENTIALLY WHERE THE
TWIN ASPECTS COMES IN.
YOU CAN FIT THE PARAMETERS ON
ONE PARTICULAR TASK OR ONE
PARTICULAR REALIZATION, AND THEN
THE TWIN, IF IT'S A REAL TWIN,
IDEAL SCENARIO, HAS PREDICTIVE
POWER SO FOR SCENARIOS WHERE THE
TWIN HAS NOT BEEN TRAINED UPON,
SO THERE'S ACTUALLY A TRANSFER
CAPACITY, WHICH IS THE WHOLE
POINT OF THE TWIN, EXACTLY THE
WHOLE POINT OF HOW IS THE TWIN
DIFFERENT FROM FOUNDATION
MODELS, YOU NEED TO TRAIN ON THE
DATA BUT YOU WANT TO TRAIN THE
TWIN -- SORRY, THE DIGITAL TWIN
IS LINKEDs TO MECHANISTIC
MODEL SO YOU WANT TO MAKE
PREDICTIONS ABOUT SITUATIONS
THAT TWIN HAS NOT BEEN TRAINED
UPON.
BEST EXAMPLE IS FOR INSTANCE THE
BRAIN STIMULATION, YOU DO NOT
NEED BRAIN STIMULATION DATA TO
ACTUALLY PARAMETERIZE THE TWIN
CORRECTLY, FOR AN INDIVIDUAL
PATIENT.
YOU CAN USE RESTING STATE DATA
OR IN THE CASE OF EPILEPSY,
YOU'RE GETTING A MUCH BETTER
PREDICTIVE POWER THAN WHEN YOU
TRAINED THE TWIN ON SURROGATE
DATA OR SOMEONE ELSE'S DATA.
SO THERE IS WELL-ESTABLISHED
PATIENT-SPECIFIC PREDICTIVE
CAPACITY.
AND THIS IS ONE WAY OF
VALIDATING THE SYSTEM, THIS
TRANSFER CAPACITY FROM ONE TASK
TO THE OTHER, AND THAT ALLOWS
YOU THEN ALSO TO GO INTO THE
REGIMES THAT ARE DELICATE, THAT
ARE POTENTIALLY DANGEROUS FOR
THE PATIENT BECAUSE YOU DON'T
NEED TO DO THIS.
THESE ARE THE LINES ALONG WHICH
NOT JUST OUR INSTITUTE BUT
DIFFERENT LABORATORIES ARE
THINKING ABOUT THIS.
>> LET ME TURN TO JEN.
>> THANK YOU.
JIM, YOU LED UP TO MY QUESTION
BEAUTIFULLY.
THANK YOU FOR DOING THAT.
THINKING OF DIGITAL TWIN IN THE
MEDICAL CONTEXT, WHEN WE THINK
ABOUT VALIDATION OF THOSE
DIGITAL TWINS, PEOPLE ARE
LOOKING FOR TREATMENTS OF SAYING
I JUST WANT IT TO WORK BUT I
KNOW MY CONDITION IS
CONTINUOUSLY CHANGING.
IF WE CAN HAVE DIGITAL TWIN THAT
CAN MORE ACCURATELY REFLECT WHAT
TREATMENTS PEOPLE CAN GET TO
TREAT THEIR CONDITION WHATEVER
STAGE IT MIGHT BE IN THAT COULD
POTENTIALLY BE A POWERFUL TOOL
FOR A DIGITAL TWIN.
HOW DO WE HANDLE FROM INFORMED
CONSENT PERSPECTIVE SO PEOPLE
CAN UNDERSTAND HOW THIS IS
TREATMENT.
ARLEEN, YOU'RE SHAKING YOUR HEAD
THAT YOU'VE GONE THROUGH THAT.
I HAVE A FEW THOUGHTS ABOUT NEXT
STEPS BECAUSE I'M APPLYING TO
NITA'S CALL.
ARLEEN, IF YOU WOULD PLEASE
RESPOND FIRST.
I THINK YOU'RE ON MUTE.
>> CAN YOU HEAR ME NOW?
>> YES.
>> YEAH, THE DATA ISSUE IS
PRESENT AT ALL STAGES IN THE
FORMULATION OF THE DIGITAL TWIN,
RIGHT?
BECAUSE YOU'RE TALKING ABOUT
CONSENT, AT THE TIME OF DATA
COLLECTION.
THEN OF COURSE YOU HAVE HOW IS
DATA MANAGED?
HOW IS DATA INTERPRETED?
HOW IS DATA USED?
SO THE ISSUE OF DATA AND HOW IT
IS ADDRESSED AT DIFFERENT STAGES
CONTINUES TO BE ONE OF THE MAIN
ISSUES.
AND DEFINITELY IMPACTS AT THE
MOMENT OF THINKING OF CONSENTS,
WHAT KIND OF CONSENTS THE
PATIENTS ARE GOING TO GIVE.
NOW, VIKTOR CAN COMPLEMENT, BUT
ONE THING TO BE CAREFUL WITH IS
BEING EXTREMELY COMPLIANT WITH
ALL TYPE OF DATA, PARTICULARLY
IN EUROPE, SO STRICT WHEN IT
COMES TO DATA PROTECTION AND
PRIVACY.
I THINK THERE IS AN EXTENT WHICH
THERE'S CERTAIN COMFORT IN
THINKING THAT THERE IS VERY
STRONG COMPLIANCE, ORGANISMS,
THAT ALLOW PEOPLE TO INITIALLY
BE AT LEAST COVERED WHEN IT
COMES TO DATA.
HOWEVER THOUGH, I DO THINK THAT
CONTINUOUS THINKING ABOUT GOING
BEYOND COMPLIANCE TO REALLY
TRYING TO UNDERSTAND HOW IN EACH
OF THESE STAGES DATA PRESENTS
ETHICAL CONCERN.
SO I DON'T KNOW WHETHER VIKTOR
WOULD LIKE TO COMPLEMENT.
>> YES, TWO DIMENSIONS.
FIRST CONFIRMING GDPR IMPOSES
STRICT CONSTRAINTS ON THE
RESEARCHERS TO THE DEGREE THAT
IT SLOWS DOWN SIGNIFICANTLY SOME
PROCESSES BUT I THINK IT'S
CORRECT TO SAY EVERYONE IS IN
SUPPORT THEREOF.
SOMETIMES THERE'S COMPLAINT WE
COULD MOVE FORWARD WITH RESEARCH
FASTER, BUT I DON'T THINK THAT
ANYONE WOULD BE OPPOSED.
THIS DIMENSION REASSURES
ESSENTIALLY THAT THE PATIENT --
THAT DATA HANDLED CORRECTLY.
THE WAY WE -- WITH THE WAY WE
HAVE HANDLED IN PREVIOUS CASES
THE QUESTION WITH REGARD TO
AUTHORIZATION OF A CLINICAL
TRIAL, FOR INSTANCE, IS MAKING
USE OF THE DIGITAL TWIN, THAT
WAS ONE OF YOUR QUESTIONS.
HOW DO YOU ACTUALLY COMMUNICATE
THIS?
ESPECIALLY IN THE CASE OF BRAIN
SURGERY, WITH A DIGITAL TWIN,
THINK ABOUT THIS.
