A Process Framework for Ethically Deploying Artificial Intelligence in Oncology
Cet article identifie les problèmes éthiques liés à l'utilisation des technologies de l'intelligence artificielle en cancérologie et propose une feuille de route pour le déploiement de ces technologies
Artificial Intelligence (AI) is an emerging technology that uses complex algorithms to arrive at an outcome over a range of circumstances, leveraging the ability of computer systems to perform tasks that would usually require human levels of intelligence.1-3 The use of AI in cancer care is rapidly expanding: a May 2022 PubMed search of the term cross-referenced with cancer revealed approximately 26,000 citations, with more than 60% published in the past five years. Ethical considerations for AI in oncology include patient equity, privacy, and autonomy; the roles of human- and machine-based judgment; and the patient-oncologist relationship.3-5 Relative to other parts of medicine, the implications of oncology AI are outsized, and some are idiosyncratic. Oncology AI tools apply to not one but two genomes (germline and somatic); can greatly complicate the existing weight of bias, discrimination, and structural racism in cancer care; and can subtly undermine patient and physician autonomy, leading to cancer care that is algorithmic rather than patient-centered. These diverse concerns, in the context of unreserved enthusiasm for AI, challenge a future where oncology AI is both widely implemented and ethically acceptable. We propose that adapting a process-focused approach for deploying AI in cancer care, such as the accountability for reasonableness framework (A4R),6 can address these concerns and realize a future where oncology AI is ethically deployed.