AI in Healthcare: Ethics Issues
ModulesAI in Healthcare: Ethics Issues
The aim
To support students, researchers, and research ethics reviewers in learning about and reflecting upon the ethics issues associated with the development and use of AI technologies in healthcare.
Learning outcomes
At the end of this module, learners will be able to:
- Explain the relevance of informed consent, transparency and explainability for AI in healthcare.
- Describe the data-related ethics issues for AI in healthcare.
- Reflect upon broader ethics issues (like social values and the environmental impact) related to AI in healthcare.
- Access relevant guidelines and regulations for the use of AI in healthcare (e.g., the European Commission Guidelines for AI Research)
Opening Poll
How confident do you feel about navigating ethics issues related to the use of AI technologies in healthcare domains? Select the most appropriate response in the anonymous poll.
Informed Consent, Transparency and Explainability
Informed consent processes can be challenging when AI technologies are involved. Bearing the important concepts of transparency and explainability in mind when designing consent documents and processes will help to centralise patients/participants’ needs and ensure a fair process.
Data-Related Ethics Issues for AI in Healthcare
With the integration of AI technologies into healthcare, shaping diagnostic tools, treatment plans, and patient care, critical questions emerge about data-related ethics issues.
Here are some examples:
Data-Related Ethics Issues for AI in Healthcare cont.
Data-Related Ethics Issues for AI in Healthcare cont.
How and at what points can bias be introduced into AI systems in healthcare? Click on the image below to find out more.
It is important for researchers and reviewers of research to be aware of the data-related ethics issues, that may arise in projects using AI technologies in the healthcare domain.
Vigilance about these matters is essential at the initial design stages and throughout projects.
The Protection and Promotion of Societal Values
Societal values are the shared beliefs, principles, and norms that guide the behaviour and interactions of individuals within a society. These values play a crucial role in shaping the culture, social cohesion, and overall functioning of a community.
AI clearly has the potential to cause harms to society, as was evident in the case of Cambridge Analytica when social media data was misused to manipulate the outcome of democratic elections. Concerns related to accountability/responsibility, patient-healthcare provider relationship, question of trust, surveillance, etc. in AI are significant and are being studied. However, in such a rapidly changing field, questions around the continuing evolution and potential uses of AI in healthcare and their broader impacts upon individuals, communities, and society in general will remain open.
The use of robots in the delivery of care offers a useful illustration of the complexity of questions to be considered about the impact of AI machines for individuals, communities, and society. James Wright observed the trialling of three types of care robots in a Japanese care home:
- Hug, an assistive robot, which was used to lift patients out of bed and reduce the need for staff to undertake manual lifting.
- Paro, a robotic furry seal, which was used to provide a form of animal therapy and companionship for elderly residents.
- Pepper, a humanoid robot, which was used to lead activities such as karaoke or exercise sessions.
AI In Healthcare: Ethics Issues Step6- Video about the use of Robots in the Delivery of Care
Reflecting on the Broader Ethics Issues Relevant to The Use of AI in Healthcare cont.
AI In Healthcare: Ethics Issues Step7- Video about the Environmental Impacts of AI in Healthcare
Reflecting on the Broader Ethics Issues Relevant to the Use of AI in Healthcare - Exercise
As AI continues to reshape the healthcare landscape, it brings about a myriad of societal and ethical considerations. This sorting exercise aims to explore the broader issues surrounding the intersection of AI and healthcare.
Please categorise each scenario into the appropriate societal or ethical dimension:AI In Healthcare: Ethics Issues Step8- Drag and Drop-Exercise
Guidelines and Regulations for the Use of AI in Healthcare
It is important for students, researchers and research ethics reviewers involved with research using and/or developing AI technologies in the healthcare domain to be aware of relevant guidelines and regulations that apply to their projects.
The WHO’s Ethics and governance of artificial intelligence for health calls for the embedding of ethics and human rights at the heart of AI design, deployment.
Click on the hotspots below to see WHO’s key ethical principles for research involving AI in healthcare.
Guidelines and Regulations for the Use of AI in Healthcare cont.
Alexei Grinbaum - Considerations for Researchers and Ethics Reviewers
End of Module Quiz
Module Evaluation
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Thank you!References and Further Resources:
Comité Consultatif National D’Ethique pour les Sciences de la Vie et de la Santé:
Medical Diagnosis and Artificial Intelligence: Ethical Issues. Joint opinion of the CCNE and CNPEN,
CCNE Opinion 141, CNPEN Opinion 4. November 2022
https://www.ccne-ethique.fr/sites/default/files/2023-05/Opinion%20No.141.pdf
Council of Europe:
Guidelines on artificial intelligence and data protection (2019)
https://ec.europa.eu/info/funding-tenders/opportunities/docs/2021- 2027/horizon/guidance/ethics-by-design-and-ethics-of-use-approaches- for-artificial-intelligence_he_en.pdf
Deutscher Ethikrat (German Ethics Council):
Opinion: Humans and Machines – Challenges of Artificial Intelligence (2023) https://www.ethikrat.org/en/publications/publication-details/?tx_wwt3shop_detail%5Bproduct%5D=168&tx_wwt3shop_detail%5Baction%5D=index&tx_wwt3shop_detail%5Bcontroller%5D=Products&cookieLevel=accept-all&cHash=4d430bf45ea980ea5f83daad9550ef88 (currently only available in German, an English translation will be available in due course)
European Commission:
Ethics By Design and Ethics of Use Approaches for Artificial Intelligence (2021)
https://ec.europa.eu/info/funding-tenders/opportunities/docs/2021- 2027/horizon/guidance/ethics-by-design-and-ethics-of-use-approaches- for-artificial-intelligence_he_en.pdf
European Commission Science Policy, Advice & Ethics Unit, DG Research & Innovation:
The ethics appraisal scheme in Horizon Europe (2021)
Chapter 8 of the ethics issues table in the EU ethics appraisal scheme is of particular importance in Horizon Europe as it specifically addresses research ethical aspects of AI. Other relevant chapters include chapter 1 on human participants, chapter 4 on personal data and chapter 10 on the potential misuse of results. The inclusion of a chapter on AI in Horizon Europe is a recent addition. The EC introduced this chapter because it identified pressing ethical concerns related to discrimination and bias, safety and liability, transparency and opaque algorithms, as well as privacy and data protection. These concerns were deemed highly urgent and thus warranted a dedicated section within the ethics appraisal scheme. The key values to be respected within the projects submitted to the EU appraisal scheme are (1) human agency and oversight, (2) privacy and data protection, (3) fairness, diversity and non-discrimination, (4) accountability, (5) transparency, and (6) societal and environmental wellbeing.
Ethics guidelines for trustworthy AI (2019)
https://digital-strategy.ec.europa.eu/en/library/ethics-guidelines- trustworthy-ai
OECD Legal Instruments:
Recommendation of the Council on Artificial Intelligence (2019)
https://legalinstruments.oecd.org/en/instruments/oecd-legal-0449
UNESCO:
Recommendations on the Ethics of Artificial Intelligence (2022)
https://unesdoc.unesco.org/ark:/48223/pf0000381137
World Health Organisation:
Ethics and governance of artificial intelligence for health (2021)
https://www.who.int/publications/i/item/9789240029200
See Chapter 4 for an overview of laws, policies, and principles that apply to the use of AI in healthcare. Chapter 5 proposes six key ethical principles which can serve as useful reminders for those involved in research utilising AI in healthcare
Also worth exploring are guidelines produced by Stanford University, UNESCO and the Horizon Europe Project SIENNA which developed ethical frameworks and recommendations for AI and robotics.