YOU USE A DIGITAL TWIN AS A WAY
OF INFORMING THE CLINICIAN, THE
NEUROLOGIST, AND THE SURGEON,
ABOUT MAKING DECISIONS, AND THEN
PERFORMING INTERVENTION.
SO WHAT IS IT?
IS THIS A SURGICAL TOOL WHICH
PUTS IT ACTUALLY ON A HIGH CLASS
IN TERMS OF MEDICAL EQUIPMENT?
OR IS IT JUST ANOTHER MODALITY
THAT IS INFORMING THE CLINICIAN
TO MAKE A DECISION IN THE SENSE
YOU HAVE EEG, MRI, PET DATA ,
THE DIGITAL TWIN IS ANOTHER
MODALITY CONTRIBUTING TO
DECISION MAKING, PUTS IT IN A
DIFFERENT CLASS OF MEDICAL
DEVICE.
IN TERMS OF RISK EVALUATION, ET
CETERA.
SO, THE WAY FINALLY IT HAS
HAPPENED IS THE WAY HOW THE
INFORMATION COMING FROM DIGITAL
TWIN HAS BEEN INTEGRATED IN THE
PROCESS, HANDLED LIKE MRI, FOR
INSTANCE, SO YOU'RE NOT USING
THE DIGITAL TWIN ITSELF IN TERMS
OF THE SIMULATOR AS I DESCRIBED
EARLIER, BUT JUST THE RESULTS
THAT ARE COMING FROM THE DIGITAL
TWIN, WHICH CAN BE REPRESENTED
AS AN IMAGE, ENTERED INTO
BATTERY OF PIECES OF INFORMATION
FROM OTHER MODALITIES, IMAGING
MODALITIES, CLINICAL HISTORY, ET
CETERA.
IT'S ONE OF THE FACTORS IN THE
DECISION-MAKING PROCESS AND THIS
IS HOW IT'S BEEN ENTERED INTO
THE ETHICAL APPROVAL AND INTO
THE CONSENT FORM, HOW IT HAS
BEEN PRESENTED IN THE CONSENT
FORM TO THE PATIENT.
THIS WENT ACTUALLY QUITE WELL,
THERE WERE MANY COMMENTS WITH
REGARD TO THIS.
HOWEVER, THAT WAS -- EVERYONE
FEELS COMFORTABLE WITH THIS
PROCESS.
>> THANKS YOU.
NEXT STEPS FORWARD, THAT WAS
INFORMATIVE, THANK YOU.
WHEN WE THINK ABOUT INFORMED
CONSENT AS DIGITAL TWINS EVOLVE,
HOW DO WE HAVE THE TOUCH POINTS
OF CONSENT AS THAT MODEL
EVOLVES?
AND PROMISE A STEP FORWARD IS
LOOKING AT SCENARIOS AND
POTENTIALLY GUIDANCE USING
DIFFERENT CASE STUDIES IN THE
MEDICAL CONTEXT.
FOR INSTANCE, NEURODEGENERATIVE
DISEASES.
WHAT ABOUT TRAUMATIC SCENARIOS
LIKE A BRAIN INJURY OR LOCKED IN
SYNDROME FROM A BRAIN STROKE
WHICH MAKES IT COMPLEX?
OR EVEN A MENTAL HEALTH SCENARIO
WHERE PEOPLE MIGHT GO INTO WAVES
OF WHEN THEY ARE HAVING A
DIFFERENT IMPACT OF MENTAL
HEALTH THAT'S IMPACTING THEIR
DECISION MAKING SO THAT MIGHT BE
A POTENTIAL WAY FORWARD FOR US
TO THINK ABOUT THESE DIGITAL
TWINS AND HOW THEY ARE TREATED
IN DIFFERENT SCENARIOS.
THANKS.
>> THANKS, JEN.
WALTER, YOU HAD YOUR HAND UP.
DID YOU WANT TO JUMP IN?
YOU'RE ON MUTE.
>> I REALLY HAD A QUICK QUESTIN
FOR VIKTOR.
DO YOU ENCOUNTER ANY PATIENTS
WHO SAY, I DON'T WANT SOME DAMN
MACHINE TO, YOU KNOW, TELL THE
SURGEON WHAT PART OF MY BRAIN TO
CUT OUT?
AND THEY JUST DON'T WANT THIS --
YOU KNOW, THIS METHOD USED AT
ALL.
YOU KNOW, I IMAGINE THERE ARE
GOING TO BE SOME, BUT HAVE YOU
RUN INTO ANY AT ALL?
>> NO, ON THE CONTRARY,
ACTUALLY WE'RE GETTING LOTS OF
REQUESTS TO GET VIRTUALIZATION
DONE.
AND THERE I REALLY NEED TO
EMPHASIZE THIS, THE MACHINE IS
NOT TELLING THE SURGEON WHICH
DECISION TO TAKE.
THAT WAS THE REASON I TOLD YOU
THE STORY ABOUT MEDICAL DEVICE
CLASSIFICATION.
IT IS AN ADDITIONAL
QUASI-IMAGING MODALITY THAT
PROVIDES YOU WITH INFORMATION.
YOU CAN DEMYSTIFY IT, DON'T UTES
THE WORD DIGITAL TWIN BUT SAY
IMAGINE THIS IS FOR A PATIENT'S
PARTICULAR BRAIN CONNECTIVITY,
COMMUNICATION BETWEEN BRAIN
AREAS, A SPECIFIC BRAIN
CONNECTION IF YOU STIMULATE
HERE, IT WILL GENERATE THESE
TYPE OF REACTIONS.
IS IT CONSISTENT WITH THE DATA?
YES /NO, IF NOT IT'S UNIKELY THE
PATIENT HAS CONNECTION.
IT'S A STATE OF LOGICAL STEPS,
YOU CAN BUILD A DECISION TREE
AND ACTUALLY GO THROUGH THE
INDIVIDUAL STEPS AND SEE WHERE
IT MAKES A CHANGE.
I CAN TELL YOU THE BIGGEST
EFFECT WHERE THIS INFORMATION IS
COMING FROM THE DIGITAL TWIN HAS
IS IN SITUATIONS WHERE THE
CLINICIAN DOES NOT KNOW EXACTLY
HE/SHE IS AT THE CUSP OF GOING
TO THE LEFT OR RIGHT, DECISION
A, B, C.
WHERE THE DECISION IS ALIGNED
WITH THE DECISION, WITH THE
INITIAL ANALYSIS DIAGNOSTICS OF
THE CLINICIAN, THE DIGITAL TWIN
INFORMATION IS ALMOST USELY
BECAUSE IT'S CONSISTENT.
COMFORTING BUT DOESN'T CHANGE
MUCH.
IF IT'S ORTHOGONAL IT DOESN'T
HELP MUCH EITHER BECAUSE AT
LEAST AT THE CURRENT STAGE NO
CLINICAL -- NO CLINICIAN WOULD
ESSENTIALLY GO ONLY FOR THE
DIGITAL TWIN BUT MAKE IT -- LOOK
AT IT IN THE CONTEXT.
THESE SITUATIONS WHERE YOU HAVE
MULTIPLE OPTIONS, MULTIPLE
HYPOTHESES WHICH HAPPENS OFTEN,
AND THEN THE DIGITAL TWIN CAN
PUSH YOU IN ONE DIRECTION OR
ANOTHER DIRECTION.
