arXiv:2412.03576cs.CYcs.AI2024-12被引 171

AI医疗应用面临公平、透明等伦理挑战,需多方协作确保公正落地。

Ethical Challenges and Evolving Strategies in the Integration of Artificial Intelligence into Clinical Practice

  • 聚焦医疗AI五大伦理问题:公平性、透明度、知情同意、责任归属与患者中心
  • 指出算法偏见源于数据不具代表性,模型黑箱影响临床信任与效果
  • 强调开发、临床与伦理者协同,推动可信赖、包容性AI在医疗中落地

人工智能(AI)已迅速改变多个领域,包括医疗健康,有望革新临床实践并改善患者预后。然而,其在医疗环境中的整合带来了重大伦理挑战,亟需审慎对待。本文审视当前医疗AI的现状,重点关注五个关键伦理问题:公正与公平、透明性、患者知情同意与隐私保护、责任归属,以及以患者为中心和公平的照护。这些问题尤为突出,因AI系统可能延续甚至加剧既有偏见,常源于非代表性数据集和模型开发过程的不透明。本文探讨了偏见、缺乏透明度及患者信任维护困难如何削弱医疗AI应用的有效性与公平性。同时,回顾现有AI监管与部署框架,识别出限制其广泛、公正采用的漏洞。分析提出应对建议,强调算法设计应注重公平性,模型决策需透明,且须以患者为中心推进知情同意与数据隐私。通过强调持续伦理审查及AI开发者、临床医生与伦理学家间的协作,本文勾勒出实现更负责任、包容性医疗AI实施的路径。若采纳这些策略,将提升AI的临床价值,并增强患者与医疗专业人员对AI系统的信任,确保技术惠及所有人群。

原文摘要 · Abstract (English)

Artificial intelligence (AI) has rapidly transformed various sectors, including healthcare, where it holds the potential to revolutionize clinical practice and improve patient outcomes. However, its integration into medical settings brings significant ethical challenges that need careful consideration. This paper examines the current state of AI in healthcare, focusing on five critical ethical concerns: justice and fairness, transparency, patient consent and confidentiality, accountability, and patient-centered and equitable care. These concerns are particularly pressing as AI systems can perpetuate or even exacerbate existing biases, often resulting from non-representative datasets and opaque model development processes. The paper explores how bias, lack of transparency, and challenges in maintaining patient trust can undermine the effectiveness and fairness of AI applications in healthcare. In addition, we review existing frameworks for the regulation and deployment of AI, identifying gaps that limit the widespread adoption of these systems in a just and equitable manner. Our analysis provides recommendations to address these ethical challenges, emphasizing the need for fairness in algorithm design, transparency in model decision-making, and patient-centered approaches to consent and data privacy. By highlighting the importance of continuous ethical scrutiny and collaboration between AI developers, clinicians, and ethicists, we outline pathways for achieving more responsible and inclusive AI implementation in healthcare. These strategies, if adopted, could enhance both the clinical value of AI and the trustworthiness of AI systems among patients and healthcare professionals, ensuring that these technologies serve all populations equitably.

医疗AI伦理挑战公平性透明性

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