Artificial Intelligence for Good Health: A Scoping Review of the Ethics Literature

Abstract

Background: Artificial intelligence (AI) has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have potential for advancing health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective? Methods: Eight electronic databases were searched for peer reviewed and grey literature published before April 2018 using the concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data charting form, and a descriptive and thematic analysis was performed. Results: Upon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability, and bias. Largely missing from the literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries (LMICs). Conclusions: The ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere.

What do academics say about artificial intelligence ethics? An overview of the scholarship

“…The geography of AI development reproduces the global distribution of economic and political power, as parts of North America and Western Europe dominate emerging technologies, including AI-powered ones, alongside China, while the poorest parts of the world also remain technologically underdeveloped [67]. One study confirms the dominance of the Global North in AI ethics in the healthcare sector [59], as well.…”

“…The fast-paced development AI technologies and concomitant development of the AI ethics field have fueled metalevel analyses of the concepts, problem definitions and proposed solutions promoted by AI ethicists [4,5,29,30,59,75]. While some of the meta-level scholarship takes issue with AI/ML researchers' work directly [5], others address AI ethics guidelines [29].…”

Artificial Intelligence in Radiology in Pakistan; Pros and Cons

“…We may need to find the answer to the question that if machines make decisions independently, then who is to blame for wrong decisions. Also, it raises many questions ethically [7] on using and selling the data with little or no consent. Medical decisions require understanding and empathy to reach a shared goal, the treatment plan.…”

Legal concerns in health-related artificial intelligence: a scoping review protocol

“…Healthrelated AI is also used in Canada, including for triage purposes and to respond to COVID-19 [4]. The development of ML as a subset of AI that uses large data sets to "make predictions and solve problems … without being explicitly programmed" [5] has produced increasingly accurate health-related applications that can "learn" from real-world data over time and improve healthcare systems. As these technological innovations continue, there is a clear need to examine whether existing laws are up to the task of ensuring beneficial health-related AI tools can be deployed in real-world settings while minimizing legitimate concerns about, e.g., bias or privacy, that may arise.…”

“…A preliminary search of MEDLINE ® , Cochrane Library, PROSPERO, and JBI Evidence Synthesis was conducted; no current or underway systematic reviews or scoping reviews on this topic were identified. Two published scoping reviews were identified that survey ethical concerns raised by the use of health-related AI [5,6] with one of the two taking a narrower focus on ethical issues concerning the disabled [6]. Although ethical issues can overlap with legal issues in some cases, legal concerns and legal responses are important to understand in their own right.…”