Kathleen Murphy1, Erica Di Ruggiero2, Ross Upshur3,4, Donald J Willison5, Neha Malhotra1, Jia Ce Cai1, Nakul Malhotra1, Vincci Lui6, Jennifer Gibson7. 1. Joint Centre for Bioethics, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Suite 754, Toronto, ON, M5T 1P8, Canada. 2. Office of Global Health Education and Training, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 408, Toronto, ON, M5T 3M7, Canada. 3. Division of Clinical Public Health, Dalla Lana School of Public Health, 155 College Street, Toronto, ON, M5T 3M7, Canada. 4. Bridgepoint Collaboratory for Research and Innovation, Lunenfeld Tanenbaum Research Institute, Sinai Health System, 1 Bridgepoint Drive, Toronto, ON, M4M 2B5, Canada. 5. Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public, Health Sciences Building, Health University of Toronto, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada. 6. Gerstein Science Information Centre, University of Toronto, 9 King's College Circle, Toronto, ON, M7A 1A5, Canada. 7. Joint Centre for Bioethics, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Suite 754, Toronto, ON, M5T 1P8, Canada. jennifer.gibson@utoronto.ca.
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 responsibility, 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.
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 responsibility, 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.
Entities:
Keywords:
Artificial intelligence; Ethics; Global health; Health care; Public and population health
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