Stypińska Justyna, Franke Annette
Department of Sociology, Institute of East European Studies, Free University of Berlin, Berlin, Germany.
European New School of Digital Studies, Viadrina University, Frankfurt (Oder), Brandenburg, Germany.
Front Sociol. 2023 Jan 23;7:1038854. doi: 10.3389/fsoc.2022.1038854. eCollection 2022.
AI systems in medicine and healthcare are being extensively explored in prevention, diagnosis, novel drug designs and after-care. The application of AI technology in healthcare systems promises impressive outcomes such as equalising healthcare, reducing mortality rate and human error, reducing medical costs, as well as reducing reliance on social services. In the light of the WHO "Decade of Healthy Ageing", AI applications are designed as digital innovations to support the quality of life for older persons. However, the emergence of evidence of different types of algorithmic bias in AI applications, ageism in the use of digital devices and platforms, as well as age bias in digital data suggests that the use of AI might have discriminatory effects on older population or even cause harm. This paper addresses the issue of age biases and age discrimination in AI applications in medicine and healthcare systems and try to identify main challenges in this area. It will reflect on the potential of AI applications to amplify the already existing health inequalities by discussing two levels where potential negative impact of AI on age inequalities might be observed. Firstly, we will address the technical level of age bias in algorithms and digital datasets (especially health data). Secondly, we will discuss the potential disparate outcomes of automatic decision-making systems (ADMs) used in healthcare on the older population. These examples will demonstrate, although only partially, how AI systems may create new structures of age inequalities and novel dimensions of exclusion in healthcare and medicine.
医学和医疗保健领域的人工智能系统正在预防、诊断、新药设计及后期护理等方面得到广泛探索。人工智能技术在医疗保健系统中的应用有望带来令人瞩目的成果，如实现医疗保健公平、降低死亡率和人为错误、降低医疗成本以及减少对社会服务的依赖。鉴于世界卫生组织的“健康老龄化十年”，人工智能应用被设计为数字创新，以支持老年人的生活质量。然而，人工智能应用中出现的不同类型算法偏差的证据、数字设备和平台使用中的年龄歧视以及数字数据中的年龄偏差表明，人工智能的使用可能会对老年人群体产生歧视性影响，甚至造成伤害。本文探讨了医学和医疗保健系统中人工智能应用中的年龄偏差和年龄歧视问题，并试图找出该领域的主要挑战。通过讨论人工智能对年龄不平等可能产生潜在负面影响的两个层面，本文将思考人工智能应用加剧现有健康不平等的可能性。首先，我们将探讨算法和数字数据集（尤其是健康数据）中年龄偏差的技术层面。其次，我们将讨论医疗保健中使用的自动决策系统对老年人群体可能产生不同结果的情况。这些例子将部分地展示人工智能系统如何在医疗保健和医学领域中创造新的年龄不平等结构和新的排斥维度。
