Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-10T21:26:54.643Z Has data issue: false hasContentIssue false
  • English
  • Français

The Ethics of Medical AI and the Physician-Patient Relationship

Published online by Cambridge University Press:  20 December 2019

SALLY DALTON-BROWN
Get access Rights & Permissions [Opens in a new window]

Abstract:

This article considers recent ethical topics relating to medical AI. After a general discussion of recent medical AI innovations, and a more analytic look at related ethical issues such as data privacy, physician dependency on poorly understood AI helpware, bias in data used to create algorithms post-GDPR, and changes to the patient–physician relationship, the article examines the issue of so-called robot doctors. Whereas the so-called democratization of healthcare due to health wearables and increased access to medical information might suggest a positive shift in the patient-physician relationship, the physician’s ‘need to care’ might be irreplaceable, and robot healthcare workers (‘robot carers’) might be seen as contributing to dehumanized healthcare practices.

Keywords

Medical AIGDPRalgorithm biascare robots
Type
Special Section: Open Forum
Information
Cambridge Quarterly of Healthcare Ethics , Volume 29 , Issue 1 , January 2020 , pp. 115 - 121
Copyright
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. Norman A. Your future doctor may not be human. This is the rise of AI in medicine. 31 Jan 2018; available at https://futurism.com/ai-medicine-doctor/ (last accessed 9 Sept 2018).

2. Artificial intelligence: Is this the future of early cancer detection? 29 Oct 2017; available at https://www.eurekalert.org/pub_releases/2017-10/sh-aii102317.php (last accessed 2 Nov 2018).

3. The FDA just opened the door to let AI make medical decisions on its own. 13 Apr 2018; available at http://www.bioethics.com/archives/43050 (last accessed 2 Nov 2018).

4. Johnston R. Australian scientists are using artificial intelligence to prevent blindness in people with diabetes. 20 Sept 2017; available at https://www.gizmodo.com.au/2017/09/australian-scientists-are-using-artificial-intelligence-to-prevent-blindness-in-people-with-diabetes/ (last accessed 9 Sept 2018).

5. See https://au.nec.com/en_AU/press/201710/researchers-explore-nec-artificial-intelligence-medical-diagnostic-tools.html.

6. AI, Radiology and the future of work. The Economist, 9 June 2018.

7. Ludwin, SK, Murray, TJ. Dilemmas in medical ethics in the age of big data. Multiple Sclerosis Journal 2017;23(10):1306–8.CrossRefGoogle ScholarPubMed

8. However, the same system has just consumed five years and $62m (£51m) in an unsuccessful attempt to transform care at the University of Texas MD Anderson Cancer Centre. Vize, R. Technology could redefine the doctor-patient relationship, The Guardian 11 Mar 2017; available at https://www.theguardian.com/healthcare-network/2017/mar/11/artificial-intelligence-nhs-doctor-patient-relationship (last accessed 9 Sept 2018).Google Scholar

9. See Lynsey Barber’s analysis of 22 Nov 2016; available at http://www.cityam.com/254167/googles-deepmind-wants-make-doctors-paperwork-obsolete-new (last accessed 21 Oct 2018).

10. Kahn, PH Jr, Ishiguro, H, Friedman, B, Kanda, T, Freier, NG, Severson, RL, Miller, J. What is a human? Toward psychological benchmarks in the field of human–robot interaction. Interaction Studies 2007;8(3):363–90. See alsoGoogle Scholar Sharkey, NE. The ethical frontiers of robotics. Science 2008;322(2):1800–1.CrossRefGoogle ScholarPubMed

11. See http://ec.europa.eu/research/ege/pdf/ege_ai_statement_2018.pdf (last accessed 30 Oct 2018).

12. See https://med.stanford.edu/news/all-news/2018/03/researchers-say-use-of-ai-in-medicine-raises-ethical-questions.html (last accessed 9 Sept 2018).

