This activity has been designed to support students in reflecting and learning about AI in helath care. Before participating in this exercise students are asked to follow the online modules developed by IRECS on this topic.

By taking part in this activity students work towards the following learning goals and become:

knowledgeable on relevant literature, developments and regulations with regards to the topic addressed

able to indicate what ethical issues are pressing regarding research concerning AI in healthcare contexts

able to apply relevant ethical concerns on a case

aware how the learning materials are relevant for their professional context

During the session, the students will be divided into subgroups (up to 6 students in each group).

To encourage the dialogue, comments and questions have been prepared for each role. These are presented on dialogue cards (see practical tips).

Practical Tips

Before starting the exercise, it can be useful to emphasize that the groups are invited to engage in dialogue rather than discussion.

It can be helpful to include a chairperson in each subgroup to coordinate the dialogue.

Appendix A Dialogue cards

Representative of patient rights advocacy How to ensure that patients have a good understanding of how HealthAI will handle their data?	Representative of patient rights advocacy May patients refuse or give preference to another treatment suggested by HealthAI?
Representative of patient rights advocacy Can data security be fully guaranteed?	Representative of HR of the hospital What kind of expertise do we need to have in our hospital to successfully implement HealthAI? Do we need to recruit new employees, or what training should be organized by whom?
Representative of HR of the hospital What kind of impact may it have on the reputation of the hospital?	Fill in yourself
Fill in yourself	Fill in yourself
Fill in yourself	Fill in yourself

Healthcare professional How will HealthAI affect your day-to-day work?	Healthcare professional How will HealthAI affect your relationship with the patient?
Healthcare professional Do you have concerns about informed consent? According to HealthAI, all patient data will be used for this AI system.	Healthcare professional Are there any conditions or what is needed to implement Health AI?
Representative of HealthAI Who takes care of responsibilities when errors have been made?	Representative of HealthAI A comment to bring to the table: The system prevents a lot of human errors.
Medical ethicist From early experience with AI systems, we have seen that the AI system can hallucinate and that biases (e.g. against certain patient groups) can be built into the algorithm. To what extent are these assumptions corrected in the system or by a healthcare professional?	Medical ethicist What ethical dilemmas or concerns could you foresee? How can we deal with them?
Representative of a health insurance company How will this affect health insurance? Should we offer different types of insurance?	Representative of a health insurance company If a cheaper and perhaps better AI system for health care becomes available outside our nation, can we recommend it and put it into practice?

Representative of patient rights advocacy How to ensure that patients have a good understanding of how HealthAI will handle their data?	Representative of patient rights advocacy May patients refuse or give preference to another treatment suggested by HealthAI?
Representative of patient rights advocacy Can data security be fully guaranteed?	Representative of HR of the hospital What kind of expertise do we need to have in our hospital to successfully implement HealthAI? Do we need to recruit new employees, or what training should be organized by whom?
Representative of HR of the hospital What kind of impact may it have on the reputation of the hospital?	Fill in yourself

1

Preparation

Before participating in this activity students prepare themselves by completing (one of) the e-modules:

AI In Healthcare: Technology Basics

AI In Healthcare: Ethics Issues

Case studies: AI in Healthcare

2

Introduction to the exericse

During the session, the students will analyse a case using role play. In subgroups (up to 6 students in each group) they will each impersonate a member of an expert grouyp who has been formed by the executive board of a prestigius institution to examin a difficult case and provide advice.

Eery participant play’s one of following roles:

Healthcare professional (physician)

Representative of “HealthAI”

Patient rights advocacy

Medical ethicist

Representative of human resources of the hospital

Representative of a health insurance company

The experts are invited to have a dialogue and to learn more from each other’s perspectives. The aim is to formulate an advice for the executive board.

Before starting the exercise, it can be useful to emphasize that the groups are invited to engage in dialogue rather than debate.

To encourage the dialogue, comments and questions have been prepared for each role (see step 3).

3

Forming groups

Create groups of 6 people max and assign one of the following roles to each participant in each group:

Healthcare professional (physician)

Representative of “HealthAI”

Patient rights advocacy

Medical ethicist

Representative of human resources of the hospital

Representative of a health insurance company
If you are facilitating this in person, you can write each role on a card and ask participants to pick a card from a deck.

4

Present the case

Present the case to the students. It is helpful to project the case or distribute copies of the case in printing, so that students can have access to it during the group work. Please find the case below: In a large hospital the executive board is considering purchasing a new AI system called “HealthAI”. HealthAI is designed to assist healthcare professionals in patient diagnoses based on input of personal data from patients (such as lab results, DNA-material and patient history), it also can be used to assist with administrative tasks. However, at national level concerns have been raised regarding the use of HealthAI due to, for example, privacy risks and system errors (false positive diagnosis). At the same time, the healthcare sector is facing an urgent shortage of health personnel as a result of societal challenges (e.g. aging population).

5

Encourage dialogue and shared reflection

Invote participants to engage in a conversation about the presented case. The experts are invited to have a dialogue and to learn more from each other’s perspectives. The aim is to formulate an advice for the executive board. The following questions also presented in practical tips can support the reflection and stimulate dialogue. They are questions that each expert might ask from thir onw specific perspective:

Below are some comments and questions that may be of help to the participant in their role.

Healthcare professional

How will HealthAI affect your day-to-day work?

How will HealthAI affect your relationship with the patient?

Do you have concerns about informed consent? According to HealthAI, all patient data will be used for this AI system.

Are there any conditions / what is needed to implement Health AI?

Representative of HealthAI

Who takes care of responsibilities when errors have been made?

A comment to bring to the table: The system prevents a lot of human errors.

Representative of patient rights advocacy

How to ensure that patients have a good understanding of how HealthAI will handle their data?

May patients refuse or give preference to another treatment suggested by HealthAI?

Can data security be fully guaranteed?

Medical ethicist

From early experience with AI systems, we have seen that the AI system can hallucinate and that biases (e.g. against certain patient groups) can be built into the algorithm. To what extent are these assumptions corrected in the system or by a healthcare professional?

What ethical dilemmas or concerns could you foresee? How can we deal with them?

Representative of Human Resources of the hospital

What kind of expertise do we need to have in our hospital to successfully implement HealthAI? Do we need to recruit new employees, or what training should be organized by whom?

What kind of impact may it have on the reputation of the hospital?

Representative of a health insurance company

How will this affect health insurance? Should we offer different types of insurance?

If a cheaper and perhaps better AI system for health care becomes available outside our nation, can we recommend it and put it into practice?

6

Forming advice and reporting to plenary

Each group formulates an advice and reports it back to the group.

Steps

Other information