Comment EDITOR’S COMMENTwith LOUISE FRAMPTON THE CLINICAL SERVICES JOURNAL Editor


Louise Frampton louiseframpton@stepcomms.com


Technical Editor Kate Woodhead


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STEP COMMUNICATIONS ISSN No. 1478-5641


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Navigating the ethics of AI in healthcare


In this latest edition, CSJ looks at discussion around the ethical implications of artificial intelligence (AI) in healthcare. In their article, ‘Implementing AI: the ethical frontier’, Kenza Benkirane and Dr. Julia Mokhova warn that AI should be “an assistant not a doctor”. They point out that the integration of AI in acute healthcare settings represents “an extraordinary opportunity and a significant challenge”. But what do patients think? Are they concerned about the use of AI in their care? Do they want


to talk to ‘bots’? And are they worried about the use of their data? Research published by the Health Foundation shows that the public is hesitant about


technologies that might be seen to ‘distance’ patients from healthcare staff or come between them, such as care robots. People named the ability to see and talk to NHS staff as their most important consideration when thinking about technology use in healthcare, with older people particularly concerned about this (39% of people aged 65 years and older named this as their most important consideration). In the survey (of over 7,000 members of the public), three-quarters (75%) said that they would support sharing some of their personal health data for the development of AI systems in the NHS. The majority were willing to share data on areas such as their eye health (59%), medicines they are taking (58%) and any long-term illnesses they live with (57%). However, the results found less willingness to share some types of data, with only 47% willing to share smart phone tracked data such as sleep activity and 44% willing to share sexual health information (fewer than the number, 46%, who were opposed). The poll also revealed differences in willingness to share data between socioeconomic groups.


Notably, people from socioeconomic groups D and E (in households where the main earner is semi-skilled, unskilled or not in work) are significantly less likely to support the use of any of their health data for AI development than people from other socioeconomic groups. For example, while 16% of people from socioeconomic group A are not happy for any of their health data to be used, this compares with 39% of people from socioeconomic group E. Analysing the results, the Health Foundation noted these findings highlight the importance of engaging all social groups in the development of new technologies, to ensure they work for everyone and do not inadvertently create or worsen inequalities. The Health Foundation’s Director of Innovation and Improvement, Dr. Malte Gerhold, said: “It is


encouraging that most people are open to sharing their data to develop AI systems in the NHS. When properly implemented, we know that AI has the potential to free up staff by supporting clinical and administrative tasks. However, these systems are only as good as the data used to design and develop them. “There are significant differences between socioeconomic groups in levels of support for sharing data for AI development and for taking part in activities to shape how technology is used in the NHS. Policymakers, NHS leaders and those involved in designing and implementing health care technologies must proactively engage with people across different social groups to ensure that healthcare technologies help tackle inequalities, rather than worsen them.” The technology is exciting and transformative, but bringing a diverse demographic of patients, across all backgrounds, on board may be the biggest challenge of all. We need to be mindful of the potential for bias, AI’s technical limitations (including ‘drift’), and its ethics, as we navigate unfamiliar territory. Ultimately, patients need to be part of the discussion. They need to be involved in how we integrate these systems in healthcare, and they need to be part of the discussion on where we integrate these systems. After all, “no decision about me, without me” must also apply to the implementation of technology.


louiseframpton@stepcomms.com Get in touch and give us your views, email me:


January 2025 I www.clinicalservicesjournal.com 5


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