Abstract
Artificial Intelligence (AI) continues to pervade several aspects of healthcare with pace and scale. The need for an ethical framework in AI to address this has long been recognized, but to date most efforts have delivered only high-level principles and value statements. Herein, we explain the need for an ethical framework in healthcare AI, the different moral theories that may serve as its basis, the rationale for why we believe this should be built around virtue ethics, and explore this in the context of five key ethical concerns for the introduction of AI in healthcare. Some existing work has suggested that AI may replace clinicians. We argue to the contrary, that the clinician will not be replaced, nor their role attenuated. Rather, they will be integral to the responsible design, deployment, and regulation of AI in healthcare, acting as the moral exemplar for the virtuous machine. We collate relevant points from the literature and formulate our own to present a coherent argument for the central role of clinicians in ethical AI and propose ideas to help advance efforts to employ ML-based solutions within healthcare. Finally, we highlight the responsibility of not only clinicians, but also data scientists, tech companies, ethicists, and regulators to act virtuously in realising the vision of ethical and accountable AI in healthcare.
Highlights
Artificial Intelligence (AI) continues to pervade several aspects of healthcare from diagnosis, epidemiology and drug-discovery to operational performance and value improvement [1,2,3,4,5,6,7,8,9]
A tentative example that could illustrate the comparison between the above two methods is the following: imagine the expert system as a keen and able student of medicine with limited clinical experience, applying externally generated rules and general principles to new patients seen on the ward, and Machine Learning (ML) as a senior, experienced clinician, who has through their training reached a method of practice tailored to their particular experience, which takes precedence over any prior rule-based approaches, able to learn from this past experience and even learn from new cases while continuously self-improving their behaviour and maintaining a decision-making process that has a probabilistic aspect to it
We have argued for the importance of virtue ethics in facilitating a deeper appreciation of the ethical dilemmas seen in healthcare, but what of virtue ethics in AI? Truly autonomous agents will require the ability to abide by ethical principles [36]
Summary
Artificial Intelligence (AI) continues to pervade several aspects of healthcare from diagnosis, epidemiology and drug-discovery to operational performance and value improvement [1,2,3,4,5,6,7,8,9]. While speculative and sensational arguments may serve to raise public awareness and focus debate on the ethical challenges that encompass the deployment of AI in healthcare, further discourse is needed within the medical community, to evolve the argument towards tangible results. We go on to propose that virtue ethics be used in further developments of ethical ML, drawing on existing arguments from the literature. These arguments help to further our main point, that the advancement of ethical healthcare AI will act to safeguard the role of the clinician. We illustrate how they are and will be integral to the responsible design, deployment, and regulation of AI in healthcare, and will keep their role as the moral exemplars for the virtuous machine
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