· 4. The Principle of Justice: “Be Fair”

For the purposes of these Guidelines, the principle of justice imparts that the development, use, and regulation of AI systems must be fair. Developers and implementers need to ensure that individuals and minority groups maintain freedom from bias, stigmatisation and discrimination. Additionally, the positives and negatives resulting from AI should be evenly distributed, avoiding to place vulnerable demographics in a position of greater vulnerability and striving for equal opportunity in terms of access to education, goods, services and technology amongst human beings, without discrimination. Justice also means that AI systems must provide users with effective redress if harm occurs, or effective remedy if data practices are no longer aligned with human beings’ individual or collective preferences. Lastly, the principle of justice also commands those developing or implementing AI to be held to high standards of accountability. Humans might benefit from procedures enabling the benchmarking of AI performance with (ethical) expectations.
Principle: Draft Ethics Guidelines for Trustworthy AI, Dec 18, 2018

Published by The European Commission’s High-Level Expert Group on Artificial Intelligence

Related Principles

· 2. The Principle of Non maleficence: “Do no Harm”

AI systems should not harm human beings. By design, AI systems should protect the dignity, integrity, liberty, privacy, safety, and security of human beings in society and at work. AI systems should not threaten the democratic process, freedom of expression, freedoms of identify, or the possibility to refuse AI services. At the very least, AI systems should not be designed in a way that enhances existing harms or creates new harms for individuals. Harms can be physical, psychological, financial or social. AI specific harms may stem from the treatment of data on individuals (i.e. how it is collected, stored, used, etc.). To avoid harm, data collected and used for training of AI algorithms must be done in a way that avoids discrimination, manipulation, or negative profiling. Of equal importance, AI systems should be developed and implemented in a way that protects societies from ideological polarization and algorithmic determinism. Vulnerable demographics (e.g. children, minorities, disabled persons, elderly persons, or immigrants) should receive greater attention to the prevention of harm, given their unique status in society. Inclusion and diversity are key ingredients for the prevention of harm to ensure suitability of these systems across cultures, genders, ages, life choices, etc. Therefore not only should AI be designed with the impact on various vulnerable demographics in mind but the above mentioned demographics should have a place in the design process (rather through testing, validating, or other). Avoiding harm may also be viewed in terms of harm to the environment and animals, thus the development of environmentally friendly AI may be considered part of the principle of avoiding harm. The Earth’s resources can be valued in and of themselves or as a resource for humans to consume. In either case it is necessary to ensure that the research, development, and use of AI are done with an eye towards environmental awareness.

Published by The European Commission’s High-Level Expert Group on Artificial Intelligence in Draft Ethics Guidelines for Trustworthy AI, Dec 18, 2018

· 3. The Principle of Autonomy: “Preserve Human Agency”

Autonomy of human beings in the context of AI development means freedom from subordination to, or coercion by, AI systems. Human beings interacting with AI systems must keep full and effective self determination over themselves. If one is a consumer or user of an AI system this entails a right to decide to be subject to direct or indirect AI decision making, a right to knowledge of direct or indirect interaction with AI systems, a right to opt out and a right of withdrawal. Self determination in many instances requires assistance from government or non governmental organizations to ensure that individuals or minorities are afforded similar opportunities as the status quo. Furthermore, to ensure human agency, systems should be in place to ensure responsibility and accountability. It is paramount that AI does not undermine the necessity for human responsibility to ensure the protection of fundamental rights.

Published by The European Commission’s High-Level Expert Group on Artificial Intelligence in Draft Ethics Guidelines for Trustworthy AI, Dec 18, 2018

· Transparency and explainability

The transparency and explainability of AI systems are often essential preconditions to ensure the respect, protection and promotion of human rights, fundamental freedoms and ethical principles. Transparency is necessary for relevant national and international liability regimes to work effectively. A lack of transparency could also undermine the possibility of effectively challenging decisions based on outcomes produced by AI systems and may thereby infringe the right to a fair trial and effective remedy, and limits the areas in which these systems can be legally used. While efforts need to be made to increase transparency and explainability of AI systems, including those with extra territorial impact, throughout their life cycle to support democratic governance, the level of transparency and explainability should always be appropriate to the context and impact, as there may be a need to balance between transparency and explainability and other principles such as privacy, safety and security. People should be fully informed when a decision is informed by or is made on the basis of AI algorithms, including when it affects their safety or human rights, and in those circumstances should have the opportunity to request explanatory information from the relevant AI actor or public sector institutions. In addition, individuals should be able to access the reasons for a decision affecting their rights and freedoms, and have the option of making submissions to a designated staff member of the private sector company or public sector institution able to review and correct the decision. AI actors should inform users when a product or service is provided directly or with the assistance of AI systems in a proper and timely manner. From a socio technical lens, greater transparency contributes to more peaceful, just, democratic and inclusive societies. It allows for public scrutiny that can decrease corruption and discrimination, and can also help detect and prevent negative impacts on human rights. Transparency aims at providing appropriate information to the respective addressees to enable their understanding and foster trust. Specific to the AI system, transparency can enable people to understand how each stage of an AI system is put in place, appropriate to the context and sensitivity of the AI system. It may also include insight into factors that affect a specific prediction or decision, and whether or not appropriate assurances (such as safety or fairness measures) are in place. In cases of serious threats of adverse human rights impacts, transparency may also require the sharing of code or datasets. Explainability refers to making intelligible and providing insight into the outcome of AI systems. The explainability of AI systems also refers to the understandability of the input, output and the functioning of each algorithmic building block and how it contributes to the outcome of the systems. Thus, explainability is closely related to transparency, as outcomes and ub processes leading to outcomes should aim to be understandable and traceable, appropriate to the context. AI actors should commit to ensuring that the algorithms developed are explainable. In the case of AI applications that impact the end user in a way that is not temporary, easily reversible or otherwise low risk, it should be ensured that the meaningful explanation is provided with any decision that resulted in the action taken in order for the outcome to be considered transparent. Transparency and explainability relate closely to adequate responsibility and accountability measures, as well as to the trustworthiness of AI systems.

