Experts: Ethical concerns over AI use in medical care pressing but answerable
Caleb Watney, a technology policy associate for the R Street Institute, believes open-sourcing and transparency can protect privacy and safeguard AI.
Computers’ memory raises privacy concerns as robots or AI programs can collect enormous amounts of data about their patients. Watney argues this is a comparable problem to data security in other sectors and can be addressed through standard security practices such as encryption and automatic deletion incentivized by making data collectors liable for breaches.
“If companies have no liability for having consumer data breached through a cyber attack then they have every incentive to just collect as much data as physically possible because you never know when it might be useful,” he said. “But if companies have to weigh the additional benefit from collecting more data against the potential liability if that data gets hacked, then that should put in more of a balance there and cause companies to always question, should we really be collecting this data?”
The Etzioni report defines AI caregivers as “all AI-enriched programs that provide care and seem affective to those they care for.” One of AI critics’ concerns is that AI caregivers are necessarily inauthentic in their performances of sympathy and emotion for their patients. Etzioni dismisses that concern, as such seeming affection is a necessary part of quality medical care and the question of authenticity is present with human nurses and doctors as well.
“When you have a nurse aide come to you, for instance into your home, and say ‘I care about you. Are you OK? Love you!’—she doesn’t give a shit, she just gets paid to be nice. So, are we going to say, ‘Well, OK, we should not accept nursing’? … the country will not be able to provide the kind of service that people need if I only employ other human beings.”
Addressing concerns that AI systems could, in misguided pursuit of their mandate to provide medical care, control or harm vulnerable patients, Etzioni said, “The answer is much easier than most people think, and it is not often that I can say that: We have laws.”
Just as laws and regulations set parameters for human behavior, what the report calls “AI Guardians” could enforce laws and regulations for AI caregivers, and identify and correct noncompliance. Etzioni pointed to self-driving cars and traffic laws to illustrate.
“We ask you to stop for stop signs,” he said. “It’s not an ethical dilemma. We are telling you to stop at stop signs and if you don’t we will make you. So 90 percent of the behavior, in all the ways that we really care about, we legislate. The ethical decisions—if you ask me who makes them, who decides—the legislature decides. The legislature reflects our values.”
The prospect of AI Guardians, Etzioni admits, raises the old question “who will guard the guardians?” There’s no easy answer, he said, beyond relying on a human presence around AI programs.
“The best we can hope for is that all smart instruments will be outfitted with a readily locatable off-switch to grant ultimate control to human agents over both operational oversight AI programs.”
Watney argues another solution to guarding the guardians may be found in transparent and open-source AI programming and software. If the AI Guardians’ inputs and functions are made public then in some sense, Watney said, “everyone watches the watcher.”
Both Watney and Etzioni push against what they see as excessive hand wringing over adopting AI systems. As Etzioni put it, when asked when these questions will become urgent: “Yesterday! …This is not next year or ten years from now this is the here and now.” Both men argue AI meets real and pressing needs and it is counterproductive to compare robot caregivers to a perfect model. Said Watney:
“Ideally we’d have a fully trained, very attentive doctor or nurse there with every single patient as they’re dying to walk them through every stage of the process, but that’s just impractical and it’s not happening now, so if we can get closer to that world by using some partnership of AI and humans that seems like a more moral and more just system.”