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neuron.2022.01.010.

Ethical Issues in
4
Neurodisorder Diagnosis
Runa Hussain, Safdar Tanweer,
Sameena Naaz, and Sherin Zafar
4.1 INTRODUCTION
Among the many ways that medical articial 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 specic 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 difcult 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 verication, 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 (benecence), 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 classication of the literature review is depicted in Figure 4.2.

FIGURE 4.2 Primary classication 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-
cic to AI for health.
These principles are:
• Autonomy: Utilization of AI in healthcare can improve patients’ treatments
more efciently. 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 dened 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 inuence 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 condence. 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 difcult 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 signicantly inuenced
by the compassionate and empathetic care that medical professionals must provide. Achieving this task is not feasible with articial 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 identication 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 workow: 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.
• Simplied 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 benets 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 signicant 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 signicant while utilizing AI in medicine, despite some thinking
that black-box AI systems do not inuence 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 fullled, we should harness the benets 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 inuences 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
benets. Professionals must consider morals and compassion when addressing this
problem.
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53 Ethical Issues in Neurodisorder Diagnosis
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