Public health, AI and ethics.

In recent months, the conversations around artificial intelligence (AI) and how it may transform our lives have become quite common. From computer and data scientists to philosophers and ethicists, there is no shortage of predictions, excitement and anxieties. ChatGPT has added a new and important dimension to the conversation about data, knowledge, creativity and our way of doing things.

As with many new tools, the realm of public health is well within the range of impact of new developments in AI. In the recent past, a number of opinions and stories in the newspapers in Pakistan have talked about how AI can make a significant positive impact on public health in the country. The arguments given in support of this thesis focus fundamentally on improving efficiency in our public health system. They talk about better diagnosis, improved patient management, enhanced delivery of health services and efficient use of patient health data. Indeed, all of these aspects of our public health system are in desperate need of an upgrade. However, it is rather troubling to note that nearly all articles, op-eds and stories that focus on the potential rewards of AI fail to even mention the deep ethical questions that emerge from not just the use of AI in public health in general, but questions that are particularly relevant to Pakistan's public health system.

First, we must note that medical ethics in the country are far from where they ought to be. A whole spectrum of medical malpractice that includes, but is not limited to, financial corruption, negligence, physical and verbal abuse of patients, overcharging for services, kickbacks and unauthorised perks from industry is rampant. Vulnerable patients, on the other end of the equation, have few rights and if they have any, remain woefully unaware. The legal framework, hefty fees and dysfunctional judicial system make it impossible for patients to be compensated for the wrong that is committed against them. The regulatory framework that should underpin all medical practices is either completely absent or absent in essence.

In this environment, a potent new tool needs...