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44 Computational Intelligence Algorithms
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neuron.2022.01.010.
Ethical Issues in
4
Neurodisorder Diagnosis
Runa Hussain, Safdar Tanweer, Sameena Naaz, and Sherin Zafar
4.1 INTRODUCTION
Among the many ways that medical articial intelligence (AI) may enhance neu­rological procedures are by helping patients get diagnosed, actively treating their symptoms in between in-person consultations, anticipating and averting likely are­ups, and more. Differential symptoms are displayed by people with a variety of mental and behavioral disorders. Verbal output, whether spoken or written, body language, tone of voice, and facial expressions can all be used to diagnose a patient. There are many moral and legal issues that medical sector must deal with. While AI has made great strides in society and may lead to better treatment results, not all cul­tures can afford it [1]. The most recent technology is still unavailable in many devel- oping and low-income countries. Not to mention, there are a lot of concerns we have to deal with, such moral dilemmas, data privacy and protection, informed consent, societal divides, medical advice, empathy, and compassion. The Indian Committee of Clinical Exploration (ICMR) has planned moral direction records every once in a while, for advancing moral and top-notch research in India. Experts and ethics com­mittees are expected to adhere to these guidelines [2]. These guidelines aim to offer guidance without restricting innovation or suggesting specic diagnostic or thera­peutic approaches for diseases, but to facilitate safe and effective use of AI technolo­gies in biomedical research and healthcare delivery. With the broad implications of AI-based technologies in healthcare, these guidelines apply to health professionals, technology developers, researchers, entrepreneurs, hospitals, research institutions, organization(s), and laypersons who wish to use health data for biomedical research and healthcare delivery using AI technology and techniques. AI is continuously using for the development of “smart” healthcare devices, which have the ability to learn difcult patterns from big and complex datasets like neurodisorders and many other mental diseases. Virtual health assistants, tailored medications, and smart dig­ital tablets are some AI-driven computer programs that will assist primary care doc­tors in more precisely identifying patients who need special treatment and care and in developing protocols that are tailored to each patient. AI can be used by doctors to take notes, evaluate patient conversations, and upload necessary data straight into electronic health record systems [3]. But AI may be abused when applied incorrectly due to biases and other factors. So, AI in smart healthcare creates a number of new ethical questions.
DO I: 10.1201/ 97810 03520 34 4 - 5
45
46 Computational Intelligence Algorithms
FIGURE 4.1 Flowchart depicting different ethical policies in healthcare.
The owchart in Figure 4.1 makes it evident that there are mainly legal policies
and organizational policies. Then there are some ethical practices:
1. Data management, which includes data collection, data protection, data cleaning, and data reporting.
2. Model development includes model training, model verication, and model reporting.
3. Deployment and monitoring includes stakeholder engagement and user­centered design, updates and ongoing validation, and supervision and auditing.
4.2 RELATED WORKS
In the beginning of healthcare research, every study in health and biomedical sci­ence, whether it uses AI or traditional approaches, must follow fundamental ethical rules: respect for individuals (autonomy), promoting well-being (benecence), avoid­ing harm (nonmalfeasance), and fairness in distribution (distributive justice). Each rule aims to guarantee the safeguarding of the respect, rights, safety, and welfare of both the community and the individuals involved. These basic principles have been broadened into 12 overarching principles in the ICMR National Ethical Guidelines, 2017 [2].
The primary classication of the literature review is depicted in Figure 4.2.
FIGURE 4.2 Primary classication of the literature review [1].
47 Ethical Issues in Neurodisorder Diagnosis
There are ten ethical principles in Figure 4.3, which shows different issues spe-
cic to AI for health.
These principles are:
• Autonomy: Utilization of AI in healthcare can improve patients’ treatments more efciently. Such a system has the capacity to operate on its own and weaken human independence, putting the power of making decisions into the hands of machines. Humans ought to possess the entire management of the AI-driven healthcare system. AI technology must always respect the autonomy of the patient.
• Data privacy: AI technology must guarantee the privacy and protection of personal data in every phase of growth and implementation. Having the trust of everyone is important for all stakeholders, such as healthcare recip­ients, who are concerned about safety and security. Data privacy should focus on stopping unauthorized entry, alteration, or deletion of personal information. AI can be used to support individual needs, but it should not impose excessive limitations on a person’s real or perceived freedom.
• Accountability and liability: Accountability is dened as the responsibility of a person or group to take responsibility for its actions, be accountable for its activities, and present the outcomes in a clear and easily understand­able way. AI technologies are designed to be implemented in the healthcare
48 Computational Intelligence Algorithms
FIGURE 4.3 Objectives of ethical principles in neurodisorder research of AI.
industry and need to be prepared for examination by relevant authorities at any given moment [4]. AI technologies need to go through routine internal and external assessments reviews to guarantee their peak performance. It is necessary to make these audit reports accessible to the public.
