Informed consent and medical artificial intelligence: What to tell the patient?

Imagine you are a patient who has been diagnosed with prostate cancer. There are two main approaches to treating it in the United States: active surveillance or the surgical option of radical prostatectomy. Your physician recommends the surgical option and spends considerable time explaining the ste...

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Bibliographic Details
Published in:The Georgetown law journal 2020-05, Vol.108 (6), p.1425-1469
Main Author: Cohen, I. Glenn
Format: Article
Language:English
Subjects:
ARTIFICIAL INTELLIGENCE
Cancer
Civil rights
Diagnosis
ETHICS
Health aspects
Informed consent
Informed consent (Medical law)
Laws, regulations and rules
Management
Medical applications
Medical ethics
Medical technology
Moral and ethical aspects
Patients
Privacy
Prostate
Prostatectomy
PUBLIC HEALTH
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Summary:Imagine you are a patient who has been diagnosed with prostate cancer. There are two main approaches to treating it in the United States: active surveillance or the surgical option of radical prostatectomy. Your physician recommends the surgical option and spends considerable time explaining the steps in the surgery, the benefits of (among other things) eliminating the tumor, and the risks of (among other things) erectile dysfunction and urinary incontinence after the surgery. What your physician does not tell you is that she has arrived at her recommendation of prostatectomy over active surveillance based on the analysis of an Artificial Intelligence (AI)/Machine Learning (ML) system, which recommended this treatment plan based on analysis of your age, tumor size, and other personal characteristics found in your electronic health record. Has the doctor secured informed consent from a legal perspective? From an ethical perspective? If the doctor actually chose to "overrule" the AI system and failed to tell you, has she violated your legal or ethical right to informed consent? If you were to find out that the AI/ML system was used to make recommendations on your care and no one told you, how would you feel? Well, come to think of it, do you know whether an AI/ML system was used the last time you saw a physician?
ISSN:0016-8092