We discuss the implementation of Responsible Research and Innovation (RRI) within a project for the development of an AI-supported exergame for assisted movement training, outline outcomes and reflect on methodological opportunities and limitations. We adopted the responsibility-by-design (RbD) standard (CEN CWA 17796:2021) supplemented by methods for collaborative, ethical reflection to foster and support a shift towards a culture of trustworthiness inherent to the entire development process. An embedded ethicist organised the procedure to instantiate a collaborative learning effort and implement RRI (...) in a translational context. Within the interdisciplinary setting of the collaboration and with the support of a technoethicist, we successfully identified relevant, project-specific challenges and developed a roadmap with derived actions, thus meaningfully integrating RRI into the development process. We discuss the methodological procedure in terms of its effectiveness and efficiency, the allocation of responsibilities and roles, particularly regarding potential frictions in the interdisciplinary context with embedded ethics, and the challenges of the translational context. We conclude that the responsibility-by-design standard effectively established a productive workflow for collaborative investigation and work on ethical challenges. We reflect on methodological difficulties and propose possible avenues to our approach. (shrink)

There have been repeated calls to ensure that clinical artificial intelligence (AI) is not discriminatory, that is, it provides its intended benefit to all members of society irrespective of the status of any protected characteristics of individuals in whose healthcare the AI might participate. There have also been repeated calls to ensure that any clinical AI is tailored to the local population in which it is being used to ensure that it is fit-for-purpose. Yet, there might be a clash between (...) these two calls since tailoring an AI to a local population might reduce its effectiveness when the AI is used in the care of individuals who have characteristics which are not represented in the local population. Here, I explore the bioethical concept of local fairness as applied to clinical AI. I first introduce the discussion concerning fairness and inequalities in healthcare and how this problem has continued in attempts to develop AI-enhanced healthcare. I then discuss various technical aspects which might affect the implementation of local fairness. Next, I introduce some rule of law considerations into the discussion to contextualise the issue better by drawing key parallels. I then discuss some potential technical solutions which have been proposed to address the issue of local fairness. Finally, I outline which solutions I consider most likely to contribute to a fit-for-purpose and fair AI. (shrink)

Artificial intelligence (AI) is increasingly relied upon by clinicians for making diagnostic and treatment decisions, playing an important role in imaging, diagnosis, risk analysis, lifestyle monitoring, and health information management. While research has identified biases in healthcare AI systems and proposed technical solutions to address these, we argue that effective solutions require human engagement. Furthermore, there is a lack of research on how to motivate the adoption of these solutions and promote investment in designing AI systems that align with values (...) such as transparency and fairness from the outset. Drawing on insights from psychological theories, we assert the need to understand the values that underlie decisions made by individuals involved in creating and deploying AI systems. We describe how this understanding can be leveraged to increase engagement with de-biasing and fairness-enhancing practices within the AI healthcare industry, ultimately leading to sustained behavioral change via autonomy-supportive communication strategies rooted in motivational and social psychology theories. In developing these pathways to engagement, we consider the norms and needs that govern the AI healthcare domain, and we evaluate incentives for maintaining the status quo against economic, legal, and social incentives for behavior change in line with transparency and fairness values. (shrink)