Orly Lobel, Professor of Law, University of San Diego, addresses some ethical issues surrounding AI in a clinical setting.

Congratulations on the publication of your latest book – The Equality Machine. Please tell us what led you to write it.

Thank you! As I describe in the book, the ways digital technology is transforming our lives are both deeply personal and universal. I begin the book by telling the story of our own family, where AI has been life-saving, as we are a diabetic family. One of my daughters has Type 1 diabetes, and last year, when the FDA approved a closed-loop insulin pump and continuous glucose monitor that makes autonomous decisions, it was a huge leap for safety and well-being. I think we all are affected by these rapid innovations in ways that we don’t even realize but as a tech policy researcher, and a former data analyst, I discovered that we are having the wrong kinds of public conversations about technology and we are too focused on the risks and wrongs of AI rather than on its potential and comparative advantage.

The application of AI in clinical practice has enormous promise to improve healthcare, but it also poses ethical issues. How can AI systems prioritize “no harm” whilst making healthcare decisions? 

Transparency and accountability are key. Just as we publicly approve drugs and medical devices through rigorous clinical trials and agency supervision, AI systems need to have sunlight shed on them so we can differentiate between systems that outperform human action and those that are unsafe or too risky. This has to come with public oversight as well as more access to data being collected.

How can healthcare professionals manage perceptions around trust of artificial intelligence?

It is important that we all have informed conversations based on facts. We don’t want patients – or doctors and other healthcare professionals – to have what we call in the behavioral literature “algorithmic adoration” – that is blind trust in AI systems. But we also don’t want “algorithmic aversion” – an irrational fear of AI. We need to educate ourselves and our community on how to monitor systems for performance. This is where collaboration between health professionals and psychologists and cognitive scientists can be fruitful and why we need experimentation on what design and what kind of information and framing of decision-making are more effective in helping individuals choose the safer systems.

How can we harness technology for good? What role do you see AI playing in the drive to address inequity in healthcare?

Technology is helping on the health front to dramatically expand data collection. Here’s an astounding figure: 90 percent of the data that exists in our world today was created in the past couple of years. The vast quantity of studies and clinical trials performed across the spectrum of science and industry has only recently become easily searchable and widely accessible thanks to AI-enabled natural language processing. For example, the Jackson Laboratory Clinical Knowledgebase (CKB) is a database that allows researchers to sort, store, and interpret data from clinical trials and research papers related to oncology. CKB provides and concentrates data previously scattered in tens of millions of publications; figures are updated daily, saving oncology professionals valuable time. The ability to process vast amounts of data using AI is allowing researchers to fine-tune their analyses, better examining the results of trials for gender, race, and age differences. Yet as health research, tracking, and treatment shift to digital technologies, we unsurprisingly find problems here too. For example, early health apps tracked many of our basic, routine health cycles—daily exercise, caloric intake, breathing, body fat, and blood pressure—but did not include the option to track one’s menstrual cycle. Now that we do have such track, there is the counter fear that attacks on women’s reproductive justice will be aided by access to such private information. So technology is a sword and shield and we need to always make sure we are harnessing new technology for good and equality.

With AI, the sheer potential to scale access to medicine through automation and remote care is a game changer, especially for underserved communities here and around the world. In The Equality Machine, I researched dozens of examples of how we can leverage AI for better health, inclusion, well-being, and accessibility for all abilities.

We were thrilled to have you join the ethics panel at the 2023 Ai-Med Global Summit. What did you enjoy about the event?

I enjoyed engaging with others on how we can not only design our AI to be more trustworthy but how we can make more informed rational decisions on what to trust and how to shift to automation when it is lifesaving and life-changing. 

You have already accomplished a great deal in your career. To what do you attribute your success?

I believe everyone can make a difference in the world and have a positive impact. I am inspired by my students, my mentors, and my collaborators. Most of all, when you do something you love, you find purpose and meaning naturally. I have a supporting family, my husband, UCSD professor On Amir is a behavioral scientist at UCSD and we have co-authored research. Raising three daughters with someone who is a full partner and respects your work is key to having work-family balance. And living here in beautiful sunny San Diego helps keeps us active and happy and productive.

We believe in changing healthcare one connection at a time. If you are interested in the opinions in this piece, in connecting with the author, or the opportunity to submit an article, let us know. We love to help bring people together! [email protected] 

Orly Lobel is the award-winning author of several books and numerous articles. Her new book The Equality Machine: Harnessing Digital Technology for a Brighter, More Inclusive Future has received rave reviews, is an Economist Best Book of the Year, and is transforming the conversations we are having about AI, health, and wellbeing. Lobel is a prolific scholar, commentator, and speaker who travels around the world with an impact on policy and industry. She is the Warren Professor of Law at the University of San Diego and received her doctoral and law degrees from Harvard University. Lobel is the recipient of prestigious research grants, including a grant from the AI and Humanities Project, is a member of the American Law Institute, regularly advises governments and private industry, and serves on several advisory boards.