Selected Publications
- Starke, G., Schopp, L., Meier, C., Baffou, J., Thanou, D., Maurer, J., & Jox, R. J. (2025). Machine Learning–Based Patient Preference Prediction: A Proof of Concept. NEJM AI. https://doi.org/10.1056/AIoa2500265
- Starke, G., & Ienca, M. (2025). AI, neurotechnology and society – a question of trust. Nature Reviews Neurology. https://doi.org/10.1038/s41582-025-01114-6
- Starke, G., Sobieska, A., Knochel, K., & Buyx, A. (2025). Epistemic humility meets virtual reality: teaching an old ideal with novel tools. Journal of Medical Ethics. https://doi.org/10.1136/jme-2024-110591
- Starke, G., & Jox, R. J. (2024). Potentially Perilous Preference Parrots: Why Digital Twins Do Not Respect Patient Autonomy. The American Journal of Bioethics, 24(7), 43-45. https://doi.org/10.1080/15265161.2024.2353810
- Starke, G., De Clercq, E., & Elger, B. S. (2021). Towards a pragmatist dealing with algorithmic bias in medical machine learning. Medicine, Health Care and Philosophy, 24(3), 341-349. https://doi.org/10.1136/jme-2024-110591
FRIAS Project
Artificial Intelligence at the end of life: a proof-of-concept and critical appraisal of a patient preference predictor.
Patient preferences are central to providing good clinical care. Special challenges arise when patients cannot make healthcare decisions themselves and have no advance directives. In such situations, surrogate decision-makers can be asked to step in and determine the patient’s presumed best interest. However, research shows that such surrogates, usually close relatives, frequently struggle to predict a patient’s wishes, creating significant ethical and emotional challenges. One recently proposed solution relies on artificial intelligence to predict and guide decision making. Supposedly, such a patient preference predictor (PPP), for instance in the form of a fine-tuned large language model, can give accurate accounts of what a person would have wanted for themselves, and possibly better than their next of kin. This project critically examines the feasibility and desirability of such a PPP. The current debate suffers from the curious fact that so far, no PPP has been developed. Drawing on a representative dataset from Switzerland, this project therefore proposes a first proof-of-principle PPP, allowing to highlight potential pitfalls with view to both data and modelling. Based on this model, an ethical assessment of the technology will then further examine the potential and limitations of AI-based preference predictors in depth, scrutinizing the risks of techno-solutionism in end-of-life decision-making.
