Letter to the editor concerning the article: “Artificial intelligence in clinical pharmacology: A case study and scoping review of large language models and bioweapon potential”

Abstract

We read with interest the case study and scoping review by Rubinic et al1 on possible misuse of artificial intelligence (AI) in bioweapon development. We agree to the authors regarding the importance of a strategic approach in ethical values following the principles of transparency, accountability, and safety. We also believe that ethics education is needed for students of clinical professionals, including educational reflection on history of bioweapon development. However, results of our recent survey show lack of such education. Approximately 90 years ago, Japanese imperial army Unit 731 was secretly organized in northeast China, to develop bacterial bioweapon prohibited by the Hague Convention.2-4 The unit included many physicians and microbiologists. Unit 731 used lethal bioweapons of Yersinia pestis, cholera and typhoid for humans. In 2002, Tokyo district court admitted that deaths from operations by Unit 731 were approximately 10 000 people. This wartime crime clearly violated ethics and professionalism of physicians. Medical students should be taught about this history as an important lesson to prevent future misconduct.4 However, there is no clear data on whether Japanese medical schools provide sufficient education about the war crimes of Unit 731. Therefore, we investigated whether education about the war crimes of Unit 731 was given to medical school students. We obtained approval from the Ethical Review Committee of the Japan Institute for Advancement of Medical Education Program (No.22-27). All participants provided informed consent before engaging in the survey following the Declaration of Helsinki. The survey was provided for 535 newly graduates of medical schools and total of 435 participated, yielding a response rate of 81%. The median age of the respondents was 25 years (male, 70%; female, 30%). We provided the following questionnaire item: “Have you been subjected to any structured educational delivery (e.g., lectures) during your medical schooling, focusing on the issue of biological weaponry utilization in China during the Asian-Pacific War by the Japanese Army's Quarantine and Water Supply Unit?” Only 31 (7.1%) responded receiving such specialized education. At current medical schools in Japan, legacy of Unit 731 has been only rarely taught. Medical schoolteachers in Japan should acknowledge our debts and teach students the history and its unethical misconduct so that Japanese students become ethical professionals and are able to prevent development of bioweapon.5 Ethics education reflecting a previous bioweapon use and integrating ethical AI use should be enhanced in professional schools. The guidelines, proposed by Rubinic et al,1 can be collaboratively established and effectively implemented by ethical professionals who adhere to ethical principles to ensure the effective, safe, and just development of new technology in science, including biology and AI research. Both authors conceived and wrote the letter. None declared.

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