• Trustworthiness: Reliability is the most sought-after attribute of a prog­nostic tool for utilization in AI healthcare. Clinicians must develop trust in the tools. AI technologies also utilize the same approach. To successfully utilize AI effectively, clinicians and healthcare providers should possess a straightforward, organized approach and a reliable method to evaluate the credibility and dependability of AI technologies.
• Validity: AI technology in healthcare needs to go through thorough clinical and eld validation prior to being used on individuals. These are crucial in order to guarantee safety and effectiveness. The AI-based algorithms’ deviation could be increased because of variations in the datasets utilized to train AI algorithms. When AI technology has an inuence on every person or medical facility, there should be a well-functioning system for receiving feedback for implementing essential changes.
• Nondiscrimination and fairness: To avoid biases and inaccuracies in the algorithms and guarantee accuracy In order to maintain quality, it is nec­essary to adhere to some principles. Inaccuracies and biases can lead to less than optimal or faulty results [5]. External, independent algorithmic audits of AI technologies and ongoing evaluation of feedback from end­users should be conducted to reduce errors and prejudices. The developers/ researchers working on AI must recognize and consider any biases present and ought to address the steps that are needed to x them.
• Optimization and data quality: AI is a technology that relies heavily on data, and its results are largely determined by that data. The information is utilized to train and test AI. Data bias is seen as the primary danger to data-focused technologies such as AI for the purpose of maintaining good health. It is important to exercise due diligence to verify the quality of the “training data.”
• Accessibility and equity: Utilizing computers for both progress and imple­mentation of AI, the presence of a broader infrastructure is necessary for the widespread implementation of healthcare technologies. AI developers and authorities must ensure fairness in how AI technology is distributed. Organizations are required to strive to offer equal chances and accessibility to AI technology within various user demographics [6]. The accessibility of these technologies for underprivileged populations that are socially and economically disadvantaged should be the focus of AI developers and other stakeholders.
• Risk minimization and safety: It is the responsibility of all stakeholders to ensure participant safety engaged in the creation and implementation of AI technology. Patients/participants must be protected, with their dignity, rights, safety, and well-being of topmost importance. Strong control mecha­nisms are essential to avoid unintentional or intentional misuse. Having secured systems and software is crucial and necessary due to the sensitive data in the healthcare industry.
• Collaboration: AI technology in healthcare contexts suffers from a severe lack of condence. More than 60% of patients, according to recent surveys, don’t trust AI in healthcare. This mistrust stems from worries about data privacy, possible biases, and the opaqueness of AI decision-making pro­cedures. Thus, the moral and societal responsibility of using AI ethically transforms it from a purely technical task.
49 Ethical Issues in Neurodisorder Diagnosis
Integrating AI into every part of medical systems looks difcult and not reach­able. Medical robots and humans may not progress at the same speed in upcom­ing years because of the unique emotions that humans have. It is impossible for doctors and other healthcare professionals to communicate with or take advice from other healthcare professionals through robotic systems. Nevertheless, it appears unlikely that patients will prefer “machine−human” to “human−human” medical interactions [7]. The recovery of patients will be signicantly inuenced by the compassionate and empathetic care that medical professionals must pro­vide. Achieving this task is not feasible with articial doctors and nurses. When
50 Computational Intelligence Algorithms
patients engage with robotic medical professionals, they may not show empathy, courtesy, or proper conduct due to the machines’ absence of human traits such as compassion. One of the key disadvantages of AI in the eld of medicine is this. AI is widely used in healthcare [8]. Some examples are booking appointments online, checking in online at hospitals, converting medical documents into digital format, sending reminders for follow-up appointments and vaccinations, calculat­ing medication dosage, and issuing alerts about possible side effects of combining medications.
4.2.1 ADVANTAGES OF INCORPORATING AI IN NEURODISORDER
There are many advantages to integrating AI into healthcare, including revolution­izing patient care. AI-enabled applications, chatbots, and interfaces allow virtual health assistants to provide individualized services. The workload for healthcare providers is lessened by these digital assistants, which help with vital sign moni­toring, medication reminders, appointment scheduling, and identication of patient problems [9]. Virtual health assistants have proven effective in-patient triaging and are available around the clock to improve healthcare accessibility. Some of the advantages are:
• Optimization of workow: AI helps healthcare workers by automating repetitive tasks, freeing them up to concentrate on important decisions and patient care.
• Improved diagnosis: AI-powered diagnostic instruments offer fast and pre- cise evaluations.
