BT08 Mapping UK frameworks for ethical artificial intelligence applied to dermatology

Abstract

Abstract There is significant enthusiasm to apply artificial intelligence (AI) in dermatology with an emphasis on image-based analyses for risk assessment of suspicious skin lesions. However, the rapid development and deployment of such AI tools raises concerns that ethical issues arising from their widespread, long-term use may not have been adequately considered during design or implementation. Dermatology, in particular, has been identified as lacking sufficient bioethics research that could standardize the approach to regulating AI-assisted applications. Despite significant efforts to develop robust guidelines for ‘ethical AI’ across private, national and international organizations, debate continues surrounding which ethical principles should be included. The 2022 National AI Strategy positions the UK as leading global efforts toward achieving safe and ethical deployment of AI. We sought to systematically review and analyse policy documents to map UK principles for promoting ethical AI as applied to dermatology. Our review identified five UK policy documents relevant to ethical AI published between 2016 and 2022. All included frameworks highlighted the importance of upholding transparency and fairness along the entire lifecycle of AI development and decision-making. The five frameworks also incorporated autonomy through reference to maintaining informed consent, data privacy and human contestability of AI decisions. The principles of accountability and nonmaleficence were each identified in four policy documents, emphasizing the needs for clear definitions of legal and organizational responsibility and for thorough testing of AI tools to avoid unintended/unwanted outcomes. The principles of beneficence (designing AI to promote good on both individual and societal levels) and sustainability (continually monitoring and adjusting AI tools for longevity and efficacy) were each included in two policy documents. Current UK policy frameworks for ethical AI converge around five key values: fairness, transparency, autonomy, nonmaleficence and accountability. The principles of beneficence and sustainability were advanced, although less frequently highlighted. Despite a reassuring level of convergence across policy documents, the practical implementation of these ethical principles in health care and particularly for skin-specific AI tools remains unclear. Furthermore, evidence of real-world integration of these ethical frameworks into developing AI-based skin cancer diagnostic tools is lacking. Future work seeks to address this gap by analysing commercially available skin cancer diagnostic applications using predefined ethical themes to identify case-specific ethical issues and to evaluate the extent to which these issues are addressed within the existing ethical frameworks. This will provide guidance for developers and adopters of these tools, ensuring responsible design and deployment.