Evaluation of artificial intelligence clinical applications: Detailed case analyses show value of healthcare ethics approach in identifying patient care issues

This paper is one of the first to analyse the ethical implications of specific healthcare artificial intelligence (AI) applications, and the first to provide a detailed analysis of AI‐based systems for clinical decision support. AI is increasingly being deployed across multiple domains. In response,...

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Bibliographic Details
Published in:Bioethics Vol. 35; no. 7; pp. 623 - 633
Main Authors: Rogers, Wendy A., Draper, Heather, Carter, Stacy M.
Format: Journal Article
Language:English
Published: England Blackwell Publishing Ltd 01.09.2021
Subjects:
AI applications in healthcare
Analysis
Application
Artificial Intelligence
Attention
Bioethics
Citizen participation
Clinical decision making
Convergence
Decision support systems
Delivery of Health Care
Deployment
Ethical dilemmas
ethical evaluation
ethical frameworks
Ethics
ethics of new technologies
Evaluation
Health care
Health Facilities
Health services
healthcare ethics
Humans
Intelligence
Medical decision making
New technology
Patient Care
Patients
Scrutiny
ethical evaluation
AI applications in healthcare
ethics of new technologies
artificial Intelligence
healthcare ethics
ethical frameworks
ISSN:0269-9702, 1467-8519, 1467-8519
Online Access:Get full text
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Summary:This paper is one of the first to analyse the ethical implications of specific healthcare artificial intelligence (AI) applications, and the first to provide a detailed analysis of AI‐based systems for clinical decision support. AI is increasingly being deployed across multiple domains. In response, a plethora of ethical guidelines and principles for general AI use have been published, with some convergence about which ethical concepts are relevant to this new technology. However, few of these frameworks are healthcare‐specific, and there has been limited examination of actual AI applications in healthcare. Our ethical evaluation identifies context‐ and case‐specific healthcare ethical issues for two applications, and investigates the extent to which the general ethical principles for AI‐assisted healthcare expressed in existing frameworks capture what is most ethically relevant from the perspective of healthcare ethics. We provide a detailed description and analysis of two AI‐based systems for clinical decision support (Painchek® and IDx‐DR). Our results identify ethical challenges associated with potentially deceptive promissory claims, lack of patient and public involvement in healthcare AI development and deployment, and lack of attention to the impact of AIs on healthcare relationships. Our analysis also highlights the close connection between evaluation and technical development and reporting. Critical appraisal frameworks for healthcare AIs should include explicit ethical evaluation with benchmarks. However, each application will require scrutiny across the AI life‐cycle to identify ethical issues specific to healthcare. This level of analysis requires more attention to detail than is suggested by current ethical guidance or frameworks.
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ISSN:0269-9702
1467-8519
1467-8519
DOI:10.1111/bioe.12885