Governance of technologies
Application of AI in healthcare, in particular regarding its impact on the doctor-patient relationship - report of the consultant expert Brent Mittelstadt
On 7 June, 2022, the Council of Europe’s Steering Committee for Human Rights in the fields of Biomedicine and Health (CDBIO) issued a new report on the impact of artificial intelligence on the doctor-patient relationship, prepared by Brent Mittelstadt, Senior Research Fellow and Director of Research at the Oxford Internet Institute, University of Oxford.
The report examines AI systems regarding the doctor-patient relationship in relation to the human rights principles referred to in the European Convention on Human Rights and Biomedicine of 1997, otherwise known as the “Oviedo Convention”. More specifically, the report investigates the potential human rights impact of AI according to six themes: (1) Inequality in access to high quality healthcare; (2) Transparency to health professionals and patients; (3) Risk of social bias in AI systems; (4) Dilution of the patient’s account of well-being; (5) Risk of automation bias, de-skilling, and displaced liability; and (6) Impact on the right to privacy.
The report was prepared in the framework of the Council of Europe Strategic Action Plan on Human Rights and Technologies in Biomedicine (2020-2025), regarding the governance of technologies and the strategic objective of “Embedding human rights in the development of technologies which have an application in the field of biomedicine”.
The report contributes to the work of a new CDBIO drafting group on AI in healthcare, responsible for preparing further reflections and recommendations to be considered by the CDBIO in 2023-24.
Strategic Action Plan on Human Rights and Technologies in Biomedicine (2020-2025)
Artificial Intelligence (AI) has the potential to improve diagnostic and therapeutic outcomes for patients. Although deep learning algorithms in a variety of tasks in radiology and in medicine generally have demonstrated significant promise, it is likely to be several years before AI is mainstreamed into the healthcare domain. The predictive capability of AI raises concerns about privacy and discrimination. Moreover, as AI evolves, it will create new complexities for the doctor-patient relationship. In the light of these challenges, the Steering Committee for Human Rights in the fields of Biomedicine and Health intends to prepare a report highlighting the role of healthcare professionals in respecting the autonomy, and right to information, of the patient, and in maintaining transparency and patient trust as critical components of the therapeutic relationship.
Technological innovation often creates its own dynamic. Major technological breakthroughs in fields such as artificial intelligence, genome editing, and neurotechnology have the potential to advance biomedicine and healthcare. However, uncertainty exists about the impact and direction of these developments. For example, artificial intelligence is increasingly proficient in diagnostics but depends on massive amounts of patient data which may impact on transparency and patient trust, thereby necessitating the provision of guidance for healthcare professionals. Genome editing techniques which introduce inheritable changes in the human genome raise serious concerns about the possibilities of irreversible harm to future persons. Developments in neurotechnologies, such as deep brain stimulation, brain-computer interfaces, and artificial neural networks, raise the prospect of increased understanding, monitoring, but also of control of the human brain, raising issues of privacy, personhood, and discrimination.
The role of governance in biomedicine is often restricted to facilitating the applications of technology and to containing the risks that come to light. In this way, human rights considerations will only come into play at the end of the process, when the technological applications are already established, and the technological pathways often have become irreversible. To overcome this problem, there is a pressing need to embed human rights in technologies which have an application in the field of biomedicine. This implies that technological developments are from the outset oriented towards protecting human rights. For that reason, governance arrangements need to be considered, which seek to steer the innovation process in a way which connects innovation and technologies with social goals and values.
- June 2022
Drafting group on AI and healthcare set up by the CDBIO