"Democratizing" artificial intelligence in medicine and healthcare: Mapping the uses of an elusive term.

Introduction: "Democratizing" artificial intelligence (AI) in medicine and healthcare is a vague term that encompasses various meanings, issues, and visions. This article maps the ways this term is used in discourses on AI in medicine and healthcare and uses this map for a normative reflection on how to direct AI in medicine and healthcare towards desirable futures. Methods: We searched peer-reviewed articles from Scopus, Google Scholar, and PubMed along with grey literature using search terms "democrat*", "artificial intelligence" and "machine learning". We approached both as documents and analyzed them qualitatively, asking: What is the object of democratization? What should be democratized, and why? Who is the demos who is said to benefit from democratization? And what kind of theories of democracy are (tacitly) tied to specific uses of the term? Results: We identified four clusters of visions of democratizing AI in healthcare and medicine: 1) democratizing medicine and healthcare through AI, 2) multiplying the producers and users of AI, 3) enabling access to and oversight of data, and 4) making AI an object of democratic governance. Discussion: The envisioned democratization in most visions mainly focuses on patients as consumers and relies on or limits itself to free market-solutions. Democratization in this context requires defining and envisioning a set of social goods, and deliberative processes and modes of participation to ensure that those affected by AI in healthcare have a say on its development and use.

Rethinking Human Embryo Research Policies.

It now seems technically feasible to culture human embryos beyond the "fourteen-day limit," which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen-day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen-day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high-quality research and public confidence in it.

"Think positively": Parkinson's disease, biomedicine, and hope in contemporary Germany.

Narratives of hope shape contemporary engagements with Parkinson's disease. On the one hand, a "biomedical narrative of hope" promises that biomedical research will help to transform this treatable but incurable disease into a curable one in the future. On the other hand, a more individual "illness narrative of hope" encourages patients to influence the course of Parkinson's disease by practicing self-care and positive thinking. This article asks how these two narratives of hope interact. It bases its argument on an analysis of data from 13 focus groups conducted in Germany in 2012 and 2014 with patients with Parkinson's disease and their relatives. Participants were asked to have their say on clinical trials for advanced therapies for Parkinson's disease and, while doing so, envisioned their biosocial selves in the present and the future. Three "modes of being" for patients were drawn from this body of data: a "users on stand-by" mode, an "unengaged" mode, and an "experimental pioneers" mode. Both narratives of hope were important to all three modes, yet they were mobilized at different frequencies and also had different statuses. While the biomedical narrative of hope was deemed an important "dream of the future" that participants passively supported without having to make it their own, the illness narrative of hope was a truth discourse that took an imperative form: having Parkinson's disease implied the need to maintain a positive attitude.

Biomarkers and their consequences for the biomedical profession: a social science perspective.

Although biomarkers are not altogether new, they are gaining a new life in our postgenomic present. This article takes this as a good reason to explore biomarkers in depth and to speculate about the consequences that biomarkers might engender in clinical practices. First, the article ventures into an endeavor of ordering the dynamic field of biomarkers, suggesting a possible classification of biomarkers, and then argues that we are currently witnessing a 'biomarkerization' of health and disease - defined as an ongoing future-oriented process that seeks to solve biomedical as well as public health problems through investments into biomarker research at the present time. Subsequently, this article reflects on some possible consequences of this phenomenon. It argues that while the movement of candidate biomarkers into the clinic is arduous, biomarkers might develop a life of their own once they arrive in the clinic. This article outlines the direction of two such possible consequences. It suggests that biomarkers might be involved in a change of the actors that order and categorize diseases, as well as trigger transformations in our understanding of what counts as disease in the first place. Hence, this article seeks to shed light on the paradox that while biomarkers are designed to add more evidence into clinical practice, they might actually increase uncertainty and ambiguity.