Operationalising ethics in artificial intelligence for healthcare: a framework for AI developers

Artificial intelligence (AI) offers much promise for improving healthcare. However, it runs the looming risk of causing individual and societal harms; for instance, exacerbating inequalities amongst minority groups, or enabling compromises in the confidentiality of patients’ sensitive data. As such, there is an expanding, unmet need for ensuring AI for healthcare is developed in concordance with human values and ethics. Augmenting “principle-based” guidance that highlight adherence to ethical ideals (without necessarily offering translation into actionable practices), we offer a solution-based framework for operationalising ethics in AI for healthcare. Our framework is built from a scoping review of existing solutions of ethical AI guidelines, frameworks and technical solutions to address human values such as self-direction in healthcare. Our view spans the entire length of the AI lifecycle: data management, model development, deployment and monitoring. Our focus in this paper is to collate actionable solutions (whether technical or non-technical in nature), which can be steps that enable and empower developers in their daily practice to ensuring ethical practices in the broader picture. Our framework is intended to be adopted by AI developers, with recommendations that are accessible and driven by the existing literature. We endorse the recognised need for ‘ethical AI checklists’ co-designed with health AI practitioners, which could further operationalise the technical solutions we have collated. Since the risks to health and wellbeing are so large, we believe a proactive approach is necessary for ensuring human values and ethics are appropriately respected in AI for healthcare.