AI Delivered Healthcare Creates Serious Legal & Ethical Issues

The use of artificial intelligence in medicine is generating great excitement and hope for treatment advances.

AI generally refers to a computers’ ability to mimic human intelligence and to learn. For example, by using machine learning,  scientists are working to develop algorithms that will help them make decisions about cancer treatment. They hope that computers will be able to analyse radiological images and discern which cancerous tumors will respond well to chemotherapy and which will not. 

But AI in medicine also raises significant legal and ethical challenges. Several of these are concerns about privacy, discrimination, psychological harm and the physician-patient relationship. 

Potential for Discrimination
AI involves the analysis of very large amounts of data to discern patterns, which are then used to predict the likelihood of future occurrences. In medicine, the data sets can come from electronic health records and health insurance claims but also from several surprising sources. 

AI can draw upon purchasing records, income data, criminal records, and social media for information about an individual’s health. Researchers are already using AI to predict a multitude of medical conditions including heart problems, stroke, diabetes and a lot of others including suicide predictions. 

Predictive Capacity
This predictive capability of AI raises significant ethical concerns in health care. If AI generates predictions about your health, it could one day be included in your electronic health records.
Anyone with access to your health records could then see predictions about cognitive decline or opioid abuse. Additionally, patients themselves often authorize others to access their records: for example, when they apply for employment or life insurance.

Such disclosures can lead to discrimination. Employers, for instance, are interested in workers who will be healthy and productive, with few absences and low medical costs. 

If they believe certain applicants will develop diseases in the future, they will likely reject them. Lenders, landlords, life insurers and others might likewise make adverse decisions about individuals based on AI predictions. AI health prediction can also lead to psychological harm. For example, many people could be traumatised if they learn that they will likely suffer cognitive decline later in life. 

It is even possible that individuals will obtain health forecasts directly from commercial entities that bought their data. Imagine obtaining the news that you are at risk of dementia through an electronic advertisement urging you to buy memory-enhancing products.

Yet another concern relates to the doctor-patient relationship. Will AI diminish the role of doctors? Will computers be the ones to make predictions, diagnoses and treatment suggestions, so that doctors simply implement the computers’ instructions? How will patients feel about their doctors if computers have a greater say in making medical determinations?

These concerns are exacerbated by the fact that AI predictions are far from infallible. Many factors can contribute to errors. If the data used to develop an algorithm are flawed – for instance, if they use medical records that contain errors, the algorithm’s output will be incorrect. Therefore, patients may suffer discrimination or psychological harm when in fact they are not at risk of the predicted ailments.

The prospect of AI can over-awe people. Yet, to ensure that AI truly promotes patient welfare, physicians, researchers and policymakers must recognise its risks and proceed with caution.

The Conversation

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