AND THESE THINGS ARE BEING ALSO
MADE VERY CLEAR, BEING ALSO
PRESENTED IN THE DISCUSSIONS,
AND YOU ASKED ABOUT NEGATIVE
FEEDBACK, SO FAR WE'VE NOT GOT
ANY NEGATIVE FEEDBACK.
ON THE CONTRARY WE HAVE REQUESTS
CAN YOU PLEASE HELP US, DO THIS
VIRTUALIZATION, ET CETERA.
>> SO EASY FOR PEOPLE TO
MISINTERPRET AND THERE'S A LOT
OF FEAR OF MACHINES TAKING OVER
OUT THERE.
SO I'M GLAD TO HEAR YOU HAVE NOT
ENCOUNTERED THAT.
>> I'VE SEEN IT A LOT WITH
RESEARCHERS IN DISCUSSIONS ON
STAGES, WHERE THEN PEOPLE ARE
COMING AND SAYING, HOW DO YOU
DARE TO -- THERE'S SO MANY
THINGS WE DON'T KNOW, ET CETERA,
ET CETERA.
THIS WE HAVE GOTTEN -- ARLEEN,
THERE WAS A WORKSHOP WE HAD IN
PARIS WHERE WE HAD THE WHOLE
RANGE WHERE PEOPLE WERE SAYING
ON THE ONE HAND SIDE, WE WILL
NEVER, EVER GET A DIGITAL TWIN,
MAKING IT REALITY.
AND THEN ON THE OTHER SIDE WE
HAD PEOPLE, OH, WHO WERE SAYING
RESEARCHERS, OBVIOUSLY
RESEARCHERS, DIGITAL TWIN IS
ALREADY A REALITY, LOOK AT YOUR
INTERNET ID THAT YOU HAVE.
IT DEPENDS ON HOW YOU POSITION
YOURSELF WITH REGARD TO DIGITAL
TWIN.
>> I CAN CLARIFY, VIKTOR, WHAT
I'M HEARING THE APPLICATION THAT
YOU'RE FOCUSING ON IS A TOOL TO
INFORM CLINICAL DECISIONS.
I SEE THAT DIFFERENT AS KIND OF
A PROXY OR SURROGATE FOR A
PERSON TO MAKE DECISIONS ON THEY
BEHALF IN A MORAL/ETHICAL WAY.
BOTH WE NEED TO LOOK INTO WHERE
THE GUARD RAILS NEED TO BE AND
THESE ARE TWO ALMOST ORTHOGONAL
ISSUES, NO?
>> WELL, IT'S GOOD, JOHN, TO BE
ABLE TO SEE THE SAME THING,
RIGHT?
THE SAME LIKE CONCEPT WHICH IS
TO BUILD A MODEL FOR CLINICAL
DECISION MAKING, LIKE THE FLIP
SIDE OF HOW PEOPLE ARE THINKING
ABOUT IT AS WELL, WHETHER THAT'S
FOR PURPOSES OF MORAL DECISION
MAKING FOR AN INDIVIDUAL OR FOR
PSYCHOLOGICAL MODELS THAT ENABLE
MENTAL HEALTH TREATMENTS AND
CARE.
THESE I THINK -- YOU COULD SAY
THE USE CASE IS IN SOME WAYS
ORTHOGONAL BUT ALL FROM THE SAME
CORPUS OF RESEARCH, AND WHAT'S
MADE POSSIBLE BY ADVANCES.
AS WE THINK BIT.
>> PERHAPS. -- PERHAPS.
>> AS WE THINK BIT, WHAT THE
PREDICTIVE MODELS ENABLE.
>> YEAH.
PERHAPS.
I THINK IT GETS BACK TO JIM'S
QUESTION ABOUT VALIDATION.
I WOULD SEE EASIER PATH TO
VALIDATION TO ASK WHETHER A
MODEL IS GOING TO BE PREDICTIVE
OF WHICH SURGERY IS GOING TO BE
BETTER FOR A GIVEN CONDITION.
THAT MIGHT BE AN EASIER LIFT,
LOWER HANGING FRUIT THAN OTHER
ISSUES WE'VE BEEN TALKING ABOUT.
I THINK THIS IS VERY FASCINATING
BUT TRYING TO THINK OF A WAY FOR
NEWG AND THEREFORE BRAIN TO
CONSIDER TANGIBLE STEPS TO TAKE
AND I'D LIKE TO -- YEAH, I'D
LIKE TO BREAK DOWN THE GIGANTIC
PROBLEMS INTO BITE-SIZED
CHANGES, HOW TO USE THIS AS A
DIAGNOSTIC TOOL FOR CLINICAL
INTERVENTIONS MAY BE EASIER THAN
OTHER FASCINATINGI. ISSUES.
>> I SEE OTHER HANDS RAISED.
WE HAVE ANOTHER PRESENTATION
THAT WE'RE GOING TO MOVE INTO,
BUILDING ON JOHN'S QUESTION AND
ALSO I THINK THE VERY VIGOROUS
QUESTIONS AND CONVERSATION,
SEEMS ONE POTENTIAL PATHWAY IS
WHETHER IT'S WORTH DOING A
WORKSHOP THAT FOCUSES ACROSS THE
SPECTRUM, I'M NOT SURE THERE'S A
BITE-SIZED PIECE WE MAY BE READY
TO BREAK OFF BUT MIGHT BE WORTH
THINKING IF THERE'S A DEEPER
DIVE THAT WE WANT TO DO THAT
LOOKS MORE BROADLY ACROSS THE
ISSUES, ACROSS THE SPECTRUM, OR
IF WE WANT TO CHOOSE SOMETHING
WE MIGHT SEE AS LOWER-HANGING
FRUIT THAT WOULD ALLOW US TO,
YOU KNOW, ENTER INTO THESE
SPACES.
WITH APOLOGIES TO THOSE WITH
HANDS RAISED, LET ME HAND OVER
TO JIM TO CARRY US FORWARD INTO
THE NEXT SESSION.
>> THANKS, NITA, AND EVERYONE
FOR THE VIBRANT DISCUSSION, VERY
INTRIGUING.
NOW WE'RE IN FOR AN ADDITIONAL
TREAT TODAY, BECAUSE WE'RE GOING
TO BE HEARING FROM JEN FRENCH,
OBVIOUSLY A MEMBER OF OUR
COMMITTEE, AND SHE AND HER
COLLEAGUE MICHAEL YOUNG ARE
GOING TO DISCUSS THE IMPLANTABLE
BCI BRAIN/COMPUTER INFLATION
COLLABORATIVE COMMUNITY AND
THINGS DONE THERE, PROGRESS
BEING MADE.
BY WAY OF INTRODUCTION FOR THOSE
NOT FAMILIAR, JEN IS FOUNDER AND
EXECUTIVE DIRECTOR OF NEUROTECH
NETWORK.
ADVOCACY GROUP FOR
NEUROTECHNOLOGY.
SERVES A VERY IMPORTANT ROLE
THINKING ABOUT BRAIN
TECHNOLOGIES, HOW TO BRING THEM
TO THE POP PLUS. -- POPULUS, A R
OF THE NINDS COUNCIL, MEMBER OF
THE BRAIN WORKING COUNCIL
WORKING GROUP, SISTER TO THIS
ONE.
SO WE CAN MOVE FORWARD, I'LL
INTRODUCE DR. MICHAEL YOUNG NOW.
