Artificial Intelligence. Image from www.vpnsrus.com with permission

Artificial Intelligence has been on my mind a lot recently as it invades medicine and the rest of society too. The Australian government is putting effort into developing ethical guidelines around AI and I been puzzling as to how that should look.

Central to that are concerns around privacy which are hardly new but are more and more in the center of developing technologies which move faster than the regulators can catch up.  If we give over personal information do we know how that is going to be used? Re-used? Re-sold?  Do we really have a clue as to how it may be used.  Should we be entitled to an expectation that all the uses of that information are related to the reason why we handed it over initially?  I think so.

If our personal information has value then who owns that value?  When we get a service for free then it’s often been said that we are the product.  But perhaps its fair to expect that the provider of that ‘free’ service let’s us know who the end users of our information are, and perhaps we should have an option to opt out.

Does the right to be forgotten help you?  There has been much made of an expectation that online services shouldn’t hold our information for ever – they should allow us to be forgotten when we want to.  Embarrasing selfie from uni days – forgotten!  Social media post espousing views you are no longer proud of – forgotten!  I fell off my chair when I discovered that Google knew exactly where I was day in and day out for several years.  But it’s now – forgotten! Perhaps even more critical to the AI debate is the right to correct information that is held about you and to know exactly what information is on file.

So given all that information is being collected, what should we expect before Artificial Intelligence systems start making decisions about us? I’ve got: Fairness, Contestability, Transparency, Privacy and Compliance with the Law.  From and society-wide viewpoint its interesting to think about net benefit – or as Google famously puts it: “don’t be evil.”

It’s the last of these that is engaging the little bit of my brain that it interested in philosophy because it really does stir up some ethical thought.  If you develop a cool AI that saves you and your customers time and money then  – cool, well done.  But what if there are losers in that process, perhaps some of your customers can’t use it or get odd, unjust or incorrect responses.  Overall you and your customers are happy but some people get shafted.  Do we accept a utilitarian type conclusion that, overall, things worked out well.  Or do we demand a social justice type approach where we do the extra yards to look after everyone.  Does the answer to that depend on the service at hand?  Or who the provider is?  Generally we’d expect our governments to do work which was inclusive, just and defensible (do you know about the Aussie RoboDebt debacle?) Other firms maybe held to a lesser standard but probably they shouldn’t be.  If your bank refuses your loan application then it seems fair that your should be able to ask ‘why?’ And get and answer that makes sense, is legally based and correct.

Temple and Mass transit from the Bangkok convention center

This year the Australasian College of Surgeons met in Bangkok.  I’ve always loved Thailand and signed up early for the week in the warm, fascinating, beautiful, crazy and polluted Kingdom of Thailand.  Bizzarely, as I dropped in for the firs visit it years the Thais were celebrating the coronation of their new King and the capital was looking more beautiful than ever with posters, flags, flowers and temples everywhere to celebrate the auspicious occasion.

The College meeting is different for everyone because there are often four, five of six sessions running concurrently with lots of choices and variety.  That’s before you get tempted by catching up with friends and colleagues for lunch, dinner or drinks. So for me the themes that came out of the meeting we about technology, especially artificial intelligence and diversity which has been front and center for a few years now.

In some ways that’s odd because there’s nothing about the technical aspects of my job. Sometimes that’s the way  – and this year the most exciting stuff about reconstructive surgery was from the genetics lab where certain ‘unsolvable’ problems are slowly being nutted out.  I will remain ever grateful to those doing that work because it won’t be me!

So, artificial intelligence, makes its way into the OR!  The smart Neurosurgeons have forever been trying to leverage technology to make some of their work more successful. (Check out the work of Antonio Di Ieva). Some brain tumours are just nasty – aggressive, prone to reccurr quickly and associated with damaging surgery and terrible long term results.  New work using Fractal geometry and computer learning is trying to steer surgery better to remove tumours more completely while damaging surrounding brain less.  Clearly the maths is making it into the mainstream and into the theatre.  Hopefully it makes a big difference.

Part of this progress is due to ever greater access to computational tools previously stuck in university departments, programmed by experts and horribly expensive.  The new centre at Maquarie Uni in computational medicine will be a first but not the last.  Artificial intelligence tools are much more broadly available and coming to be used in new ways every month.

This has me thinking about my field and especially about melanoma.  We still have problems with diagnosis in melanoma – too many patioents needs invasive biopsies for rule out the presence of melanoma when all along they have benign moles.  Expert assessment is not that accurate and cameras, microscopes and fancy lights have only helped a little.  The field is crying out for better tools and they are coming.  I’m expecting the AI would to march into skin assessment just as it is taking steps into radiology and pathology.  Interesting days!

Busy Bangkok