医疗人工智能的原则主义审思及治理探析

Principle-based reflection and governance exploration of medical artificial intelligence

医疗人工智能发展与应用带来的伦理挑战,已经超脱了传统生命医学伦理的原则主义框架的规制边界,但这并不意味既往的原则主义路径已经“过时”。事实上,原则主义应被视作医疗人工智能伦理治理的基础性进路,为伦理风险的治理提供一个基准性的价值标杆。通过对医疗人工智能伦理风险的原则主义进行分析,发现仅靠叠加更多的伦理原则,或只是在有限语境内的重新诠释和扩展既有原则的内涵范畴,不足以适应快速变化的技术环境和伦理风险。因而,医疗人工智能的伦理治理应当以一种动态、灵活且持续性的视角,发展一种基于优化原则主义的医疗人工智能伦理治理体系,在充分吸纳实际语境伦理诉求的基础上,建设包括学术研究、机制建设、文化培育三个路径组成的医疗人工智能伦理治理体系。

The ethical challenges brought by the development and application of medical artificial intelligence(AI)have transcended the regulatory boundaries of the traditional principle-based framework of bio-medical ethics.However,this does not mean that the previous path of principlism has become“outdated.”In fact,principlism should be regarded as a foundational approach to the ethical governance of medical AI,providing a benchmark value standard for the governance of ethical risks.Through analysis of principlism of the ethical risks of medical AI,it was found that the shortcomings of principlism were insufficient to adapt to the rapidly changing technological environment and ethical risks by simply adding more ethical principles or just reinterpreting and expanding the connotations and scope of existing principles within a limited perspective.Therefore,the ethical governance of medical AI should develop a medical AI ethical governance system based on optimization principle from a dynamic,flexible,and continuous perspective,as well as establishing a medical AI ethical governance system consisting of three paths,including academic research,mechanism construction,and cultural cultivation,based on fully absorbing the ethical demands of the actual context.