THEY ARE DOING A TAG TEAM
PRESENTATION.
DR. YOUNG IS A NEUROLOGIST AT
MGH, AND HE'S ASSOCIATE DIRECTOR
OF THE MGH NEURORECOVERY CLINIC
AND DIRECTOR OF NEUROETHICS
CENTER AT MGH.
SO, WITH THAT INTRODUCTION, I'LL
TURN IT OVER TO JEN.
>> THANKS FOR THAT GREAT
INTRODUCTION.
AND THANK YOU, MICHAEL, FOR
JOINING US TODAY.
MICHAEL YOUNG IS GOING TO BE TAG
TEAMING, AS JIM MENTIONED.
I'D LIKE TO GIVE A BRIEF
INTRODUCTION TO THE
BRAIN/
BRAIN-COMPUTER INTERFACE
COLLABORATIVE COMMUNITY AND
NEURAL INTERFACE NET NETWORK AD
HAND OVER TO MICHAEL ABOUT
SPECIFICS.
I HOPE YOU CAN SEE MY SCREEN.
CAN YOU?
>> YES.
>> OKAY, PERFECT.
QUICKLY, JUST TO TO NEUROTECH
NETWORK, A SMALL ORGANIZATION,
THAT MAY NOT BE FAMILIAR, TO
GIVE A CONTEXT, WE'RE A
NON-PROFIT FOCUSING ON IMPROVING
EDUCATION AND ADVOCACY OF
NEUROTECHNOLOGY DEVICE,S,
THERAPIES, TREATMENTS, FOR
PEOPLE LIVING WITH NEUROLOGICAL
CONDITIONS, CAREGIVERS, MEDICAL
PROFESSIONALS.
WE WORK DIRECTLY WITH THEM.
WE HAVE FOUR PILLARS OF AREAS
WHERE WE WORK.
ONE IS WE WORK WITH OUR INDUSTRY
PARTNERS TO OFFER A NEUROTECH
DIRECTORY.
WE FOCUS ON DEVICES THAT ARE
EITHER AVAILABLE OR IN CLINICAL
TRIALS SO WE DON'T FOCUS ON
DEVICES THAT ARE BEING
INVESTIGATED IN PRE-CLINICAL
MODELS BECAUSE WE KNOW PEOPLE
LIVING WITH CONDITIONS ARE
TRYING TO FIND SOLUTIONS TODAY.
THAT DATABASE IS AVAILABLE
FREELY AND WE WORK WITH OUR
NON-PROFIT PARTNERS TO HELP
SPREAD THE WORD ABOUT THAT.
WE ALSO DO WEBINARS AND
PRESENTATIONS, MEDIA PRESENCE IN
TERMS OF BUILDING EDUCATION
ABOUT NEUROTECHNOLOGY, HOW IT
CAN BE USED, HOW IT'S HELPING
PEOPLE WITH NEUROLOGICAL
CONDITIONS, AGAIN IN THE MEDICAL
CONTEXT.
WE ALSO SHARE REAL STORIES OF
PEOPLE WHO ARE PIONEERS IN THE
NEUROTECHNOLOGY SPACE,
FIRST-TIME USERS, OR THOSE WHO
ARE EXPLORING NEW TECHNOLOGIES,
SO WE WANT TO BE ABLE TO
HUMANIZE NEUROTECHNOLOGY.
FINALLY WE DO COMMUNITY
ENGAGEMENT, BOTH WITH THE
NON-PROFIT PARTNERS AND THOSE
DEVELOPING TECHNOLOGIES TO HELP
CONNECT WITH PEOPLE WITH LIVED
EXPERIENCE TO HELP INFORM
DEVELOPMENT OF THOSE
TECHNOLOGIES, THAT'S A QUICK
OVERVIEW OF WHAT WE DO.
AND OF COURSE YOU CAN ALWAYS GO
TO OUR WEBSITE TO LEARN MORE.
I DID MENTION THIS EARLY ON WHEN
SURING.
WE'RE THRILLED TO WORK WITH THE
AMERICAN BRAIN COALITION TO
BRING TO YOU THE PUBLIC AND
PRIVATE PARTNERSHIP OF THE NINDS
NON-PROFIT FORUM ON JUNE 25.
WE WERE THRILLED THAT NINDS WILL
ALLOW US TO USE THE NEUROSCIENCE
CENTER, TO BRING TOGETHER
NON-PROFITS, IN THIS SPACE, TO
COLLABORATE AND TO HELP BUILD
CAPACITY WITHIN THE NON-PROFIT
WORLD SO PLEASE MARK YOUR
CALENDARS, REGISTRATION IS OPEN.
YOU CAN FIND THAT ON THE
AMERICAN BRAIN COALITION
WEBSITE.
SO, THOSE ARE MY QUICK PLUGS BUT
NOW I WOULD LIKE TO GET INTO THE
IMPLANTABLE BRAIN-COMPUTER
INTERFACE COLLABORATIVE
COMMUNITY, IBCI-CC WHICH
LAUNCHED IN MARCH OF 2024 WHEN
WE LAUNCHED THE ORGANIZATION.
THERE WERE A LOT OF PEOPLE
INVOLVED IN LAUNCHING THIS BUT I
HAVE TO RECOGNIZE THE
ORGANIZERS, LEIGH, JOE, AND
JESSICA TO THE IBCI-CC AS
ORGANIZERS.
I'LL GO ON ABOUT WHAT IT IS AND
WHAT WE DO.
SOMETIMES EXPLAINING A
COLLABORATIVE COMMUNITY BEST IN
STORY TELLING, SO THIS IS NOT A
BRAIN-COMPUTER INTERFACE BUT THE
FIRST COLLABORATIVE COMMUNITY
CAME AROUND WITH THE INTEROCULAR
LENSES.
THERE WERE NONE APPROVED, WAY
BACK WHEN, OR ON THE MARKET.
THERE WAS AN EVOLVING INDUSTRY
THAT WAS STUCK.
THEY WERE STUCK WITH THE FACT
THEY DIDN'T HAVE CLEAR
ENDPOINTS, DIDN'T HAVE A CLEAR
CLINICAL PATHWAY, DIDN'T HAVE
CLEAR QUALITY CONTROLS FOR
APPROVAL, A LOT OF UNANSWERED
QUESTIONS AROUND THIS TECHNOLOGY
SO THERE WAS A DEVELOPING
INDUSTRY, A LOT OF RESEARCH
BEHIND IT, BUT THEY JUST
COULDN'T SEE TO MOVE THIS
TECHNOLOGY FORWARD.
SO, AN INCREDIBLE INNOVATOR AND
CLINICIAN AND NOW LEADER AT FDA,
MICHELLE TARVER, PULLED TOGETHER
DIVERSE STAKEHOLDERS TO SAY
LET'S COME UP WITH CONSENSUS TO
MOVE THE INDUSTRY FORWARD.
TODAY WE HAVE A THRIVING
INTRAOCULAR LENS INDUSTRY.
TO IMPLANTABLE BCIs, WE HAVE A
LOT OF UNANSWERED QUESTIONS, AN
INDUSTRY STARTING TO MOVE
FORWARD, DECADES OF RESEARCH,
BRINGING THE SAME CONCEPT TO IT.