Published by The United Nations Educational, Scientific and Cultural Organization (UNESCO) in Draft Text of The Recommendation on the Ethics of Artificial Intelligence, Nov 24, 2021

4 Foster responsibility and accountability

Humans require clear, transparent specification of the tasks that systems can perform and the conditions under which they can achieve the desired level of performance; this helps to ensure that health care providers can use an AI technology responsibly. Although AI technologies perform specific tasks, it is the responsibility of human stakeholders to ensure that they can perform those tasks and that they are used under appropriate conditions. Responsibility can be assured by application of “human warranty”, which implies evaluation by patients and clinicians in the development and deployment of AI technologies. In human warranty, regulatory principles are applied upstream and downstream of the algorithm by establishing points of human supervision. The critical points of supervision are identified by discussions among professionals, patients and designers. The goal is to ensure that the algorithm remains on a machine learning development path that is medically effective, can be interrogated and is ethically responsible; it involves active partnership with patients and the public, such as meaningful public consultation and debate (101). Ultimately, such work should be validated by regulatory agencies or other supervisory authorities. When something does go wrong in application of an AI technology, there should be accountability. Appropriate mechanisms should be adopted to ensure questioning by and redress for individuals and groups adversely affected by algorithmically informed decisions. This should include access to prompt, effective remedies and redress from governments and companies that deploy AI technologies for health care. Redress should include compensation, rehabilitation, restitution, sanctions where necessary and a guarantee of non repetition. The use of AI technologies in medicine requires attribution of responsibility within complex systems in which responsibility is distributed among numerous agents. When medical decisions by AI technologies harm individuals, responsibility and accountability processes should clearly identify the relative roles of manufacturers and clinical users in the harm. This is an evolving challenge and remains unsettled in the laws of most countries. Institutions have not only legal liability but also a duty to assume responsibility for decisions made by the algorithms they use, even if it is not feasible to explain in detail how the algorithms produce their results. To avoid diffusion of responsibility, in which “everybody’s problem becomes nobody’s responsibility”, a faultless responsibility model (“collective responsibility”), in which all the agents involved in the development and deployment of an AI technology are held responsible, can encourage all actors to act with integrity and minimize harm. In such a model, the actual intentions of each agent (or actor) or their ability to control an outcome are not considered.

Published by World Health Organization (WHO) in Key ethical principles for use of artificial intelligence for health, Jun 28, 2021

5 Ensure inclusiveness and equity

Inclusiveness requires that AI used in health care is designed to encourage the widest possible appropriate, equitable use and access, irrespective of age, gender, income, ability or other characteristics. Institutions (e.g. companies, regulatory agencies, health systems) should hire employees from diverse backgrounds, cultures and disciplines to develop, monitor and deploy AI. AI technologies should be designed by and evaluated with the active participation of those who are required to use the system or will be affected by it, including providers and patients, and such participants should be sufficiently diverse. Participation can also be improved by adopting open source software or making source codes publicly available. AI technology – like any other technology – should be shared as widely as possible. AI technologies should be available not only in HIC and for use in contexts and for needs that apply to high income settings but they should also be adaptable to the types of devices, telecommunications infrastructure and data transfer capacity in LMIC. AI developers and vendors should also consider the diversity of languages, ability and forms of communication around the world to avoid barriers to use. Industry and governments should strive to ensure that the “digital divide” within and between countries is not widened and ensure equitable access to novel AI technologies. AI technologies should not be biased. Bias is a threat to inclusiveness and equity because it represents a departure, often arbitrary, from equal treatment. For example, a system designed to diagnose cancerous skin lesions that is trained with data on one skin colour may not generate accurate results for patients with a different skin colour, increasing the risk to their health. Unintended biases that may emerge with AI should be avoided or identified and mitigated. AI developers should be aware of the possible biases in their design, implementation and use and the potential harm that biases can cause to individuals and society. These parties also have a duty to address potential bias and avoid introducing or exacerbating health care disparities, including when testing or deploying new AI technologies in vulnerable populations. AI developers should ensure that AI data, and especially training data, do not include sampling bias and are therefore accurate, complete and diverse. If a particular racial or ethnic minority (or other group) is underrepresented in a dataset, oversampling of that group relative to its population size may be necessary to ensure that an AI technology achieves the same quality of results in that population as in better represented groups. AI technologies should minimize inevitable power disparities between providers and patients or between companies that create and deploy AI technologies and those that use or rely on them. Public sector agencies should have control over the data collectedby private health care providers, and their shared responsibilities should be defined and respected. Everyone – patients, health care providers and health care systems – should be able to benefit from an AI technology and not just the technology providers. AI technologies should be accompanied by means to provide patients with knowledge and skills to better understand their health status and to communicate effectively with health care providers. Future health literacy should include an element of information technology literacy. The effects of use of AI technologies must be monitored and evaluated, including disproportionate effects on specific groups of people when they mirror or exacerbate existing forms of bias and discrimination. Special provision should be made to protect the rights and welfare of vulnerable persons, with mechanisms for redress if such bias and discrimination emerges or is alleged.

Published by World Health Organization (WHO) in Key ethical principles for use of artificial intelligence for health, Jun 28, 2021