13. Zapusek, T. Artificial intelligence in medicine and confidentiality of data. Asia Pacific Journal of Health Law and Ethics 2017:105–26.Google Scholar

14. Amoako-Agyei E. Blockchain and AI merge for healthcare in new partnership deal. 23 Feb 2018, at https://www.coinstaker.com/blockchain-ai-merge-healthcare-new-partnership/ (last accessed 29 Oct 2018).

15. See https:// www.innovationaus.com/2018/07/AI-ethics-hits-political-nerve (last accessed 30 Oct 2018).

16. Oakden-Rayner, L. Artificial intelligence won’t replace doctors soon but it can help with diagnosis.The Conversation 19 Sept 2017; available at http://www.abc.net.au/news/2017-09-19/ai-wont-replace-doctors-soon-but-it-can-help-diagnosis/8960530 (last accessed 9 Sept 2018).Google Scholar

17. Sullins, JP. Open questions in robethics. Philosophy and Technology 2011;24(3):233–8.CrossRefGoogle Scholar

18. Cheshire, WP. Loopthink: A limitation of medical artificial Intelligence. Ethics and Medicine 2017;33(1):7–12.Google Scholar

19. Garibaldi, I. Application of simulated annealing fuzzy model tuning to umbilical cord ccid-base interpretation. IEEE Transactions on Fuzzy Systems (1999);7:72–84.CrossRefGoogle Scholar

20. My thanks to Professor Uwe Aickelin from the University of Melbourne for a very enlightening conversation on 8 May 2018 at Jimmy Watson’s, on algorithms, inconsistency and decision making, and for ongoing advice on reference material.

21. Miller, S, Appleby, S, Garibaldi, JM, Aickelin, U. Towards a more systematic approach to secure systems design and analysis. International Journal of Secure Software Engineering 2013;4 (1):11–30.CrossRefGoogle Scholar

22. See https://medium.com/syncedreview/will-new-eu-regulations-starve-data-hungry-deep-learning-models-25403795d26c; and https://www.eugdpr.org/key-changes.html (last accessed 9 Sept 2018).

23. Hamet, P, Tremblay, J. Artificial intelligence in medicine. Metabolism - Clinical and Experimental (2017);69:36–40.CrossRefGoogle Scholar

24. Hoey, J, Zutis, K, Leuty, V, Mihailidis, A. A tool to promote prolonged engagement in art therapy: design and development from arts therapist requirements. Conference on Computers and Accessibility 2010:211–8.Google Scholar

25. Reller T. AI’s revolutionary role in healthcare: Experts debate the pros and cons of artificial intelligence, which is changing many aspects of patient care. 2 June 2017; available at https://www.elsevier.com/connect/ais-revolutionary-role-in-healthcare (last accessed 3 Sept 2018).

26. Nicolson, MA. Nicholas Jewson and the disappearance of the sick man from medical cosmology, 1770–1870. International Journal of Epidemiology 2009;38(3):639–42.CrossRefGoogle ScholarPubMed

27. The EU Legal Affairs Committee Report with recommendations to the Commission on Civil Law Rules on Robotics; available at http://europa.eu/rapid/press-release_IP-18-3362_en.htm (last accessed 16 Sept 2018).

28. Clarke H, Burger J, Paxton V. Australia: Do robotics and artificial intelligence have a future in the healthcare space? 21 Feb 2018; available at http://www.mondaq.com/australia/x/675750/Healthcare/ (last accessed 6 Sept 2018).

29. In Robot and Frank, a 2012 film about an aging ex-burglar cared for by a therapy robot, the human wins out over the artificial, as the robot is quickly turned to crime by his patient.

30. What doctor? Why AI and robotics will define New Health; available at https://www.pwc.com/gx/en/industries/healthcare/publications/ai-robotics-new-health.html (last accessed 2 Aug 2019).

31. Luxton, DD. Recommendations for the ethical use and design of artificial intelligent care providers. Artificial Intelligence in Medicine 2014;62:1–10.CrossRefGoogle ScholarPubMed