COLLABORATIVE COMMUNITIES ARE
PUBLIC/PRIVATE FORUMS CONTINUING
FORUMS THAT FOCUS ON SOLVING
SHARED CHALLENGES AND REALLY
HARNESSING AND LEVERAGING
COLLECTIVE OPPORTUNITIES.
AND IT BRINGS TOGETHER THE
DIVERSE STAKEHOLDERS OF
CLINICIANS, INDUSTRY,
REGULATORS, FUNDERS, PATIENT
ADVOCACY ORGANIZATIONS, AND OUR
FEDERAL PARTNERS, FDA AND OTHERS
TO WORK TOGETHER IN THIS OPEN
FORUM.
THERE'S FOUR KEY COMPONENTS.
ONE IS WE NEED TO BE VERY
TRANSPARENTS ON WHAT WE DO.
SO A LOT IS WE HAVE PUBLIC
OUTPUTS, GET PUBLIC INPUT.
AS I MENTIONED BEFORE WE HAVE TO
HAVE -- WE'RE ENGAGED WITH A
BROAD RANGE OF STAKEHOLDERS
WHICH ARE DISPLAYED ON THIS
WHEEL PROVIDED BY FDA ALTHOUGH I
STILL HAVEN'T QUITE FIGURED OUT
WHAT THE THREE DOTS STAND FOR,
REPRESENTING COMMUNITY PARTNERS
INTERESTED IN IMPLANTABLE
BCIs.
TWO OTHER COMPONENTS REALLY
IMPORTANT, ONE IS WE OPERATE IN
THIS SPACE CALLED THE
PRE-COMPETITIVE SPACE.
SO THIS IS AN AREA WHERE
INDUSTRY CAN COME TOGETHER AND
WORK TOGETHER TO SOLVE
COLLECTIVE PROBLEMS.
SO, TO GIVE SOME EXAMPLES OF
WHAT IS OUTSIDE OF THE
PRE-COMPETITIVE SPACE THINGS
LIKE PRICING, LIKE INTELLECTUAL
PROPERTY, CONSULTING AGREEMENTS,
ET CETERA.
THOSE ARE OUTSIDE OF WHAT I CALL
OUR SANDBOX.
BUT WHAT'S INSIDE OF THAT ARE
THINGS COLLECTIVELY PROBLEMS
LIKE USER PREFERENCES, LIKE WHAT
ARE THE CLINICAL ENDPOINTS FOR
THIS TECHNOLOGY?
SO, THOSE ARE THINGS WE CAN
ADDRESS WITHIN THE COLLABORATIVE
COMMUNITY WITH ALL OF THESE
STAKEHOLDERS, WITHOUT VIOLATING
ANY LAWS, IF YOU WILL, OR
STRUCTURES OR NORMS WE HAVE
WITHIN OUR SOCIETY.
AND FINALLY WE USE WHAT'S CALLED
REGULATORY SCIENCE TO BUILD
EVIDENCE AND CONSENSUS FROM OUR
COMMUNITY.
SO THAT'S A REALLY IMPORTANT
POINT ABOUT WHAT IS REGULATORY
SCIENCE.
AND REGULATORY SCIENCE IS VERY
SPECIFIC LANGUAGE.
WE FOCUS ON INTENSIVE USE,
INDICATION OF USE, INSTRUCTION
OF USE.
THOSE ARE THINGS WE'RE THINKING
OF AS WE'RE DEVELOPING
TECHNOLOGY, GOING THROUGH
CLINICAL TRIALS, PREPARING FOR
MARKET LAUNCH BUT THE OTHER TWO
ARE REALLY IMPORTANT, REGULATORY
SCIENCE, LOOKING AT WHAT ARE
PERFORMANCE MEASURES THAT WE'RE
LOOKING FOR, WHAT ARE THOSE
VALIDATIONS OR VERIFICATIONS
THAT THIS TECHNOLOGY IS HITTING
THE MARKET, IF YOU WILL?
BUT ALSO WHAT ARE MITIGATION
STRATEGIES WE CAN COME UP WITH
TO REDUCE RISK AND REDUCE
FAILURE OF THIS TECHNOLOGY BUT
ALSO MAXIMIZE BENEFIT.
SO, WE USE THE LANGUAGE WITHIN
REGULATORY SCIENCE IN OUR
COLLABORATIVE COMMUNITY SPACE.
SO, OUR COLLABORATIVE COMMUNITY,
WE LAUNCHED IN MARCH OF 2024.
THERE'S A DISTINCT STRUCTURE WE
NEED FOR OUR COLLABORATIVE
COMMUNITIES SO WE HAVE A
CONVENER THAT NEEDS TO BE A
501(c)3, AND THAT'S MASS
GENERAL BRIGHAM, BAILEY IS OUR
MAIN CONTACT THERE.
WE ALSO HAVE ORGANIZERS WHO I
INTRODUCED EARLIER IN ORGANIZING
THE COLLABORATIVE COMMUNITY.
WHEN WE LAUNCHED, WE LAUNCHED
WITH KEY SIGNATORIES, AND THEY
ARE THOSE WHO HELPED ARE THE
FOUNDING MEMBERS BUT ALSO
CHARTER SIGNERS SO REALLY ARE
KIND OF THE OVERSEERS OF THE
CHARTER MAKING SURE THE
COLLABORATIVE COMMUNITY IS
WORKING TOGETHER.
WE HAVE OUR FIVE MAIN LEADERS IN
INDUSTRY ON THIS BUT WE ALSO
HAVE A VERY GREAT DIVERSE GROUP
OF NON-PROFIT AT PATIENT
ADVOCACY ORGANIZATIONS THAT WERE
INVOLVED IN AS CHARTER
SIGNATORIES.
SO AS WELL AS THE BCI SOCIETY,
REPRESENTING THEIR RESEARCH
ENTERPRISE AND REALLY
IMPORTANTLY WE HAVE KAREN FROM
THE INSTITUTE OF NEUROETHICS
THAT IS REPRESENTING ETHICS IN
OUR SIGNATORIES BECAUSE WE THINK
BRINGING IBCIs FORWARD IS
INCREDIBLY IMPORTANT.
WE HAVE OUR GENERAL MEMBERS,
STAKEHOLDERS AS I MENTIONED.
TODAY WE'RE UP TO OVER 400
MEMBERS, WITHIN OUR COMMUNITY.
AND GROWING.
SO WE'RE SO HAPPY TO GET SO MANY
DIVERSE VOICES TOGETHER AND
REALLY OUR COLLECTIVE FOCUS IS
TO ACCELERATE THE DEVELOPMENT OF
IMPLANTABLE BCIs, SAFETY AND
EFFICACY AND MAKE THEM
ACCESSIBLE TO THOSE INTENDED IN
THE MEDICAL USE.
I DON'T THINK IT'S ANYTHING NEW
THERE'S A LONG ACADEMIC HISTORY
OF DEVELOPMENT BUT WE ARE AT
THIS CRITICAL POINT WHERE WE
HAVE A LOT OF UNANSWERED
QUESTIONS.
SO THERE IS GREAT SCIENCE GOING
ON, GREAT DEVELOPMENT.
