Justice in Healthcare Artificial Intelligence in Africa

There is an ongoing debate on balancing the benefits and risks of artificial intelligence (AI) as AI is becoming critical to improving healthcare delivery and patient outcomes. Such improvements are essential in resource-constrained settings where millions lack access to adequate healthcare services, such as in Africa. AI in such a context can potentially improve the effectiveness, efficiency, and accessibility of healthcare services. Nevertheless, the development and use of AI-driven healthcare systems raise numerous ethical, legal, and socio-economic issues. Justice is a major concern in AI that has implications for amplifying social inequities. This paper discusses these implications and related justice concepts such as solidarity, Common Good, sustainability, AI bias, and fairness. For Africa to effectively benefit from AI, these principles should align with the local context while balancing the risks. Compared to mainstream ethical debates on justice, this perspective offers context-specific considerations for equitable healthcare AI development in Africa.

Data Ethics in the Era of Healthcare Artificial Intelligence in Africa: An Ubuntu Philosophy Perspective

Data are essential in developing healthcare artificial intelligence (AI) systems. However, patient data collection, access, and use raise ethical concerns, including informed consent, data bias, data protection and privacy, data ownership, and benefit sharing. Various ethical frameworks have been proposed to ensure the ethical use of healthcare data and AI, however, these frameworks often align with Western cultural values, social norms, and institutional contexts emphasizing individual autonomy and well-being. Ethical guidelines must reflect political and cultural settings to account for cultural diversity, inclusivity, and historical factors such as colonialism. Thus, this paper discusses healthcare data ethics in the AI era in Africa from the Ubuntu philosophy perspective. It focuses on the contrast between individualistic and communitarian approaches to data ethics. The proposed framework could inform stakeholders, including AI developers, healthcare providers, the public, and policy-makers about healthcare data ethical usage in AI in Africa.

Individual Fairness Through Reweighting and Tuning

Inherent bias within society can be amplified and perpetuated by artificial intelligence (AI) systems. To address this issue, a wide range of solutions have been proposed to identify and mitigate bias and enforce fairness for individuals and groups. Recently, Graph Laplacian Regularizer (GLR), a regularization technique from the semi-supervised learning literature has been used as a substitute for the common Lipschitz condition to enhance individual fairness. Notable prior work has shown that enforcing individual fairness through a GLR can improve the transfer learning accuracy of AI models under covariate shifts. However, the prior work defines a GLR on the source and target data combined, implicitly assuming that the target data are available at train time, which might not hold in practice. In this work, we investigated whether defining a GLR independently on the train and target data could maintain similar accuracy. Furthermore, we introduced the Normalized Fairness Gain score (NFG) to measure individual fairness by measuring the amount of gained fairness when a GLR is used versus not. We evaluated the new and original methods under NFG, the Prediction Consistency (PC), and traditional classification metrics on the German Credit Approval dataset. The results showed that the two models achieved similar statistical mean performances over five-fold cross-validation. Furthermore, the proposed metric showed that PC scores can be misleading as the scores can be high and statistically similar to fairness-enhanced models while NFG scores are small. This work therefore provides new insights into when a GLR effectively enhances individual fairness and the pitfalls of PC.