This document discusses some of the key ethical issues related to the use of artificial intelligence and blockchain in healthcare. It outlines principles of ethics like autonomy, beneficence, non-maleficence, and justice. It also examines specific ethical issues for AI like consent, data privacy, bias and fairness, transparency, and safety. For blockchain, it looks at issues like job loss, wealth creation, and potential to facilitate crime or be overhyped. The document advocates that regulatory frameworks may need to be developed to provide oversight of AI systems, such as through institutional review boards, to help address ethical challenges.

1. Your Health
App may be
Illegal
AN OVERVIEW OF ETHICS IN HEALTHCARE
FOR AI & BLOCKCHAIN
PART OF THE IEEE: HEALTHCARE
BLOCKCHAIN & AI VIRTUAL SERIES
SEAN MANION, PHD - CHIEF SCIENTIFIC
OFFICER AT CONSENSYS HEALTH

2. Ethics
AUTONOMY – SELF
DETERMINATION
BENEFICENCE (DO GOOD)
NON-MALEFICENCE (DO NO HARM)
JUSTICE – EQUAL TREATMENT
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3. 3
Wikipedia's complete (as of 2016) list of cognitive biases, arranged and designed by John Manoogian III (jm3). Categories and descriptions originally by Buster Benson

4. Bias - the action of supporting or opposing
a particular person or thing in an unfair
way
•Cognitive bias can be good, bad or neutral
•Cognitive bias can be exacerbated and
exploited
•Individuals each have their own combination
of biases
•Laws and regulations are often meant to
offset individual biases
•Laws and regulations are drafted and
overseen by biased individuals
•Systematic and/or systemic bias can result
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5. Ethical issues for AI & Blockchain
AI (NARROW – E.G. MACHINE LEARNING)
Consent
Data Privacy
Bias/Fairness
Transparency
Safety & Effectiveness
Economic – Job Loss and Wealth Creation
BLOCKCHAIN
Job Loss and Wealth Creation
Bias/Fairness
Facilitate crime?
Overhyping?
OTOH: Can it bring more transparency and
fairness to AI?
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6. 6

7. AI ETHICS – Facial Recognition
Surveillance group exposes disturbing Huawei patent for
AI-powered Uighur detection
Thomas Macaulay, TNW Neural, 13 Jan 2021
A range of Chinese tech firms have filed patents for
systems that identify ethnic groups.
A Huawei patent that mentions AI-powered
identification of Uighur people and other ethnic groups
has been discovered.
The patent was exposed by video surveillance research
group IPVM, the same organization that had previously
spotted references to an AI “Uighur alarm” on Huawei‘s
website, as well as evidence that Alibaba had offered
“Uighur-detection-as-a-service.”
Study finds gender and skin-type bias in commercial
artificial-intelligence systems
Larry Hardesty, MIT News Office, 11 Feb 2018
Examination of facial-analysis software shows error rate
of 0.8 percent for light-skinned men, 34.7 percent for
dark-skinned women.
Ref: “Gender Shades: Intersectional Accuracy
Disparities in Commercial Gender Classification”
Joy Buolamwini, Timnit Gebru ; Proceedings of
the 1st Conference on Fairness, Accountability
and Transparency, PMLR 81:77-91, 2018.
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8. https://map.ai-global.org/
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9. Artificial Intelligence is part of the
Digital Health Ecosystem.
Use of AI in healthcare & medicine is
booming – here's how the medical field
is benefiting from AI in 2021 and
beyond
Alicia Phaneuf Business Insider, Jan 29,
2021
•AI has the ability to analyze big data
sets – pulling together patient insights
and leading to predictive analysis.
•Insider Intelligence projects AI in
healthcare will grow at an annualized
48% between 2017 and 2023.
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10. Tuskegee Experiment
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11. Nuremberg Code
• The judgment by the war crimes tribunal at Nuremberg laid down 10
standards to which physicians must conform when carrying out experiments
on human subjects in a new code that is now accepted worldwide.
• This judgment established a new standard of ethical medical behavior for
the post World War II human rights era. Amongst other requirements, this
document enunciates the requirement of voluntary informed consent of the
human subject. The principle of voluntary informed consent protects the
right of the individual to control his own body.
• This code also recognizes that the risk must be weighed against the expected
benefit, and that unnecessary pain and suffering must be avoided.
• This code recognizes that doctors should avoid actions that injure human
patients.
• The principles established by this code for medical practice now have been
extended into general codes of medical ethics.
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12. Belmont
Report
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13. Human Subjects Research
Definition of Human Subjects Research
According to 45 CFR 46 , a human subject is "a living individual about whom an
investigator (whether professional or student) conducting research:
•Obtains information or biospecimens through intervention or interaction with
the individual, and uses, studies, or analyzes the information or biospecimens; or
•Obtains, uses, studies, analyzes, or generates identifiable private information or
identifiable biospecimens."
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14. Identifiable Health Information
Full name or last name and initial(s)
Geographical identifiers smaller than a state, except the initial
three digits of a zip code, provided the combination of all zip
codes starting with those three digits. When the initial three
digits of a zip code contains 20,000 or fewer people it is
changed to 000
Dates directly related to an individual, other than year
Phone Numbers
Fax numbers
Email addresses
Social Security numbers
Medical record numbers
Health insurance beneficiary numbers
Account numbers
Certificate/license numbers
Vehicle identifiers
Device identifiers and serial numbers;
Web Uniform Resource Locators (URLs)
IP addresses
Biometric identifiers, including finger, retinal and voice prints
Full face photographic images and any comparable images
Any other unique identifying number, characteristic, or code
except the unique code assigned by the investigator to code
the data
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15. Is Machine Learning
Generalizable
Research?
HHS has defined "research" as a systematic
investigation, including research development,
testing and evaluation, designed to develop or
contribute to generalizable knowledge.
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16. Institutional
Review Board
(IRB)
• Review Scientific, Medical, and
Ethical aspects of research
• Made of experts along with at
least one member whose interest
is non-scientific and another not
affiliated with the university/trial
site
• Some research is exempted, but
this generally requires an IRB rep
to determine, not the investigator
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17. AI-Institutional Review Board (AIRB)?
Should some medical AI be reviewed or
exempted by an IRB?
Should IRBs be utilized for expanded ethical
review for AI?
Should a parallel structure be developed?
◦ Future of Privacy Forum, “Designing an
Artificial Intelligence Research Review
Committee” (2019)
◦ AI Global, “Responsible AI Guidelines:
Independent Review” (2020)
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