Ethical Implications of Artificial Intelligence in Population Health and the Public’s Role in Its Governance: Perspectives From a Citizen and Expert Panel (Preprint)

Abstract

BACKGROUND Artificial intelligence (AI) systems are spreading in the health sector. Mainly used for individualized care, AI is increasingly aimed at population health. This raises important ethical considerations, but also calls for responsible governance, considering that this will affect the population. However, the literature points to a lack of citizen participation in the governance of AI in health. It is therefore timely to investigate the governance of the ethical and societal implications of AI in population health. OBJECTIVE To explore the perspectives and attitude of citizens and experts on (1) the ethics of AI in population health, (2) the engagement of citizens in AI governance, and (3) the potential of a digital application to foster citizen engagement. METHODS We recruited a panel of 21 citizens and experts. Using an online survey, we explored their perspectives and attitudes on the ethical issues of AI in population health, the relative role of citizens and other actors in AI governance, and the ways in which citizens can be supported to take part in AI governance through a digital application. The responses of the participants were both analyzed quantitatively and qualitatively. RESULTS According to the participants, AI is perceived to be already present in population health, its benefits are regarded positively, but there is a consensus that AI raises significant societal implications. Participants also showed a high level of agreement toward involving citizens into AI governance. They highlighted aspects to be considered in the creation of a digital application to foster this involvement. They recognized the importance of creating an application both accessible and transparent. CONCLUSIONS These results offer avenues for the development of a digital application to raise awareness, survey, and support citizens’ decision-making on the ethical, legal, and social issues of AI in population health.