AI Ethics in Smart Healthcare

Abstract

This article reviews the landscape of ethical challenges of integrating artificial intelligence (AI) into smart healthcare products, including medical electronic devices. Differences between traditional ethics in the medical domain and emerging ethical challenges with AI-driven healthcare are presented, particularly as they relate to transparency, bias, privacy, safety, responsibility, justice, and autonomy. Open challenges and recommendations are outlined to enable the integration of ethical principles into the design, validation, clinical trials, deployment, monitoring, repair, and retirement of AI-based smart healthcare products.

Clearing the Fog: A Scoping Literature Review on the Ethical Issues Surrounding Artificial Intelligence-Based Medical Devices

“…It is not surprising, therefore, given the range of arguments, that it was noted by several authors that for the final AI-based device to be considered transparent and acceptable for use, stakeholders such as patients and the public should be involved early in the development process [58,66,80,89,90,95,111]. This was supported by several studies highlighting the need for a multidisciplinary approach to the issue of transparency and ethics more widely (specifically, ethics training or integrating ethicists) [44,47,59,69,75,100,101]. In terms of barriers, AI development experts identified a lack of transparency to be seen as a limit to positive relationships between vulnerable patient groups (such as patients of older generations) and clinicians [107].…”

“…The most frequently addressed ethical theme was transparency (n = 40) [44,46,47,49,[55][56][57][58][59][60][61][62]64,66,69,70,75,76,[78][79][80][81][82]85,86,[88][89][90]92,[94][95][96][99][100][101]107,110,111,113,114], concerning a wide range of medical contexts but focusing mainly in the area of clinical decision support. While the majority of studies reported a narrative evaluation of ethical issues, seven qualitative studies employed surveys or focus groups that identified transparency as an ethical priority by either healthcare professionals [44,78], experts in AI implementation [107], a combination of AI experts and citizens [65] or a combination of designers, clinician-users, administrators and patients, [69,70,…”

“…More broadly, several studies noted that the public should have access to transparent information regarding the use of AI in healthcare [61,66,69,76], with some pinpointing that governments should play a role in raising awareness, especially of prospective vulnerable populations, such that information provided regarding AI-based devices can be well understood [96]. Further, to facilitate transparency, AI standardised ethical frameworks and clear regulations are required, with some studies calling to enforce their use with legislation [46,56,57,75,82,94,107,110,114].…”

“…Accountability emerged as a theme from 25 studies, particularly from studies concerning applications of large language models/chatbots and robotics [42,46,55,56,60,61,69,71,74,75,[78][79][80][81]84,88,97,[100][101][102][103][104][110][111][112].…”

“…A total of 33 of the included papers examined the challenges and considerations surrounding the use of AI, particularly in healthcare, and the imperative of safeguarding confidentiality in the digital age [42][43][44]46,47,50,53,54,[58][59][60][61][66][67][68]71,72,[74][75][76]84,90,93,94,96,98,102,104,105,[109][110][111]113].…”