Adopting and expanding ethical principles for generative artificial intelligence from military to healthcare.

TitleAdopting and expanding ethical principles for generative artificial intelligence from military to healthcare.
Publication TypeJournal Article
Year of Publication2023
AuthorsOniani D, Hilsman J, Peng Y, Poropatich RK, Pamplin JC, Legault GL, Wang Y
JournalNPJ Digit Med
Volume6
Issue1
Pagination225
Date Published2023 Dec 02
ISSN2398-6352
Abstract

In 2020, the U.S. Department of Defense officially disclosed a set of ethical principles to guide the use of Artificial Intelligence (AI) technologies on future battlefields. Despite stark differences, there are core similarities between the military and medical service. Warriors on battlefields often face life-altering circumstances that require quick decision-making. Medical providers experience similar challenges in a rapidly changing healthcare environment, such as in the emergency department or during surgery treating a life-threatening condition. Generative AI, an emerging technology designed to efficiently generate valuable information, holds great promise. As computing power becomes more accessible and the abundance of health data, such as electronic health records, electrocardiograms, and medical images, increases, it is inevitable that healthcare will be revolutionized by this technology. Recently, generative AI has garnered a lot of attention in the medical research community, leading to debates about its application in the healthcare sector, mainly due to concerns about transparency and related issues. Meanwhile, questions around the potential exacerbation of health disparities due to modeling biases have raised notable ethical concerns regarding the use of this technology in healthcare. However, the ethical principles for generative AI in healthcare have been understudied. As a result, there are no clear solutions to address ethical concerns, and decision-makers often neglect to consider the significance of ethical principles before implementing generative AI in clinical practice. In an attempt to address these issues, we explore ethical principles from the military perspective and propose the "GREAT PLEA" ethical principles, namely Governability, Reliability, Equity, Accountability, Traceability, Privacy, Lawfulness, Empathy, and Eutonomy, for generative AI in healthcare. Furthermore, we introduce a framework for adopting and expanding these ethical principles in a practical way that has been useful in the military and can be applied to healthcare for generative AI, based on contrasting their ethical concerns and risks. Ultimately, we aim to proactively address the ethical dilemmas and challenges posed by the integration of generative AI into healthcare practice.

DOI10.1038/s41746-023-00965-x
Alternate JournalNPJ Digit Med
PubMed ID38042910
PubMed Central IDPMC10693640
Grant ListR01 LM014306 / LM / NLM NIH HHS / United States
UL1 TR001857 / TR / NCATS NIH HHS / United States
R00 LM013001 / LM / NLM NIH HHS / United States
U24 TR004111 / TR / NCATS NIH HHS / United States