BUT WE'VE EVOLVED INTO HUMAN
PILOT TRIALS AND NOW WE'RE IN
THE STAGE OF COMMERCIAL
TRANSLATION, AND REALLY LOOKING
TOWARDS THOSE PIVOTAL TRIALS TO
BRING TOWARDS THE
COMMERCIALIZATION OF IMPLANTABLE
BCIs, SO THIS LEADS TO THESE
QUESTIONS AROUND WHAT ARE THE
RIGHT CLINICAL ENDPOINTS, HOW DO
WE CATEGORIZE FOR REIMBURSEMENT,
WHAT DO WE THINK ABOUT IN TERMS
OF DUAL USE OF IMPLANTED BCIs,
ALSO CLINICAL SPECIALTIES AND
WHAT GUIDELINES CLINICIANS CAN
USE WHEN THEY ARE PRESCRIBING
IMPLANTABLE BCI GOING FORWARD
ALONG WITH OTHERS.
WE'RE TAKING THESE CRITICAL
QUESTIONS AND WE'VEE ORGANIZED
INTO SEVEN WORK GROUPS DISPLAYED
HERE.
EACH ONE OF THEM HAVE THEIR OWN
SPECIFIC GOALS SO WE HAVE USER
PRIORITIES AND CLINICAL PRACTICE
GUIDELINES, PAYER INTERACTIONS,
CLINICAL STUDY ENDPOINTS,
MODULARITY, INTEROPERABILITY,
ETHICS AND NEURAL PRIVACY
SECURITY WORK GROUP WHICH
MICHAEL WILL HIGHLIGHT IN JUST A
MOMENT.
EACH WORK GROUP HAS VARIOUS
PROJECTS GOING ON BUT THE GOAL
TO HAVE DELIVERABLES, SOME TYPE
OF DELIVERABLE THAT'S AN OUTPUT
FROM THE PROJECTS AND FROM THE
WORK GROUPS SO WE CAN HELP
EVOLVE AND BUILD EVIDENCE AND
HAVE CONSENSUS WHERE I AM
PLANTABLE BCIs CAN GO, THESE
ARE SOME -- IMPLANTABLE BCIs
CAN GO AND THESE ARE EXAMPLES.
ONE OF THE THINGS WE'VE LAUNCHED
IN THE LAST -- THIS YEAR, WE'RE
HAVING EDUCATION AND TRAINING
SESSION ALSO THAT CAN BE
AVAILABLE ON OUR WEBSITE BUT
THEY ARE WEBINARS ON VARIOUS
TOPICS, SPECIFICS.
EARLIER THIS YEAR OUR FRIENDS AT
FDA DID A WEBINAR ON CLINICAL
OUTCOME ASSESSMENTS AND HOW TO
THINK ABOUT THOSE.
I ENCOURAGE YOU TO JOIN.
I'LL PUT THE LINK IN THE CHAT,
TO THE COLLABORATIVE COMMUNITY.
IT'S OPEN.
PLEASE APPLY.
WE CAN ASSIGN TO YOU A WORK
GROUP IF YOU'RE INTERESTED.
I ALSO WANT TO RECOGNIZE OUR
FUNDERS AND OUR SPONSORS FOR
THIS.
WE COULDN'T HAVE LAUNCHED THE
COLLABORATIVE COMMUNITY WITHOUT
THE SEED GRANT FROM THE DANA
FOUNDATION.
THEY HELPED US ALONG WITH OUR
COMMERCIAL PARTNERS WHO ARE
HELPING FUND THE COLLABORATIVE.
PLEASE JOIN.
I'LL PUT IT IN THE CHAT IN A
BIT.
FINALLY I ALLUDED TO IT EARLIER
TO INTRODUCE THE ETHICS AND
NEURAL DATA PRIVACY ANDS DATA
SECURITY WORK GROUP THAT MICHAEL
YOUNG IS LEADING.
REALLY ADDRESSING KEY QUESTIONS
ABOUT WHAT HAPPENS IF COMMERCIAL
ENTITY GOES OUT OF BUSINESS, AND
WHAT ARE SOME BEST PRACTICES
AROUND NEURAL DATA AS WELL AS
OTHER ETHICAL QUESTIONS THAT
SURROUND IMPLANTABLE BCIS.
I DO WANT TO SAY THAT ETHICS
TRANSCENDS ALL OF OUR WORK
GROUPS.
AND WHY DID WE PUT ETHICS WITH
NEURODATA AND NEUROSECURITY TO
START ?
ETHICS IS NOT ONLY ISOLATED TO
THAT TOPIC.
WE JUST COLLECTIVELY LOOKED AT
WHERE IS THE LOWEST HANGING
FRUIT AND WHERE IS THE MOST
REALLY KEY AREA THAT WE NEED TO
BE FOCUSING ON INITIALLY, FOR
ETHICS, AND IT WAS DECIDED ON
COLLECTIVELY IN OUR COMMUNITY
THAT NEURODATA PRIVACY AND DATA
SECURITY IS ONE WE NEED TO FOCUS
ON.
BUT WE DO HAVE ETHICS EMBEDDED
IN OUR OTHER WORK GROUPS AS
WELL.
FINALLY I WANT TO INTRODUCE
MICHAEL YOUNG, MICHAEL HAS BEEN
ONE OF OUR CO-LEADS FOR THE WORK
GROUP.
WE HAVE KAMAL, A TEAM LEAD AT
NEURAL LINK, A PARTNER IN CRIME,
IF YOU WILL, WITH MICHAEL YOUNG
ON LEADING THIS WORK GROUP,
CURRENTLY HAS 113 MEMBERS WITHIN
THE WORK GROUP, SO MICHAEL HAS A
LOT OF PROJECTS AND INTEREST TO
MANAGE AND WE SO APPRECIATE
THAT.
BUT REALLY THIS WORK GROUP IS
FOCUSING IN ON NEURAL DATA,
SYSTEM SECURITY, HOW DO WE
ADDRESS THE ETHICAL IMPLICATIONS
AROUND THAT AS WELL AS SOME OF
THE -- DEVELOPING COMPREHENSIVE
GUIDANCE ABOUT HOW BCIs ARE
USED IN A RESPONSIBLE AND SECURE
MANNER.
WITH THAT I WOULD LIKE TO HAND
IT -- I'LL STOP SHARING AND I'M
GOING TO HAND IT OVER TO
MICHAEL.
SO MICHAEL, THE SCREEN IS YOURS.
>> THANK YOU, JEN.
AND TO THE NEWG FOR THIS
OPPORTUNITY TO PRESENT SOME OF
THE PROGRESS THAT OUR WORK GROUP
THAT BE MAKING.
OUR MISSION AS A WORK GROUP IS
REALLY TO ADVANCE ETHICAL
STANDARDS AND FRAMEWORKS FOR THE
RESPONSIBLE, SECURE, AND
VALUE-SENSITIVE FUTURE OF
IMPLANTABLE BCIs AND IBCI
DATA, INDISPENSABLE FOR
TRANSLATING THE PROMISE OF THIS
TECHNOLOGY INTO TRANSIBLE AND
RESILIENT BENEFIT FOR PEOPLE
WITH NEUROLOGIC CONDITIONS IN
OUR COMMUNITY AND AROUND THE
WORLD .
JE N
INTRODUCED MO
WE ROO .
OUR
GROUPS ISES OF
118 MECHANICS AND
GROWING .
WE BRING
TOGETHER RESEARCHERS
, CLINICIANS
ENGINEERS .
INDUSTRY
LEADERS , PATIENT
ADVOCATES.
