人工智能系统(人工智能系统)(例如机器学习、生成人工智能),在医疗保健和医学方面,收到了更好的护理质量的希望,效率更高,降低护理成本,等。同时,这些系统对其对利益相关者隐私的影响持保留意见,关于不断变化的动力动态,关于系统偏见,等。幸运的是,医疗保健和医学一直受到许多道德原则的指导,框架,或方法,它还指导人工智能系统在医疗保健和医学中的使用,以一种或另一种形式。然而,在这篇文章中,我认为,这些方法中的大多数都是受到当地对人工智能系统的孤立主义观点的启发,这里以原则主义方法为例。尽管对医疗保健和医学中人工智能系统的伦理格局做出了积极贡献,这种伦理方法过于关注特定的当地医疗保健和医疗环境,是一种特殊的护理关系,一个特殊的护理组织,或特定的社会或地区。通过这样做,他们忽视了人工智能系统的全球影响,特别是环境影响和相关的社会影响,例如增加健康风险。为了弥补这个差距,这篇文章提出了一个全球的方法来伦理的人工智能系统在医疗保健和医学,包括五个层面的伦理影响和分析:个人关系,组织,社会,全球,和历史。因此,这种全球方法通过将本地孤立主义观点纳入更广泛的道德考虑范围,以确保人工智能系统满足世界各地每个人的需求。
Artificial intelligence systems (ai-systems) (e.g. machine learning, generative artificial intelligence), in healthcare and
medicine, have been received with hopes of better care quality, more efficiency, lower care costs, etc. Simultaneously, these systems have been met with reservations regarding their impacts on stakeholders\' privacy, on changing power dynamics, on systemic biases, etc. Fortunately, healthcare and
medicine have been guided by a multitude of ethical principles, frameworks, or approaches, which also guide the use of ai-systems in healthcare and
medicine, in one form or another. Nevertheless, in this article, I argue that most of these approaches are inspired by a local isolationist view on ai-systems, here exemplified by the principlist approach. Despite positive contributions to laying out the ethical landscape of ai-systems in healthcare and
medicine, such ethics approaches are too focused on a specific local healthcare and medical setting, be it a particular care relationship, a particular care organisation, or a particular society or region. By doing so, they lose sight of the global impacts ai-systems have, especially environmental impacts and related social impacts, such as increased health risks. To meet this gap, this article presents a global approach to the ethics of ai-systems in healthcare and
medicine which consists of five levels of ethical impacts and analysis: individual-relational, organisational, societal, global, and historical. As such, this global approach incorporates the local isolationist view by integrating it in a wider landscape of ethical consideration so to ensure ai-systems meet the needs of everyone everywhere.