Ethical considerations about artificial intelligence for prognostication in intensive care

Background Prognosticating the course of diseases to inform decision-making is a key component of intensive care medicine. For several applications in medicine, new methods from the field of artificial intelligence (AI) and machine learning have already outperformed conventional prediction models. D...

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Bibliographic Details
Published in:Intensive care medicine experimental 2019-12, Vol.7 (1), p.70-13, Article 70
Main Authors: Beil, Michael, Proft, Ingo, van Heerden, Daniel, Sviri, Sigal, van Heerden, Peter Vernon
Format: Article
Language:English
Subjects:
Artificial intelligence
Clinical decision making
Critical Care Medicine
Decision making
Intensive
Intensive care
Machine learning
Medical ethics
Medical prognosis
Medicine
Medicine & Public Health
Patient care planning
Prognostication
Review
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Summary:Background Prognosticating the course of diseases to inform decision-making is a key component of intensive care medicine. For several applications in medicine, new methods from the field of artificial intelligence (AI) and machine learning have already outperformed conventional prediction models. Due to their technical characteristics, these methods will present new ethical challenges to the intensivist. Results In addition to the standards of data stewardship in medicine, the selection of datasets and algorithms to create AI prognostication models must involve extensive scrutiny to avoid biases and, consequently, injustice against individuals or groups of patients. Assessment of these models for compliance with the ethical principles of beneficence and non-maleficence should also include quantification of predictive uncertainty. Respect for patients’ autonomy during decision-making requires transparency of the data processing by AI models to explain the predictions derived from these models. Moreover, a system of continuous oversight can help to maintain public trust in this technology. Based on these considerations as well as recent guidelines, we propose a pathway to an ethical implementation of AI-based prognostication. It includes a checklist for new AI models that deals with medical and technical topics as well as patient- and system-centered issues. Conclusion AI models for prognostication will become valuable tools in intensive care. However, they require technical refinement and a careful implementation according to the standards of medical ethics.
ISSN:2197-425X
2197-425X
DOI:10.1186/s40635-019-0286-6