PEOPLE TO HELP US NAVIGATE THE
MOST PRESSING ETHICAL QUESTIONS
FACING OUR FIELD.
I'LL GIVE A SNAPSHOT OF FOUR
INITIATIVES, FIRST ON IBCI DATA
SECURITY, SECOND OPTIMIZING
IBCI-INFORMED CON THIRD, THIRD
GAP ANALYSIS ADVANCING FROM
INVESTIGATIONAL USE TO CLINICAL
PRACTICE AND FOURTH DEVELOPMENT
OF CURATED NEUROETHICS RESOURCE
HUB FOR OUR COMMUNITY.
THE FIRST PROJECT THAT I'LL
HIGHLIGHT TODAY IS IBCA DATA
SECURITY INITIATIVE WHICH IS
WORKING TO IDENTIFY AND DEVELOP
SAFEGUARD.
WHY CARE ABOUT IBCI DATA?
WHAT MAKES IT DIFFERENT FROM ALL
OTHER KINDS OF DATA?
STUDYING THE LANDSCAPE OF WHAT
IBCI DATA MIGHT CURRENTLY REVEAL
OR POTENTIALLY REVEAL IN THE
FUTURE ONE MIGHT CONSIDER
SOMEONE'S LEVEL OF
CONSCIOUSNESS, SLEEP HABITS, DAY
TIME ACTIVITIES, MEDICATIONS,
SENSORY PERCEPTIONS, LANGUAGE,
COMMUNICATION, PERHAPS BRAIN
CONDITIONS OR RISK OF DEVELOPING
FUTURE CONDITIONS AND MAYBE IN
THE FUTURE THINGS LIKE MOOD OR
EMOTIONAL STATE, MEMORIES,
PREFERENCES, BELIEFS, ELEMENTS
OF IMAGINATION OR INTROSPECTION.
FIGURING OUT HOW TO TRULY
DE-IDENTIFY THESE DATASETS,
PARTICULARLY GIVEN POTENTIAL
RANGE OF INSIGHTS ONE COULD IN
THE FUTURE DRAW FROM THESE DATA
IS A KNOWN ETHICAL CHALLENGE AND
THERE ARE CURRENTLY NO BROADLY
ACCEPTED STANDARDS FOR
COLLECTING AND SHARING
INTRACRANIAL NEUROPHYSIOLOGY
DATA, ACCENTUATED THAT
PARTICIPANTS HAVE BEEN AND ARE
STILL LIKELY TO BECOME KNOWN TO
THE WIDER COMMUNITY AND DATA
UNLIKE NEUROIMAGING DATA OR
ROUTINE EEG DATA COLLECTED FROM
HUNDREDS OR THOUSANDS OF PEOPLE
IN CLINICAL CONTEXT ANNUALLY AND
STRAIGHT FORWARD TO DE-IDENTIFY.
AS WE CONSIDER THE SENSITIVITIES
OF IBCI-DEREQUIRED NEURAL DATA,
WHAT IS THE ONTOLOGICAL STATUS
OF THESE DATA?
BEYOND WHAT CAN BE DONE WITH
THEM.
WHAT THEY REALLY ARE, UNDERSTOOD
AS A SPECIAL KIND OF HEALTH
DATA?
ARE THEY SOMETHING CATEGORICALLY
DIFFERENT LIKE INTELLECTUAL
PROPERTY?
RAW MATERIAL OF THOUGHT?
EXTENSION OR EVEN REFLECTION OF
THE SELF?
THESE ONTOLOGICAL QUESTIONS
MATTER BECAUSE THEY SHAPE HOW
IBCI-DERIVED NEURAL DATA ARE
GOVERNED AND HOW ANSWER WILL
INFORM WHETHER AND HOW BCI DATA
MIGHT BE SHARED, BOUGHT, SOLD,
DELETED AND WILL WEIGH HEAVILY
ON THE RIGHTS AND
RESPONSIBILITIES OF THOSE WHO
INTERACT WITH OR GENERATE THESE
KINDS OF DATA.
WE'VE IDENTIFIED A NUMBER OF
PRIORITIES IN THIS AREA.
I WON'T GO THROUGH EACH OTHER
THAN TO POINT TO SOME
FOUNDATIONAL PHILOSOPHICAL
QUESTIONS THAT STILL REMAIN.
WHAT IS THE ONTOLOGICAL STATUS
OF IBCI DATA?
HOW MIGHT THESE DISCOVERIES
INFORM CONCEPTS SELF-IDENTIFY
AND CONSCIOUSNESS?
CAN MENTAL STATES BE REDUCED TO
IBCI-RECORDED BRAIN STATES AND
WHAT IS RELATIONSHIP BETWEEN
REPRESENTATION OF THESE BRAIN
STATES THAT IBCI'S MIGHT CAPTURE
AND SUBJECTIVE EXPERIENCE?
RECOGNIZING THESE SENSITIVITIES
THE WORK GROUP IS FOCUSED ON
IDENTIFYING AND ANALYZING UNIQUE
SECURITY VULNERABILITIES UNIQUE
ACROSS OF THE LIFE CYCLE.
A KEY OBJECTIVE IS TO MAP HOW
SECURITY RISKS INTERSECT WITH
PRIVACY CONCERNS AND ENSURING
PROTECTIONS ARE REALLY BUILT
INTO EVERY STAGE OF DATA
HANDLING AND WE'RE ENVISIONING A
STRUCTURED TAXONOMY TO
CATEGORIZE IBCI SPECIFIC
VULNERABILITIES, STRATEGIES THAT
COULD BE INFORMED BOTH BY
TECHNICAL EXPERTISE AND ETHICS
INPUT WITH THE ULTIMATE GOAL OF
PRODUCING SECURITY
RECOMMENDATIONS FOR IBCI
DEVELOPERS, CLINICIANS,
REGULATORS.
SECOND AND INTERTWINED
INITIATIVE IS OPTIMIZING
INFORMED CONSENT TO REFLECT
RISKS AND REALITIES AS IBCIs
MOVE INTO CLINICAL USE.
AS PART OF THESE EFFORTS WE'RE
DEVELOPING A BCI INFORMED
CONSENT CHECK LIST DESIGNED TO
SUPPORT RESEARCHERS, CLINICIANS,
LOCAL IRBs AND OTHERS AS
IBCIs OF FROM INVESTIGATIONAL
USE TOWARD BROADER CLINICAL
INTEGRATION.
AND WE BRING ATTENTION TO
SEVERAL CHALLENGES.
FIRST, NEED TO DISTINGUISH
CLEARLY BETWEEN DEVICE CONSENT
AND DATA CONSENT.
IMPORTANCE OF CONSENT PROCESSES
THAT CAN BE DYNAMIC OVER TIME.
AND ACCOMMODATE PATIENTS WITH
IMPAIRED COMMUNICATION OR
DECISION-MAKING CAPACITY.
CLARIFYING OPTIMAL APPROACHES TO
SURROGATE CONSENT FOR PEOPLE WHO
MAY BE UNABLE TO PROVIDE
FIRST-PERSON CONSENT, EITHER DUE
TO SEVERE SPEECH AND MOTOR
IMPAIRMENT OR LOCKED IN SYNDROME
AND NEED FOR CLEAR FRAMEWORKS
AROUND NEURAL DATA OWNERSHIP AND
SHARING.
