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Lifecycles, pipelines, and value chains: toward a focus on events in responsible artificial intelligence for health

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Abstract

Process-oriented approaches to the responsible development, implementation, and oversight of artificial intelligence (AI) systems have proliferated in recent years. Variously referred to as lifecycles, pipelines, or value chains, these approaches demonstrate a common focus on systematically mapping key activities and normative considerations throughout the development and use of AI systems. At the same time, these approaches risk focusing on proximal activities of development and use at the expense of a focus on the events and value conflicts that shape how key decisions are made in practice. In this article we report on the results of an ‘embedded’ ethics research study focused on SPOTT– a ‘Smart Physiotherapy Tracking Technology’ employing AI and undergoing development and commercialization at an academic health sciences centre. Through interviews and focus groups with the development and commercialization team, patients, and policy and ethics experts, we suggest that a more expansive design and development lifecycle shaped by key events offers a more robust approach to normative analysis of digital health technologies, especially where those technologies’ actual uses are underspecified or in flux. We introduce five of these key events, outlining their implications for responsible design and governance of AI for health, and present a set of critical questions intended for others doing applied ethics and policy work. We briefly conclude with a reflection on the value of this approach for engaging with health AI ecosystems more broadly.

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Funding

This study was funded by the Collaborative Health Research Project special call: Artificial Intelligence, Health, and Society (Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council CPG-163963).

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Authors and Affiliations

  1. Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

    Joseph Donia & Gayathri Embuldeniya

  2. Department of Biology, Faculty of Arts and Science, University of Toronto, Toronto, Canada

    Lola Oyefeso

  3. Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada

    Lola Oyefeso & James A. Shaw

  4. Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada

    Cari Whyne, David Burns, Philip Boyer & Helen Razmjou

  5. Institute of Biomedical Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, Canada

    Cari Whyne

  6. Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada

    Cari Whyne

  7. Division of Orthopedic Surgery, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada

    Cari Whyne & David Burns

  8. Joint Centre for Bioethics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

    James A. Shaw

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  1. Joseph Donia
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Correspondence to Joseph Donia.

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Conflict of interest

DB and CW hold equity in Halterix Corporation, a digital physiotherapy company founded by DB which holds the rights to the SPOTT technology.

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Donia, J., Oyefeso, L., Embuldeniya, G. et al. Lifecycles, pipelines, and value chains: toward a focus on events in responsible artificial intelligence for health. AI Ethics (2024). https://doi.org/10.1007/s43681-024-00594-4

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