Operationalising AI ethics through the agile software development lifecycle: a case study of AI-enabled mobile health applications

Abstract

Although numerous ethical principles and guidelines have been proposed to guide the development of artificial intelligence (AI) systems, it has proven difficult to translate these principles into actionable practices beyond mere adherence to ethical ideas. This is particularly challenging in the context of AI systems for healthcare, which requires balancing the potential benefits of the solution against the risks to patients and the wider community, including minorities and underserved populations. To address this challenge, we propose a shift from one-size-fits-all ethical principles to contextualized case-based ethical frameworks. This study uses an AI-enabled mHealth application as a case study. Our framework is built on existing ethical guidelines and principles, including the AI4People framework, the EU High-Level Expert Group on trustworthy AI, and wider human rights considerations. Additionally, we incorporate relational perspectives to address human value concerns and moral tensions between individual rights and public health. Our approach is based on ”ethics by design,” where ethical principles are integrated throughout the entire AI development pipeline, ensuring that ethical considerations are not an afterthought but implemented from the beginning. For our case study, we identified 7 ethical principles: fairness, agility, precision, safeguarding humanity, respect for others, trust and accountability, and robustness and reproducibility. We believe that the best way to mitigate and address ethical consequences is by implementing ethical principles in the software development processes that developers commonly use. Finally, we provide examples of how our case-based framework can be applied in practice, using examples of AI-driven mobile applications in healthcare.

Application of Agile Methodology in Managing the Healthcare Sector

“…The above findings highlight the benefits of applying agile methods and frameworks in healthcare, such as improving patient outcomes, enhancing ethical standards, and facilitating Innovation (Amugongo et al, 2023;Lakhani et al, 2020;Miyake et al, 2022). The authors also emphasize the importance of healthcare feedback loops, collaboration, and adaptation to improve patient outcomes.…”

“…The second theme that the SLR revealed includes the impact of agile methodology on patient outcomes. This theme highlights the benefits of applying Agile methodologies in healthcare (Amugongo, Kriebitz, Boch, & Lütge, 2023;Lakhani et al, 2020;Miyake, Ito, & Karasuyama, 2022). Agile principles enhance patient outcomes, especially in managing chronic conditions like ADHD, by creating feedback loops between patients, caregivers, and clinicians (Lakhani et al, 2020).…”

“…Agile principles enhance patient outcomes, especially in managing chronic conditions like ADHD, by creating feedback loops between patients, caregivers, and clinicians (Lakhani et al, 2020). Additionally, Agile software development may operationalize AI ethics in healthcare, ensuring fairness, agility, precision, safeguarding humanity, respect for others, trust and accountability, and robustness and reproducibility in AI-enabled mHealth applications (Amugongo et al, 2023). Also, the articles stressed the importance of feedback loops, collaboration, and adaptation to improve patient-centered care (Amugongo et al, 2023;Lakhani et al, 2020;Miyake et al, 2022).…”

“…Additionally, Agile software development may operationalize AI ethics in healthcare, ensuring fairness, agility, precision, safeguarding humanity, respect for others, trust and accountability, and robustness and reproducibility in AI-enabled mHealth applications (Amugongo et al, 2023). Also, the articles stressed the importance of feedback loops, collaboration, and adaptation to improve patient-centered care (Amugongo et al, 2023;Lakhani et al, 2020;Miyake et al, 2022). The findings for theme two are presented in the table below.…”

“…The authors also emphasize the importance of healthcare feedback loops, collaboration, and adaptation to improve patient outcomes. While Lakhani et al (2020) focus on the patient-centered aspect of agile healthcare, Amugongo et al (2023); Miyake et al (2022) focus on the technical and organizational aspects. For instance, Amugongo et al (2023) propose a specific agile software development approach for operationalizing AI ethics in healthcare, while Lakhani et al (2020); Miyake et al (2022) offer more general agile principles and frameworks for collaborative healthcare teams and enterprise architecture respectively.…”