医疗人工智能算法决策的伦理风险及规制策略

The ethical risks and regulatory strategies of medical artificial intelligence algorithm decision-making

算法是医疗人工智能优化患者就医的运行关键。随着医疗人工智能算法的逐步推行应用,其决策在生成样态上呈现出数据驱动、算法黑箱以及概率范式的主要特征,这些特征推动了人工诊疗向智能诊疗的转变,也同步滋生了相应的“算法”代替医生决策、“算法利维坦”消解患者基本权利以及医患信任危机等现实问题。为有效防范医疗人工智能算法决策所产生的伦理风险,应当呼唤回归主体本位,以医生为主体,以算法技术为羽翼,强化医生决策能力,尊重患者基本权利;推进算法优化,规训技术向善;锚定风险关键,加强医患信任建构。

Algorithms are the operational key for medical artificial intelligence(AI)to optimize the patients seeking medical treatment.With the gradual implementation and application of medical AI algorithms,their decision-making presents the main characteristics of the data-driven,algorithmic black box,and probabilistic paradigms in generating patterns.These characteristics have driven the transformation from artificial diagnosis and treatment to intelligent diagnosis and treatment,but have also simultaneously spawned corresponding practical problems such as“algorithms”replacing doctor decision-making,“algorithmic Leviathan”resolving patients’basic rights,and doctor-patient trust crisis.To effectively prevent ethical risks arising from medical AI algorithm decision-making,it is necessary to call for a return to the subject-centered approach with doctors as the main body and algorithm technology as the wings,strengthen the doctor’s decision-making ability,respect patients’basic rights,promote algorithm optimization,train technology to improve,anchor risk keys,and strengthen doctor-patient trust construction.