Artificial intelligence (AI) is expected to revolutionise the practice of medicine. Recent advancements in the field of deep learning have demonstrated success in variety of clinical tasks: detecting diabetic retinopathy from images, predicting hospital readmissions, aiding in the discovery of new drugs, etc. AI’s progress in medicine, however, has led to concerns regarding the potential effects of this technology on relationships of trust in clinical practice. In this paper, I will argue that there is merit to these concerns, since AI (...) systems can be relied on, and are capable of reliability, but cannot be trusted, and are not capable of trustworthiness. Insofar as patients are required to rely on AI systems for their medical decision-making, there is potential for this to produce a deficit of trust in relationships in clinical practice. (shrink)

Artificial intelligence (AI) systems have demonstrated impressive performance across a variety of clinical tasks. However, notoriously, sometimes these systems are 'black boxes'. The initial response in the literature was a demand for 'explainable AI'. However, recently, several authors have suggested that making AI more explainable or 'interpretable' is likely to be at the cost of the accuracy of these systems and that prioritising interpretability in medical AI may constitute a 'lethal prejudice'. In this paper, we defend the value of interpretability (...) in the context of the use of AI in medicine. Clinicians may prefer interpretable systems over more accurate black boxes, which in turn is sufficient to give designers of AI reason to prefer more interpretable systems in order to ensure that AI is adopted and its benefits realised. Moreover, clinicians may be justified in this preference. Achieving the downstream benefits from AI is critically dependent on how the outputs of these systems are interpreted by physicians and patients. A preference for the use of highly accurate black box AI systems, over less accurate but more interpretable systems , may itself constitute a form of lethal prejudice that may diminish the benefits of AI to - and perhaps even harm - patients. (shrink)

A number of Artificial Intelligence (AI) ethics frameworks have been published in the last 6 years in response to the growing concerns posed by the adoption of AI in different sectors, including healthcare. While there is a strong culture of medical ethics in healthcare applications, AI-based Healthcare Applications (AIHA) are challenging the existing ethics and regulatory frameworks. This scoping review explores how ethics frameworks have been implemented in AIHA, how these implementations have been evaluated and whether they have been successful. (...) AI specific ethics frameworks in healthcare appear to have a limited adoption and they are mostly used in conjunction with other ethics frameworks. The operationalisation of ethics frameworks is a complex endeavour with challenges at different levels: ethics principles, design, technology, organisational, and regulatory. Strategies identified in this review are proactive, contextual, technological, checklist, organisational and/or evidence-based approaches. While interdisciplinary approaches show promises, how an ethics framework is implemented in an AI-based Healthcare Application is not widely reported, and there is a need for transparency for trustworthy AI. (shrink)

Despite the importance of discussions over the epistemic role that artificially intelligent decision support systems ought to play, there is currently a lack of these discussions in both the AI literature and the epistemology literature. My goal in this paper is to rectify this by proposing an account of the epistemic role of AI decision support systems in medicine and discussing what this epistemic role means with regard to how these systems ought to be utilized. In particular, I argue that (...) AI decision support systems are not epistemic superiors, inferiors, or peers. Instead, I recommend that they be classified in an epistemic category of their own, as “epistemic nudges.” With my proposed account of the epistemic role of AI decision support systems, I aim to provide answers the following two questions: 1. How ought disagreements between a clinician and an AI decision support system be handled? 2. How ought responsibility and accountability be allocated when an AI decision support system used by a human clinician in decision-making results in harm? (shrink)

The adoption of AI in the health sector has its share of benefits and harms to various stakeholder groups and entities. There are critical risks involved in using AI systems in the health domain; risks that can have severe, irreversible, and life-changing impacts on people’s lives. With the development of innovative AI-based applications in the medical and healthcare sectors, new types of risks emerge. To benefit from novel AI applications in this domain, the risks need to be managed in order (...) to protect the fundamental interests and rights of those affected. This will increase the level to which these systems become ethically acceptable, legally permissible, and socially sustainable. In this paper, we first discuss the necessity of AI risk management in the health domain from the ethical, legal, and societal perspectives. We then present a taxonomy of risks associated with the use of AI systems in the health domain called HART. HART mirrors the risks of a variety of different real-world incidents caused by use of AI in the health sector. Lastly, we discuss the implications of the taxonomy for different stakeholder groups and further research. (shrink)

Recently, a growing number of experts in artificial intelligence (AI) and medicine have be-gun to suggest that the use of AI systems, particularly machine learning (ML) systems, is likely to humanise the practice of medicine by substantially improving the quality of clinician-patient relationships. In this thesis, however, I argue that medical ML systems are more likely to negatively impact these relationships than to improve them. In particular, I argue that the use of medical ML systems is likely to comprise the (...) quality of trust, care, empathy, understanding, and communication between clinicians and patients. (shrink)