• Individualized care programs: AI uses patient data analysis to customize treatment plans based on response, genetics, and individual traits.
• Accurate forecasting: AI models can effectively address possible health issues by predicting disease trends.
• Effective management of resources: AI aids in resource optimization, enabling healthcare providers to better manage personnel, assets, and facilities.
• Simplied administrative duties: By automating administrative proce- dures, more patient-centric tasks can be completed with less paperwork and bureaucracy.
• Instantaneous decision assistance: AI helps medical professionals make educated decisions during patient consultations and treatments by provid­ing timely and pertinent information.
• Ongoing education: Healthcare workers can remain up to date on the most recent developments in medicine thanks to medical AI.
• Remote observation: AI-driven monitoring systems make it possible for physicians to track patients’ health outside of conventional clinical settings by facilitating remote patient monitoring.
• Increased involvement of patients: AI technologies improve dialogue between patients and doctors, encouraging greater understanding, compli­ance, and engagement with treatment regimens.
51 Ethical Issues in Neurodisorder Diagnosis
4.2.2 CHALLENGES OF AI
In spite of many benets of AI in healthcare, there are many challenges that a health­care professional has to deal with [10]. Some of these are:
• The major ethical dilemma in AI-powered mental healthcare is data pri­vacy issues, like data breaches and exploitation of patient information for commercial use, which require strict protection measures.
• Bias in algorithms is a signicant issue in mental health assessment and care; AI algorithms use extensive datasets that may have biases, resulting in discrepancies in diagnosis and treatment suggestions that impact marginal­ized communities.
• Informed consent is highly essential in healthcare as it allows patients to make informed decisions based on complete information. The right is equally signicant while utilizing AI in medicine, despite some thinking that black-box AI systems do not inuence it. A patient should be given the option to say no to AI-informed treatments if they are concerned [11].
• Keeping up with ethical guidelines in AI-based mental healthcare, lack of transparency in AI can impede understanding of how decisions are made. Understanding how AI operates and makes decisions is essential for patients and healthcare providers to ensure responsible use. Furthermore, it is crucial to hold AI accountable for its outcomes in cases of adverse events or mistakes.
We give a summary of ongoing research endeavors aimed at creating an AI focused on humans. These initiatives involve a core reevaluation of user-focused data control and handling, alongside the creation of safe and privacy-protecting machine learning (PPML) algorithms and implementing clear and transparent algorithms and incorporating machine learning fairness principles and methodologies to address biases and discriminatory outcomes. According to our perspective, it is essential to focus on humans, as they are both the doers and the main focus of the discussion of the choices determined by algorithms [12]. If we can make sure that these criteria are fullled, we should harness the benets of AI-powered decision-making but also reduce the associated dangers of potential adverse effects on individuals and the entire society [13].
4.3 CONCLUSION
In the future, research in AI-driven healthcare will focus on improving algorithms for better interpretation, minimizing biases, and maintaining strong privacy protec­tions. Continuous updating of ethical guidelines is essential to adapt to technologi­cal advances, and promoting interdisciplinary collaborations is necessary to tackle intricate challenges. The investigation of cutting-edge technologies like robotics, augmented reality, and blockchain in healthcare offers promising opportunities for future studies. Grasping the lasting effects on society and tackling accessibility issues will be essential in fully utilizing AI for improving global healthcare [14].
52 Computational Intelligence Algorithms
This study lays the groundwork for ongoing discussions, partnerships, and exami­nation of ethical dilemmas as AI further inuences the healthcare eld. In this research, we found that there are just as many supporters as detractors of this new era of AI-augmented practice. Many aspiring and current doctors are concerned about the decline in employment opportunities brought about by the rising use of technol­ogy. While machines can interpret human behavior logically and analytically, they cannot develop human qualities like creativity, emotional intelligence, interpersonal and communication skills, critical thinking, or creative thinking. AI is going to be increasingly used in healthcare and hence needs to be morally accountable. Even though AI can’t replace the role of clinical judgment completely, it can nonetheless aid in decision-making for clinicians. In many cases where there is a lack of medical knowledge and resources, AI can be utilized for screening and evaluation. AI deci­sions, unlike human decision-making, are always methodical due to the presence of algorithms [15]. It is observed by many groups that the fast speed development of AI in healthcare is an excellent strategy that might support healthcare practitioners. Nevertheless, despite the extensive potential and development of AI in the medical and healthcare sectors, this achievement has created additional challenges for medi­cal ethics. We should be cautious because the disadvantages of it may outweigh the benets. Professionals must consider morals and compassion when addressing this problem.
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53 Ethical Issues in Neurodisorder Diagnosis
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