This review highlights several critical issues that should be considered by policy-makers, the NHS and developers to ensure the responsible integration of AI in medical screening.
For the NHS, key factors include the need for:
- Equity of access: ensuring AI deployment does not widen inequalities across regions or resource-limited hospitals.
- Workforce implications: addressing how AI may alter the roles of radiologists, ophthalmologists and other specialties, and planning for training and professional development.
- Regulatory and governance frameworks: putting in place robust oversight to address liability, accountability and standards of clinical safety.
For policy-makers, important considerations are:
- Public trust and acceptability: developing clear communication with patients and the public about the role and limitations of AI in screening.
- Data governance: ensuring compliance with national and international standards on privacy, consent and security.
For developers, priorities include:
- Transparency: designing AI systems that are explainable and able to be independently reviewed in real-world NHS contexts.
- Adaptability: ensuring that systems are validated across diverse populations and screening pathways to mitigate bias.
Overall, the ethical considerations identified in this review suggest that careful co-ordination between the NHS, regulators and policy-makers and developers is required to ensure that AI is implemented in a way that supports equity, transparency and patient safety.
The ethical consideration that may be disease-specific and the long-term ethical implications of the use of AI should be evaluated in future research.