Analysis of ethics dumping and proposed solutions in the field of biomedical research in China

Use of artificial intelligence to address health disparities in low- and middle-income countries: a thematic analysis of ethical issues

OBJECTIVES

Artificial intelligence (AI) is reshaping health and medicine, especially through its potential to address health disparities in low- and middle-income countries (LMICs). However, there are several issues associated with the use of AI that may reduce its impact and potentially exacerbate global health disparities. This study presents the key issues in AI deployment faced by LMICs.

STUDY DESIGN

Thematic analysis.

METHODS

PubMed, Scopus, Embase and the Web of Science databases were searched, from the date of their inception until September 2023, using the terms "artificial intelligence", "LMICs", "ethic∗" and "global health". Additional searches were conducted by snowballing references before and after the primary search. The final studies were chosen based on their relevance to the topic of this article.

RESULTS

After reviewing 378 articles, 14 studies were included in the final analysis. A concept named the 'AI Deployment Paradox' was introduced to focus on the challenges of using AI to address health disparities in LMICs, and the following three categories were identified: (1) data poverty and contextual shifts; (2) cost-effectiveness and health equity; and (3) new technological colonisation and potential exploitation.

CONCLUSIONS

The relationship between global health, AI and ethical considerations is an area that requires systematic investigation. Relying on health data inherent with structural biases and deploying AI without systematic ethical considerations may exacerbate global health inequalities. Addressing these challenges requires nuanced socio-political comprehension, localised stakeholder engagement, and well-considered ethical and regulatory frameworks.

How Do Molecular Systems Engineering Scientists Frame the Ethics of Their Research?

BACKGROUND

There are intense discussions about the ethical and societal implications of biomedical engineering, but little data to suggest how scientists think about the ethics of their work. The aim of this study is to describe how scientists frame the ethics of their research, with a focus on the field of molecular systems engineering.

METHODS

Semi-structured qualitative interviews were conducted during 2021-2022, as part of a larger study. This analysis includes a broad question about how participants view ethics as related to their work, with follow up probes about the topics they consider most important. Interviews were transcribed, inductively coded by two researchers to consensus, and analyzed thematically.

RESULTS

Twenty-four scientists participated in the study. Interviewees hold positions as professors, principal investigators, and senior staff researchers in universities or research institutes in the United States and Europe. Among those scientists who reported reflecting on ethical considerations in their work, many equated ethics with research ethics topics (e.g., safety, replicability), or with regulation and guidelines. Participants expressed the view that ethical issues are primarily relevant for clinical trials of bioengineered products, or for those working with animal or human subjects. Scientists described their research as "too early" or "not examining anything living" with regard to ethical reflection. Finally, many felt that ethics is seen as territory for experts and therefore beyond scientists' competencies.

CONCLUSIONS

Molecular systems engineering scientists currently focus on regulatory aspects as the framework for their ethical analyses. They describe using a framework to define when life arises, as a means to determine when further ethical engagement is warranted. Further research is needed to investigate how scientists relate to the ethics of their scientific work, and build consensus around concepts of life, autonomous behavior, and physiological relevance of bioengineered systems.