Piotr Wiliński¹, Robert Ranisch¹

¹ Assistant Professorship in Medical Ethics with a focus on digitalisation, School of Health Sciences Brandenburg, University of Potsdam

The implementation of AI in healthcare – for example, in diagnostic and imaging processes, medical decision-making, and the use of robots in care and surgery – holds both great promise and serious risks. The increasing autonomy of these technologies challenges existing accountability practices within the patient-physician relationship. Where medical staff cannot be justly and fairly held responsible for outcomes caused by autonomous technologies, ‘responsibility gaps’ may emerge. It has been argued that the moral permissibility of AI technologies in healthcare depends on our ability to successfully close these gaps. To that end, some authors propose ‘responsibilisation’: an approach whereby doctors can voluntarily assume responsibility for outcomes caused by AI by virtue of their professional role. The contribution of this paper is a moral framework that enables practices of responsibilisation to be meaningful, i.e., based on reasonable and morally relevant conditions. We argue that although doctors may not be morally responsible for outcomes caused by AI in the traditional sense, they can – and perhaps should – nonetheless assume responsibility by extending their existing moral obligations towards the people in their care (and justifiably so). These existing moral obligations stem from their professional role as carers and are directly embedded in the patient–physician relationship. We propose two conditions for meaningful attributing of responsibility: (1) expertise and (2) professional role. The first condition concerns the epistemic standing that empowers physicians to fulfil their duties; the second condition relates to the strict legal and moral standards governing the various duties (and their limits) imposed on doctors depending on their specialisation, and is directly linked to the sort of person doctors are expected to be – a condition upon which the nature of the doctor-patient relationship is founded. It is important to consider the conditions for meaningful and reasonable accountability in medical practice, given the considerable potential for medical staff to be made scapegoats for outcomes caused by AI, or for the process of attributing responsibility to be ‘randomised’.