Mapping ethico‐legal principles for the use of artificial intelligence in gastroenterology

Abstract

The rapid development of artificial intelligence (AI) and digital health raise concerns about equitable access to innovative interventions, appropriate use of health data and privacy, inclusiveness, bias and discrimination, and even changes to the clinician-patient relationship. This article outlines a number of ethical and legal issues when examining the use of AI in gastroenterology. Substantive ethico-legal principles including respect for persons, privacy and confidentiality, integrity, conflict of interest, beneficence, nonmaleficence, and justice, are discussed. Much of what we articulated is relevant to the use of AI in other medical fields. Going forward, consorted efforts should be use to address more particular and concrete problems, but for now, a principle-based approach is best used in problemsolving.

Artificial intelligence for gastroenterology: Singapore artificial intelligence for Gastroenterology Working Group Position Statement

“…As our understanding of genomic and meta‐genomic data increases, together with collection of personal lifestyle information, protection of personal data against illegitimate use becomes more important. Privacy and confidentiality are both values that also stem from respect for persons 8 . AI usage of private and confidential data must be based on consent and legally justified alternatives that protect the rights of people.…”

“…In recent years, scientific conferences and medical journals are reporting a substantial volume of papers on AI‐assisted diagnosis and management of medical conditions. Yet, that is not sufficient to build up acceptance, trust and engagement of stakeholders on the use of AI 8 . Without proper training of medical students and doctors in AI assisted medicine, it is hard to build trust and improve acceptance of AI tools in medicine.…”

“…Privacy and confidentiality are both values that also stem from respect for persons. 8 AI usage of private and confidential data must be based on consent and legally justified alternatives that protect the rights of people. Deidentification and anonymization of data should be applied to protect privacy of individual patients.…”

“…24 When offering AI-assisted treatment to patients, healthcare professionals need to allow patients to apply their own values to the questions of consent and participation. 8 In the treatment of IBD, there are questions such as accuracy of diagnosis and differentiation between IBD relapse or infection, the choice of investigations (CT, MRI, endoscopy, and blood test), choice of treatment (step-up or change of medication, endoscopy, surgery, and stoma creation) and prognostication and quality of life. These factors need to be incorporated into the algorithm and generalized across the myriad context in which a patient may present.…”

“…The Working Group believes that the goal of healthcare technologies and delivery must be used to promote the best interest of patients. 8 There are already AI principles published in the past, but they lay down broad terms and principles without specific examples in clinical medicine and healthcare provision. [9][10][11] The basic principles include respecting human rights and democratic values, diversity and transparency, accountability and responsibility, preventing biases and discriminations protecting privacy by default and by design.…”