  Current ethical debates on the use of artificial intelligence (AI) in health
care treat AI as a product of technology in three ways: First, by assessing
risks and potential benefits of currently developed AI-enabled products with
ethical checklists; second, by proposing ex ante lists of ethical values seen
as relevant for the design and development of assisting technology, and third,
by promoting AI technology to use moral reasoning as part of the automation
process. Subsequently, we propose a fourth approach to AI, namely as a
methodological tool to assist ethical reflection. We provide a concept of an
AI-simulation informed by three separate elements: 1) stochastic human behavior
models based on behavioral data for simulating realistic settings, 2)
qualitative empirical data on value statements regarding internal policy, and
3) visualization components that aid in understanding the impact of changes in
these variables. The potential of this approach is to inform an
interdisciplinary field about anticipated ethical challenges or ethical
trade-offs in concrete settings and, hence, to spark a re-evaluation of design
and implementation plans. This may be particularly useful for applications that
deal with extremely complex values and behavior or with limitations on the
communication resources of affected persons (e.g., persons with dementia care
or for care of persons with cognitive impairment). Simulation does not replace
ethical reflection but does allow for detailed, context-sensitive analysis
during the design process and prior to implementation. Finally, we discuss the
inherently quantitative methods of analysis afforded by stochastic simulations
as well as the potential for ethical discussions and how simulations with AI
can improve traditional forms of thought experiments and future-oriented
technology assessment.
