Author: Dr Sarah Ball
In November 2024, the Australian investigators for the ESRC funded project “Expertise and Ethics in Times of Crisis” ran a witness seminar with six deidentified participants to get a better understanding of the ethics advisory landscape in the field of artificial intelligence (AI) in health policy. During this seminar we learned a lot about the many challenges and ethical moments which have shaped key policy decisions around the growing use of AI in the health in Australia, and we wanted to share some of the high-level learnings from this event.
First, witness seminars are a method of historical inquiry that bring together participants with direct experience of a specific topic to elicit their diverse perspectives and enable the construction of a more non-linear and multi-faceted narrative of an event – in this case the emergence of ethics advice in AI in health policy. These facilitated discussions aim to capture key events, actors, and networks, acknowledging the partial and constructed nature of historical accounts while fostering dialogue among a range of stakeholders, such as professionals, activists, and researchers.
Key themes
Some of the key areas discussed included:
The Integration of AI into Healthcare
AI’s role in healthcare is multifaceted, with applications ranging from medical scribing to diagnostic tools. However, these innovations bring challenges such as automation bias, the reliability of AI systems, and questions of how these can even be integrated into existing processes. Stakeholders are grappling with questions of accountability, particularly when AI recommendations conflict with clinician judgment or when systems “drift” from their original purpose over time.
Governance and Regulation
The regulatory landscape for AI is still evolving. A critical challenge is determining the appropriate balance between hard and soft regulation. For instance, Australia’s eight AI Ethics Principles have been influential, yet their abstract nature raises questions about their enforceability. Effective governance frameworks must address these gaps while ensuring that AI systems are safe, equitable, and reliable.
Industry Influence and International Collaboration
The involvement of Big Tech in shaping AI ethics discourse has led to concerns about “ethics washing,” where ethical debates are co-opted to delay regulation. At the same time, global frameworks and principles from the EU and the US continue to influence Australian policy. Policymakers must navigate these dynamics while fostering homegrown innovation and ensuring that Australian values are reflected in AI applications.
Challenges
Some of the key concerns captured in this witness seminar involved first, a discussion on how the intersection of ethics, government, and policy making is becoming increasingly complex as emerging technologies such as artificial intelligence reshape societal norms and institutional practices. Participants highlighted the need for better integration of efforts between various agencies, including regulatory bodies, academic institutions, and private organizations. Pivotal players in shaping AI ethics in healthcare, such as the Federal and state departments of health, as well as the Therapeutic Goods Administration, will need to be supported to avoid gaps or overlaps. This will be a massive undertaking.
Second, participants raised the critical importance of public trust for the ethical adoption of technologies. Concepts such as social licence emphasise the importance of community approval and understanding, especially in sectors like healthcare where AI applications can impact sensitive areas such as patient care and privacy. Deliberative processes that engage diverse public perspectives are increasingly seen as essential to maintaining legitimacy and fostering informed decision-making.
Third, what constitutes an ethical question was itself a matter of debate at the seminar. Some organizations view ethics narrowly, focusing on compliance, while others adopt broader definitions encompassing societal values and equity. This tension highlights the need for clarity and consensus on what ethics entails in policymaking contexts, especially when navigating contested areas like AI in mental health or the equitable use of health data.
Looking Ahead: Ethical Advice in Future Crises
As our research is exploring, the lessons of the Covid-19 pandemic underscore the need for robust mechanisms to address ethical dilemmas during crises. Whether tackling acute challenges like pandemics or addressing systemic issues such as the sustainability of healthcare systems, ethical advice must be actionable, timely, and adaptable. Key recommendations from participants included:
- Building Capacity for Rapid Ethical Assessments: Establishing protocols and dedicated teams to evaluate ethical dimensions swiftly during emergencies.
- Leveraging Existing Governance Systems: Integrating AI ethics considerations into established healthcare governance frameworks rather than creating potentially redundant new structures.
- Enhancing Public Engagement: Strengthening public discourse through deliberative methods to ensure diverse voices are heard and integrated into decision-making.
Future role of ethics
As government and policymaking adapt to the challenges of emerging technologies, the role of ethics advice becomes ever more critical. By fostering collaboration, clarifying ethical frameworks, and enhancing public trust, policymakers can navigate the complexities of technological innovation while ensuring that societal values remain at the forefront. The path forward lies in leveraging existing strengths while addressing gaps with creativity and resolve.