Ethics Board member Prof. Dr. Dr. Eva Winkler

In future, she will contribute to key ethical issues of relevance to society and the life sciences in particular. In a brief interview with Stefanie Seltmann, Head of Corporate Communications and Press Spokesperson at Heidelberg University Hospital, Winkler talks about her motivation, the particular challenges she faces and her role on the Ethics Council.

Stefanie Seltmann: Ms. Winkler, you have been elected to the National Ethics Council, congratulations!

Eva Winkler: Thank you.

Stefanie Seltmann: Were you happy?

Eva Winkler: Yes, I was delighted. But I also paused for a moment to see if I could do it in terms of time. And I also spoke to the people who were on the previous council in various roles. And then I canceled or terminated some things to create space. And then I said yes.

Stefanie Seltmann: You are a medical ethicist and Managing Director at the NCT Heidelberg. What can you contribute to this National Ethics Council?

Eva Winkler: The role of the Ethics Council is to advise the Bundestag on ethical issues of social relevance and to address them in a multidisciplinary way with many perspectives and with the corridors of action that can be defined in a democratic, pluralistic society. But it should also take up new technologies that come from research into healthcare and examine them ethically. In other words, topics such as big data, the secondary use of data, or the robotics and care opinion. And that is basically my main area of research: translation, findings and research results that are developed to such an extent that the first studies with people can be started or that are even used in healthcare. In this respect, it's even a synergism in terms of content. It is precisely this area of “translation” that plays a central role at the NCT.

Stefanie Seltmann: Where does your interest in medical ethics come from? Was there a key moment or has it always been there?

Eva Winkler: I already had an interest in philosophy before I started my studies. I had even considered going into philosophy. But my interest really came from my clinical work, because we have value issues in so many areas. For example, in the course of treatment: it's not difficult to decide because you don't know what is medically, therapeutically or diagnostically possible, but because questions of evaluation arise. For example, weighing up the benefits and side effects of certain therapies in advanced tumor disease. How do we negotiate this with the patient and the family? Patients don't always know straight away how intensively they want to be treated, how important life expectancy is in relation to quality of life. We have to find out together. After all, the topic of study endpoints is also a central issue at the NCT. And we develop recommendations that make it easier in acute individual cases because we have already thought about it beforehand. And in Heidelberg, this is not only the case in clinical ethics, but also very strongly in research, where researchers also have this forward-looking approach. A typical example is genome sequencing, which is also being used in the first nationwide recruiting NCT study, RATIONALE: If this becomes available now and we carry it out on many patients, what does that mean? How do we deal with the findings?

Stefanie Seltmann: You have now indicated that you are particularly interested in AI and robotics in medicine. AI is also an important topic at the NCT. Are there any particular ethical problems, new ethical problems or challenges?

Eva Winkler: There are indeed new questions. One new aspect of the data is perhaps the risk of an imbalance in the data, which then increases like a magnifying glass. For example, if we have too little data from women, the medicine based on this data cannot be good because we simply don't have a good representation of both genders in the data used to train the algorithms. The same goes for skin color and so on. And of course the question arises: where is the ultimate human responsibility when automated systems are increasingly capturing images faster and are superior to us in terms of processing speed? At some point, patients may say: I'd rather have AI, which is better than a doctor. But who will take responsibility if the AI isn't right?

Stefanie Seltmann: You have just come from the first meeting, the constituent meeting in Berlin. How was it?

Eva Winkler: It was very exciting, and there was a much broader spectrum of expertise in the room: theologians, economists, sociologists who do extensive research, environmental ethicists, some from social work, from self-help, from cancer self-help... And everyone made a very committed, interested and motivated impression. It's a large group of 24 people. That will certainly be another new experience, how to write a joint statement.

Stefanie Seltmann: Do you think the National Ethics Council has a substantial influence on politics?

Eva Winkler: It is difficult to say how big its influence actually is. But the National Ethics Council definitely has greater visibility after the pandemic. The President of the Bundestag appointed us and was also present at the inaugural meeting. She not only gave a short introductory speech, but there was also an exciting discussion because we also asked her: What impact does this actually have? And she said that these statements are a real help for members of the Bundestag when it comes to current issues. Especially when it comes to issues that are decided across party lines. She told us not to underestimate our work because, although it doesn't decide the outcome of a particular discussion, it does provide orientation. I would have taken a more modest approach, but perhaps she also told us that to motivate us.

Stefanie Seltmann: Thank you very much, Ms. Winkler, and I hope you enjoy your work on the National Ethics Council.  Your perspectives will certainly benefit both the Ethics Council and the NCT.

Eva Winkler: Thank you very much.
 

About the German Ethics Council