AND IMPORTANTLY THIS CHECKLIST
IS NOT MEANT TO REPLACE EXISTING
FRAMEWORKS BUT RATHER COMPLEMENT
STANDARD REQUIREMENTS SUCH AS
COMMON RULE BY HIGHLIGHTING
ETHICAL CONSIDERATIONS THAT ARE
DISTINCTIVE TO IMPLANTABLE
BCIs WHICH PLAY NOT BE FULLY
ADDRESSEDDED BY PREVAILING
CONSENT OR ASSENT FRAMEWORKS.
IN PARALLEL WITH THIS CHECKLIST
WE'RE IDENTIFYING NEED TO
DISENTANGLE, GOAL TO PROVIDE
PROSPECTIVE USERS OR CURRENT
USERS A VOICE IN HOW THEIR BRAIN
DATA MAY BE USED ONCE THEY ARE
RECORDED THROUGH DYNAMIC PROCESS
TO REVISE PROCESSES AND
TECHNOLOGIES EVOLVE.
TO SURFACE MISSING ISSUES, THIRD
THRUST OF THE WORK GROUP IS
FOCUSED ON IDENTIFYING
UNDEREXPLORED ETHICAL CHALLENGES
TRANSITIONING FROM THE BENCH TO
CLINIC.
WE'RE CATALOGING HIGH PRIORITY
ISSUES AND POTENTIAL BLIND SPOTS
IN TRANSLATION TO THE CLINIC.
THIS MATRIX MAPS EIGHT DOMAINS
WE'VE IDENTIFIED ACROSS
IMAGINING, CONSENT, ACCESS,
REGULATION, DATA GOVERNANCE,
LIABILITY AND SOCIAL AND
CULTURAL IMPACT ACROSS THE FULL
BCI LIFE CYCLE THROUGH CONSENT
CONVERSATION TO YEARS-LONG
RELATES OF REGULAR USE,
MAINTENANCE, UPGRADES, POTENTIAL
EXPLANTATION.
BY IDENTIFYING WHERE GUIDANCE IS
THIN AND WHERE RESPONSIBILITIES
ARE BLURRY A GOAL HERE IS TO
PROVIDE CONCRETE SIGN POSTS FOR
FUTURE ACTION SO THE AMAZING
TECHNICAL PROGRESS WE'RE SEEING
CAN CONTINUE TO ADVANCE
ALONGSIDE WELL CONSIDERED
ADAPTIVE ETHICAL SAFEGUARDS.
AS THESE EFFORTS UNFOLD WE'RE
DEVELOPING RESOURCE HUB TO SERVE
AS CENTRALIZED LIVING HOME FOR
OUTPUTS OF OUR WORK GROUP.
IN ADDITION ADDITION TO THIS, S
UNDERTAKING TO DEVELOP A HUB
WILL REALLY BE ANIMATED BY A
BROADER REALIZATION THAT
EXISTING RESOURCES INFORMATIVE
AS THEY MAY BE REMAIN FRAGMENTS
AND DISCONNECTED.
THIS HUB WILL ADDRESS THIS GAP
BY CREATING A CENTRALIZED LIVING
COMPENDIUM OPEN TO ONGOING
CONTRIBUTION THROUGH USER
SUGGESTIONS, HOPEFULLY HELPING
COMMUNITY PARTNERS EASILY FIND
WHAT THEY NEED TO SUPPORT
RESPONSIBLE BCI DEVELOP.
AND DEPLOYMENT.
WE'VE BUILD A ROBUST DIRECTY
INCLUDING SOME NEWG ITSELF HAS
PRODUCED.
THANK YOU FOR THE OPPORTUNITY TO
PRESENT THIS WORK.
IF YOU'RE INTERESTED IN LEARNING
MORE OR JOINING THESE EFFORTS
WE'D BE THRILLED TO WELCOME YOUR
INSIGHTS AND PARTICIPATION AS WE
GROW THIS COMMUNITY TOGETHER.
THANK YOU.
>> THANK YOU, JEN AND MICHAEL.
WE HAVE TIME FOR MAYBE ONE
QUESTION IF ANYONE MIGHT HAVE
ONE.
FEEL FREE TO CONTACT JEN, E-MAIL
HER, SHE CAN PASS QUESTIONS TO
MICHAEL, AND THEY ARE HAPPY TO
ANSWER ANY QUESTIONS YOU MIGHT
HAVE.
BEFORE I TURN BACK OVER TO NITA,
LET ME THANK ALL THE SPEAKERS,
ALL THE VISITORS, IT WAS A
WONDERFUL SESSION TODAY.
AND I REALLY APPRECIATED HEARING
ABOUT BCI NETWORK AND THESE
ISSUES WITH RESPECT TO DIGITAL
TWINS AND IT'S ALWAYS NICE TO
COME TO THIS MEETING TO LEARN
HOW EVERYONE IS THINKING ABOUT
THESE PARTICULAR ETHICAL ISSUES.
LET ME TURN IT OVER TO NITA.
>> ECHOING THANKS BUT REQUEST,
WHICH IS FOR ALL OF THE
STIMULATING CONVERSATIONS THAT
THIS CREATED, I WOULD BE
GRATEFUL FOR ALL OF YOUR
THOUGHTS AND RECOMMENDATIONS
ABOUT NEXT STEPS.
DO HOPE TO SEE A WORKSHOP DIVE
MORE DEEPLY IN TO DIGITAL TWIN,
DO YOU HOPE TO BREAK OFF A PIECE
AND THINK ABOUT POINTS TO
CONSIDER, ET CETERA.
FEEL FREE TO SUBMIT IDEAS TO
NINA AND THANKS TO EVERYONE,
THANKS TO JIM FOR STEPPING IN,
IN THE CO-CHAIR POSITION WITH ME
TODAY.
THANKS TO ALL OF OUR PRESENTERS,
TRULY WONDERFUL CONVERSATION AND
SET OF PRESENTATIONS THAT
OBVIOUSLY HAVE SPARKED A LOT OF
INTEREST ACROSS THE COMMITTEE.
SO THANK YOU.
>> THANKS VERY MUCH, NITA AND
JIM.
BEFORE WE CLOSE, I WANT TO TALK
TO JOHN, IF YOU HAVE CLOSING
REMARKS.
>> JUST A QUICK NOTE OF THANKS
TO THE CO-CHAIRS AND EVERYBODY
HERE, ANDREA, TO YOU AS WELL,
AND ALL THE STAFF THAT MADE THIS
POSSIBLE.
ANOTHER GREAT AFTERNOON OF
INTENSE AND INTERESTING
DISCUSSION, MUCH FOR US TO THINK
ABOUT.
YOU'LL BE HEARING FROM US AGAIN
SOON.
>> YEAH.
THANKS VERY MUCH, EVERYONE.
A QUICK REMINDER OUR NEXT
MEETING WILL BE ON AUGUST
26th, A TUESDAY.
THAT IS THE DAY BEFORE OUR MCWG
ON AUGUST 27.
HOPE YOU CAN JOIN US THOSE TWO
DAYS AND LOOK FORWARD TO SEEING
I THEN.
THANKS, EVERYONE.
HAVE A GREAT WEEKEND AND HAPPY
MOTHER'S DAY TO THOSE OF YOU WHO
CELEBRATE.
>> THANKS FOR THE REMINDER.
>> BYE-BYE.
[END OF PROGRAM]