AI-DSS in healthcare and their power over health-insecure collectives
- AI-based systems are nearing ubiquity not only in everyday low-stakes activities but also in medical procedures. To protect patients and physicians alike, explainability requirements have been proposed for the operation of AI-based decision support systems (AI-DSS), which adds hurdles to the productive use of AI in clinical contexts. This raises two questions: Who decides these requirements? And how should access to AI-DSS be provided to communities that reject these standards (particularly when such communities are expert-scarce)? This chapter investigates a dilemma that emerges from the implementation of global AI governance. While rejecting global AI governance limits the ability to help communities in need, global AI governance risks undermining and subjecting health-insecure communities to the force of the neo-colonial world order. For this, this chapter first surveys the current landscape of AI governance and introduces the approach of relational egalitarianism as key to (global health) justice. To discuss the two horns of the referred dilemma, the core power imbalances faced by health-insecure collectives (HICs) are examined. The chapter argues that only strong demands of a dual strategy towards health-secure collectives can both remedy the immediate needs of HICs and enable them to become healthcare independent.
