Benosman, M. (2024, January 7).
PsyArXiv Preprints
https://doi.org/10.31234/osf.io/mdq8v
Introduction:
In recent years, the integration of chatbots in mental health care has emerged as a groundbreaking development. These artificial intelligence (AI)-driven tools offer new possibilities for therapy and support, particularly in areas where mental health services are scarce or stigmatized. However, the use of chatbots in this sensitive domain raises significant ethical concerns that must be carefully considered. This essay explores the ethical implications of employing chatbots in mental health, focusing on issues of non-maleficence, beneficence, explicability, and care. Our main ethical question is: should we trust chatbots with our mental health and wellbeing?
Indeed, the recent pandemic has made mental health an urgent global problem. This fact, together with the widespread shortage in qualified human therapists, makes the proposal of chatbot therapists a timely, and perhaps, viable alternative. However, we need to be cautious about hasty implementations of such alternative. For instance, recent news has reported grave incidents involving chatbots-human interactions. For example, (Walker, 2023) reports the death of an eco-anxious man who committed suicide following a prolonged interaction with a chatbot named ELIZA, which encouraged him to put an end to his life to save the planet. Another individual was caught while executing a plan to assassinate the Queen of England, after a chatbot encouraged him to do so (Singleton, Gerken, & McMahon, 2023).
These are only a few recent examples that demonstrate the potential maleficence effect of chatbots on-fragile-individuals. Thus, to be ready to safely deploy such technology, in the context of mental health care, we need to carefully study its potential impact on patients from an ethics standpoint.
Here is my summary:
The article analyzes the ethical considerations around the use of chatbots as mental health therapists, from the perspectives of different stakeholders - bioethicists, therapists, and engineers. It examines four main ethical values:
Non-maleficence: Ensuring chatbots do not cause harm, either accidentally or deliberately. There is agreement that chatbots need rigorous evaluation and regulatory oversight like other medical devices before clinical deployment.
Beneficence: Ensuring chatbots are effective at providing mental health support. There is a need for evidence-based validation of their efficacy, while also considering broader goals like improving quality of life.
Explicability: The need for transparency and accountability around how chatbot algorithms work, so patients can understand the limitations of the technology.
Care: The inability of chatbots to truly empathize, which is a crucial aspect of effective human-based psychotherapy. This raises concerns about preserving patient autonomy and the risk of manipulation.
Overall, the different stakeholders largely agree on the importance of these ethical values, despite coming from different backgrounds. The text notes a surprising level of alignment, even between the more technical engineering perspective and the more humanistic therapist and bioethicist viewpoints. The key challenge seems to be ensuring chatbots can meet the high bar of empathy and care required for effective mental health therapy.
