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Published in: BMC Medical Informatics and Decision Making 1/2023

Open Access 01-12-2023 | Artificial Intelligence | Research

Ethics and governance of trustworthy medical artificial intelligence

Authors: Jie Zhang, Zong-ming Zhang

Published in: BMC Medical Informatics and Decision Making | Issue 1/2023

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Abstract

Background

The growing application of artificial intelligence (AI) in healthcare has brought technological breakthroughs to traditional diagnosis and treatment, but it is accompanied by many risks and challenges. These adverse effects are also seen as ethical issues and affect trustworthiness in medical AI and need to be managed through identification, prognosis and monitoring.

Methods

We adopted a multidisciplinary approach and summarized five subjects that influence the trustworthiness of medical AI: data quality, algorithmic bias, opacity, safety and security, and responsibility attribution, and discussed these factors from the perspectives of technology, law, and healthcare stakeholders and institutions. The ethical framework of ethical values-ethical principles-ethical norms is used to propose corresponding ethical governance countermeasures for trustworthy medical AI from the ethical, legal, and regulatory aspects.

Results

Medical data are primarily unstructured, lacking uniform and standardized annotation, and data quality will directly affect the quality of medical AI algorithm models. Algorithmic bias can affect AI clinical predictions and exacerbate health disparities. The opacity of algorithms affects patients’ and doctors’ trust in medical AI, and algorithmic errors or security vulnerabilities can pose significant risks and harm to patients. The involvement of medical AI in clinical practices may threaten doctors ‘and patients’ autonomy and dignity. When accidents occur with medical AI, the responsibility attribution is not clear. All these factors affect people’s trust in medical AI.

Conclusions

In order to make medical AI trustworthy, at the ethical level, the ethical value orientation of promoting human health should first and foremost be considered as the top-level design. At the legal level, current medical AI does not have moral status and humans remain the duty bearers. At the regulatory level, strengthening data quality management, improving algorithm transparency and traceability to reduce algorithm bias, and regulating and reviewing the whole process of the AI industry to control risks are proposed. It is also necessary to encourage multiple parties to discuss and assess AI risks and social impacts, and to strengthen international cooperation and communication.
Literature
13.
go back to reference Collingridge D. The social control of technology. London: Frances Pinter; 1980. Collingridge D. The social control of technology. London: Frances Pinter; 1980.
14.
go back to reference Guo R. The ethics and governance of artificial intelligence. Beijing: Law Press; 2020. p. 42. Guo R. The ethics and governance of artificial intelligence. Beijing: Law Press; 2020. p. 42.
20.
go back to reference Wang H, Meng XF, Wang Q, et al. Strategy for management and quality control of datasets in artificial intelligence medical device. China Med Devices. 2018;33(12):1–5. Wang H, Meng XF, Wang Q, et al. Strategy for management and quality control of datasets in artificial intelligence medical device. China Med Devices. 2018;33(12):1–5.
21.
go back to reference Xu Y, Ma XM, Yue Q, et al. Ethics of lung cancer image data and artificial intelligence. Med Soc. 2021;34(5):100–104 Xu Y, Ma XM, Yue Q, et al. Ethics of lung cancer image data and artificial intelligence. Med Soc. 2021;34(5):100–104
31.
go back to reference Price W, Nicholson II. Medical AI and contextual bias. Harv J Law Technol. 2019;33:65–116. Price W, Nicholson II. Medical AI and contextual bias. Harv J Law Technol. 2019;33:65–116.
40.
go back to reference Feldman R, Aldana E, Stein K. Artificial intelligence in the health care space: how we can trust what we cannot know. Stanf Law Policy Rev. 2019;30:399–419. Feldman R, Aldana E, Stein K. Artificial intelligence in the health care space: how we can trust what we cannot know. Stanf Law Policy Rev. 2019;30:399–419.
41.
go back to reference Kamensky S. Artificial intelligence and technology in health care: overview and possible legal implications. DePaul J Health Care Law. 2020;21(3):1–13. Kamensky S. Artificial intelligence and technology in health care: overview and possible legal implications. DePaul J Health Care Law. 2020;21(3):1–13.
61.
go back to reference Warwick K, Shah H. Passing the turing test does not mean the end of humanity. Cognit Comput. 2016;8(3):409–19.CrossRef Warwick K, Shah H. Passing the turing test does not mean the end of humanity. Cognit Comput. 2016;8(3):409–19.CrossRef
66.
go back to reference Jessica SA. From Jeopardy to Jaundice: the medical liability implications of Dr. Watson and other artificial intelligence systems. La Law Rev. 2013;73:1049. Jessica SA. From Jeopardy to Jaundice: the medical liability implications of Dr. Watson and other artificial intelligence systems. La Law Rev. 2013;73:1049.
67.
go back to reference Chung J, Zink A. Hey Watson, can i sue you for malpractice? Examining the liability of artificial intelligence in medicine. Asia Pac J Health Law Eth. 2018;11(2):51–80. Chung J, Zink A. Hey Watson, can i sue you for malpractice? Examining the liability of artificial intelligence in medicine. Asia Pac J Health Law Eth. 2018;11(2):51–80.
68.
go back to reference Weaver JF, Zheng ZF. How to sue a robot: liability and AI. Law Econ. 2019;1:140–60. Weaver JF, Zheng ZF. How to sue a robot: liability and AI. Law Econ. 2019;1:140–60.
76.
go back to reference Beauchamp T, Childress J. Principles of biomedical ethics. New York: Oxford University Press; 2013. Beauchamp T, Childress J. Principles of biomedical ethics. New York: Oxford University Press; 2013.
82.
go back to reference Macnish K, Gauttier S. A pre-occupation with possession: the (non-) ownership of personal data. Big data and democracy. Edinburgh: Edinburgh University Press; 2020. p. 42–56. Macnish K, Gauttier S. A pre-occupation with possession: the (non-) ownership of personal data. Big data and democracy. Edinburgh: Edinburgh University Press; 2020. p. 42–56.
87.
go back to reference Manson NC, O’Neill O. Rethinking informed consent in bioethics. Cambridge: Cambridge University Press; 2007.CrossRef Manson NC, O’Neill O. Rethinking informed consent in bioethics. Cambridge: Cambridge University Press; 2007.CrossRef
Metadata
Title
Ethics and governance of trustworthy medical artificial intelligence
Authors
Jie Zhang
Zong-ming Zhang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2023
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-023-02103-9

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