Applied Ethics Group, RWTH Aachen University, Aachen, Germany
Applied Ethics Group, RWTH Aachen University, Aachen, Germany.
J Med Ethics. 2022 Apr;48(4):222-229. doi: 10.1136/medethics-2021-107440. Epub 2021 Dec 14.
In this paper, we first classify different types of second opinions and evaluate the ethical and epistemological implications of providing those in a clinical context. Second, we discuss the issue of how artificial intelligent (AI) could replace the human cognitive labour of providing such second opinion and find that several AI reach the levels of accuracy and efficiency needed to clarify their use an urgent ethical issue. Third, we outline the normative conditions of how AI may be used as second opinion in clinical processes, weighing the benefits of its efficiency against concerns of responsibility attribution. Fourth, we provide a 'rule of disagreement' that fulfils these conditions while retaining some of the benefits of expanding the use of AI-based decision support systems (AI-DSS) in clinical contexts. This is because the rule of disagreement proposes to use AI as much as possible, but retain the ability to use human second opinions to resolve disagreements between AI and physician-in-charge. Fifth, we discuss some counterarguments.
在本文中，我们首先对不同类型的第二意见进行分类，并评估在临床环境中提供此类第二意见的伦理和认识论含义。其次，我们讨论了人工智能（AI）如何替代提供此类第二意见的人类认知劳动的问题，并发现有几种 AI 达到了需要明确其使用的准确性和效率水平，这是一个紧迫的伦理问题。第三，我们概述了 AI 如何在临床流程中用作第二意见的规范条件，权衡其效率的益处与责任归因的担忧。第四，我们提供了一条“分歧规则”，该规则满足这些条件，同时保留在临床环境中扩大使用基于人工智能的决策支持系统（AI-DSS）的一些益处。这是因为分歧规则建议尽可能多地使用 AI，但保留使用人类第二意见来解决 AI 和主治医生之间的分歧的能力。第五，我们讨论了一些反对意见。
