Cracking the Code: A Scoping Review to Unite Disciplines in Tackling Legal Issues in Health Artificial Intelligence
Authors: Nunnelley Sophie , Flood Colleen M. , Da Silva Michael , Horsley Tanya , Kanathasan Sarathy , Thomas Bryan , Da Silva Emily Ann , Ly Valentina , Daniel Ryan C. , Hassani Mohsen Sheikh , Singh Devin 
Published: April 2024

Objectives

The rapid integration of artificial intelligence (AI) in healthcare requires robust legal safeguards to ensure safety, privacy, and non-discrimination, crucial for maintaining trust. Yet, unaddressed differences in disciplinary perspectives and priorities risks impeding effective reform. This study uncovers convergences and divergences in disciplinary comprehension, prioritization, and proposed solutions to legal issues with health-AI, providing law and policymaking guidance.

Methods

Employing a scoping review methodology, we searched MEDLINE® (Ovid), EMBASE (Ovid), HeinOnline Law Journal Library, Index to Foreign Legal Periodicals (HeinOnline), Index to Legal Periodicals and Books (EBSCOhost), Web of Science (Core Collection), Scopus, and IEEE Xplore, identifying legal issue discussions published, in English or French, from January 2012 to July 2021. Of 18,168 screened studies, 432 were included for data extraction and analysis. We mapped the legal concerns and solutions discussed by authors in medicine, law, nursing, pharmacy, other healthcare professions, public health, computer science, and engineering, revealing where they agree and disagree in their understanding, prioritization, and response to legal concerns.

Results

Critical disciplinary differences were evident in both the frequency and nature of discussions of legal issues and potential solutions. Notably, innovators in computer science and engineering exhibited minimal engagement with legal issues. Authors in law and medicine frequently contributed but prioritized different legal issues and proposed different solutions.

Discussion and Conclusion

Differing perspectives regarding law reform priorities and solutions jeopardize the progress of health-AI development. We need inclusive, interdisciplinary dialogues concerning the risks and trade-offs associated with various solutions to ensure optimal law and policy reform.

KEY MESSAGES

What is already known on this topic

There has been no systematic examination of the multidisciplinary literature discussing legal challenges posed by health-AI. Prior efforts have addressed ethical concerns or limited subsets of legal issues or technologies, and therefore do not establish the comprehensive groundwork essential for fostering meaningful cross-disciplinary dialogue on health-AI regulation.

What this study adds

Our study uncovers a shared interdisciplinary apprehension regarding the effective regulation of health-AI. However, distinct stakeholders such as physicians, innovators, and legal scholars hold divergent perspectives on these issues and their relative significance. Notably, certain critical voices, such as within discussions around informed consent, are conspicuously absent, hindering the prospects of effective reform.

How this study might affect research, practice, or policy

The findings underscore the imperative for governments to facilitate inclusive dialogue and reconcile disparate disciplinary viewpoints. Effective regulation is pivotal in ensuring the safe and responsible deployment of health-AI for the public good. This study presents essential entry points for the much-needed discourse on this challenge facing governments around the world.