The guiding thread of this issue of the journal Medicina y Ética is the increasingly frequent incorporation of technology and “smart” technology in our lives, both professionally and personally. The rise of so-called Artificial Intelligence (AI) and its incorporation in various areas has facilitated processes due to its speed and accuracy, however, it presents important challenges for ethics and bioethics that must be analyzed in depth.

Two articles and two reviews are published that address some of these bioethical issues that merit serious reflection. There are also three other articles that, without dealing with technology and AI, bring us back to a critical look at other equally important issues for the defense of human life and the dignity of the person.

This issue, moreover, is of great relevance since it features the first article, written by Monsignor Renzo Pegoraro, Chancellor of the Pontifical Academy for Life who shares his reflections on the ethics of AI in the care of life, basing them on the document, signed in 2020, by Pope Francis and Monsignor Paglia, President of the Academy and the directors of Microsoft and IBM, among others to ethically guide the use of intelligent technology.

Monsignor Pegoraro shares with us the central idea that we are not only facing an era of change, but a true change of era that imposes challenges for human beings. Among them, the most pressing and urgent is the ethical use of AI and he affirms that there are particularly three areas where this application presents the greatest ethical questions: Big Data, the care of the elderly and the early detection of diseases.

Regarding the first, the author warns of the risk of obtaining and using personal data where problems about privacy and confidentiality become sensitive issues. Concerning the second, he states that, although the uses and scope of AI are not only numerous, but also beneficial, such as those implemented for the monitoring and medical follow-up of this sector of the population, these applications are not exempt from the danger of depersonalizing medical care, especially the doctor-patient relationship, so it is advisable to monitor its use at all times for the good of the individual and of society.

Finally, in regard to early diagnosis and timely treatment of diseases, AI also offers great benefits, but warns against its absolutization, which can lead to the abandonment of patients due to excessive confidence in the machines. It is important to emphasize the idea that AI should always be at the service of the good and the person through the practice of ethical and bioethical principles, education and the defense and promotion of the human dignity of all people.

The second article by Maroun Badr, puts on the table of bioethical discussion the argument on the embryonic discontinuity of St. Thomas Aquinas and its implications in the field of Bioethics.

With a deep knowledge of Aquinas’ thought, the author provides the theory of embryonic discontinuity which affirms that the person, from his development, is already a substance, but whose soul, granted by God, progresses as he develops from the merely vegetative soul to the sensitive soul and finally, to the rational soul. Despite this progression, the author affirms that the Thomistic explanation cannot and should not be interpreted to argue that the embryo, lacking a rational soul until a certain stage of its development, is not a person and a unity of body and soul where both components are on a par and arise at the same and unique moment.

With this, Maroun Badr defends respect for the embryo as a priority in the face of current situations that use arguments to maintain that the embryo is not a person until it presents a human form or rational activity, such as abortion, twinning, the production of embryos through assisted reproduction techniques or even the creation of chimeras where human cells are combined with animal cells.

The third article presented in this issue by Agustín Herrera, is a clear denunciation of the non-compliance with the right to the protection of the health of children and adolescents through the prohibition, in the Health Commission of the Mexican Chamber of Deputies in 2022, the Expanded Newborn Screening (ENBS). This is due to the fact that neonatal screening is useful to diagnose metabolic or genetic diseases early and to provide timely treatment or prevent them from developing later. The simple neonatal screening, explains the author, includes the possible detection of only six diseases while the expanded screening includes up to 67, many of which present adverse conditions for the life of the children or trigger serious consequences for their health.

This is why, in addition to the non-fulfillment of a fundamental human right, this prohibition leaves out bioethical principles such as therapeutics, freedom-responsibility, justice, solidarity, subsidiarity, among others.

The following article by Gabriela Morales, takes up the reflection on AI and places the debate on the cognitive biases that can creep into the creation and programming of artificial intelligence systems and can represent great risks and marked processes of discrimination that entail important consequences.

Morales demonstrates in his argument that such biases that are presented in AI on decisions inclined in favor of certain groups of people who meet certain patterns, actually come from the prejudices and biases of the people who programmed such systems since our ethical and moral decisions are loaded, almost always, of previous beliefs, judgments, prejudices, considerations, previous experiences, and so on.

This is even more dramatic in the scientific field where competition is such that, without being aware of it, researchers and scientists run the risk of falling into at least four biases that the author exposes, ranging from adherence to certain ideas to believing only those results that support the hypothesis they want to sustain.

The author points out that it is important, therefore, to realize that AI systems are permeated by the hidden biases of the very people who programmed them, which can be destructive or lead to unethical or even discriminatory decisions.

The fifth article presented in this issue, written by Alfonso Noguera, has as its context the analysis of the distribution of drugs according to the Spanish National Health System, but it can be extended to other realities insofar as the central proposal is that biosimilar drugs can be patented and marketed, thus helping to improve their accessibility and distribution. This is based on the fact that, in terms of quality and safety, they are equal to biological drugs and, therefore, it is necessary to strive for greater coverage of those who require them.

The author supports the patenting and commercialization of these drugs based on the practical application of the principle of justice in bioethics in health regulations.

The two reviews that make up this issue allude, once again, to the backbone of this edition. The first, by José Enrique Gómez, describes the book entitled Post and Transhumans by Caleb Olvera, whose central thesis is that, given that human beings have always evolved over time, transhumanism and posthumanism are not presented as anything different or surprising because it is even impossible, due to this evolutionary inertia, to find a truly human essence. Thus, the truly human condition would be, rather, a “transhuman” one.

The second and last review by Rubén Torres, narrates what is exposed in the book AI: 2041. Ten visions of our future and begins by launching the first sentence that thinking about the future is always uncertain, which is confirmed throughout the review when the different technological and AI advances are presented in different fields ranging from the economy, health, the arms industry, the automotive industry, quantum computing, etcetera. This provides an overview of the different future uses of AI and its bioethical considerations.

These lines serve to introduce the reader to the current questions and challenges of our time regarding the incorporation of technology into our existence -or the technologization of our lives- in order to also envision possible paths that benefit and serve the individual and society.