Job interview in the year 2042

MILTON (MachIne Learning with phenoType associatONs), a system that uses artificial intelligence (AI) to analyse vast amounts of biological data to predict diseases with remarkable accuracy, is a remarkable innovation (see BioNews 1256).

Developed using routine clinical biomarkers and data from plasma protein measurements, MILTON has the potential to revolutionise healthcare by identifying disease risks years before diagnosis, facilitating early intervention and more personalised treatments. However, the growing power of such systems also raises important ethical considerations, particularly concerning data privacy and the potential for misuse.

Transport yourself to the year 2042, a time when innovation and progress have reshaped the world as we know it, leaving 2024 far behind us. MILTON has undergone a significant evolution. Now, in the form of MILTON Generation (MILTON.G16), it has become an integral part of our daily lives.

Arin Korvix – a bright, freshly-minted graduate from the prestigious Hyperion Institute of Nanomedicine – was eager to start his first job. Arin had spent years studying bio-engineered prosthetics and was thrilled to land an interview at CytoStemCorp, one of the leading biotech companies specialising in advanced medical technologies. The job offer was everything he had dreamed of, but there was a small catch: he needed to undergo a routine blood test, a standard procedure for workers in his field due to the nature of their lab work.

The blood test was quick and painless. What Arin didn't know, however, was that CytoStemCorp also used MILTON.G16, the cutting-edge AI system that could predict an individual's future health status with startling accuracy. With access to vast data on biomarkers, plasma proteins, and genetic information, MILTON.G16 could forecast potential diseases years before any symptoms appeared. While Arin thought the blood test was simply for screening infectious diseases, MILTON.G16 quietly went to work, analysing his sample for much more.

As MILTON.G16 processed the data, it identified something unusual in Arin's biomarkers. The system flagged a series of predictive signatures that indicated a high likelihood of Arin developing early-onset Parkinson's disease within the next five to ten years. This devastating neurodegenerative disorder, while slow-progressing, would eventually affect his motor functions, leading to tremors, difficulty with balance, and muscular stiffness. Beyond that, Parkinson's disease is notoriously costly to manage, with ongoing medication, physical therapy, and, in advanced stages, potential surgeries to alleviate symptoms.

For CytoStemCorp, this was a red flag – not just because of the potential impact on Arin's future job performance, but also because of the significant healthcare costs associated with the disease. Armed with this foresight, the company quietly adjusted their offer.

Ending One: Ignorance is Bliss

A few days later, Arin received an offer letter from CytoStemCorp. The company congratulated him on passing all tests and interviews but explained that, given their workforce planning and current market conditions, they could only offer him a five-year contract. They assured him that he could apply for a renewal closer to the end of the contract, though the ambiguity of the situation puzzled him.

Arin was also contacted by CytoStemCorp's partnered health insurance provider, which outlined the details of his new health plan. As he reviewed the policy, he noticed a clause that limited coverage for neurodegenerative disorders. The clause seemed oddly specific, but Arin, confident in his health, didn't give it much thought. After all, he was young, fit, and had no family history of neurological disorders.

What Arin did not realise was that the five-year contract and the insurance coverage limitation were direct consequences of MILTON.G16's findings. CytoStemCorp and the insurance provider knew that Arin was at high risk for developing Parkinson's disease within a decade, but they chose not to disclose this information to him. Their decision to keep him in the dark was based on a mixture of legal and financial considerations; after all, disclosing this information could lead to unwanted scrutiny or backlash.

Unaware of what lay ahead, Arin eagerly signed the contract and dove headfirst into his career. For the next five years, he excelled at his job, pushing the boundaries of medical technology with his innovative ideas. Yet, in the background, the early stages of Parkinson's were quietly taking root in his nervous system, waiting to surface. By the time his contract ended, the first symptoms would begin to appear, and Arin would find himself facing an uncertain and daunting future – one he never saw coming.

Ending Two: The Unbearable Truth

In another version of the story, CytoStemCorp decided to take a more transparent, albeit unsettling, approach. One week after Arin's blood test, he was called in for a meeting with a representative from human resources and a company health advisor. The room felt tense, and Arin could sense that something wasn't right.

'Arin,' the HR rep began, 'we have received the results from your blood test. Using MILTON.G16, our AI system that analyses health markers, we've detected some predictive biomarkers that suggest you have a high likelihood of developing Parkinson's disease in the next five to ten years.'

Arin stared blankly, trying to process the information. 'Parkinson's? But I'm only 25, and I have no family history of it. How can you be sure?'

'The AI is extremely accurate,' the health advisor explained. 'While this doesn't guarantee you will develop the disease; it is highly likely. Given the nature of this prediction, we can only offer you a five-year contract at this time.'

Stunned, Arin nodded mechanically, feeling the weight of his future suddenly press down on him. As he left the meeting, he contacted the health insurance provider to inquire about his policy. His worst fears were confirmed. The company had excluded neurodegenerative disorders – like Parkinson's disease – from coverage, citing it as a 'pre-existing condition' based on MILTON.G16's analysis. No matter how hard Arin argued, he could not force either the insurance company or CytoStemCorp to extend better coverage or offer him a longer contract.

He was faced with the harsh reality that the predictive power of MILTON.G16 had reshaped his future without his input. Though he now knew about the looming threat of Parkinson's disease, there was nothing he could do to stop the corporate gears from turning. The AI had made its predictions, and those predictions had quietly influenced every decision about his career and healthcare.

In this version of the future, knowledge came at a steep price. Arin's career and health were no longer his to control, but rather dictated by the cold precision of a machine that saw what he couldn't – and made decisions before he had the chance to live his life on his own terms.

To prevent these potential misuses, it is essential that the deployment of MILTON and similar systems is governed by strict regulations. These regulations should ensure that individuals' health data is used responsibly and only with their explicit consent.

Furthermore, transparency in how these predictions are made and used is vital to maintain public trust in AI-driven healthcare innovations. Policymakers, healthcare providers, and technologists must work together to create ethical guidelines that protect individuals while allowing the scientific and medical benefits of tools like MILTON to flourish.

Professor Dusko Ilic will be speaking at the 2024 PET Annual Conference – 40 Years after the Warnock Report: What Is the Embryo's Special Status? – in central London on Wednesday 4 December 2024.

Professor Ilic is speaking at the session 'What Is the Embryo's Special Status in the Lab?', where his presentation is entitled 'Human In Vitro Derived Gametes: How Far Are We Allowed to Go?'.

Find out more about the conference, and register to attend, here.