Medical Ethicist Weighs in on Direct-to-Patient Approach for AI Radiology, Part 1

A Medical Ethicist Weighs in on the Direct-to-Patient Approach for AI Radiology, Part 1

It is essential to consider the ethical implications of payment models for AI radiology services, especially when startups, hospital systems, radiology firms are saving resources and trying to financially support early innovation. In this blog post, we will explore the ethical issues surrounding this topic, with a particular focus on justice and rights to AI access drawing upon insights from an interview with Dr. Eric Keller, Senior IR Resident at Stanford, and an expert in medical ethics.

The Notion of Justice in Medical Ethics

Justice, as one of the pillars of medical ethics, encompasses the fair distribution of healthcare resources and the equitable treatment of patients. It ensures that all individuals, regardless of their socioeconomic status, have access to the appropriate  medical services. However, the introduction of AI within radiology raises questions about whether medical integrity is being upheld when patients are required to pay out-of-pocket for these services.

Dr. Keller: “Given the current state of evidence, or lack thereof, is AI radiology something we consider a basic healthcare right? Should everyone have access to it? Currently, it feels more like a luxury to me, as it is not yet the standard of care. We still don’t fully understand its benefits and limitations. Some studies even suggest that AI may introduce biases and confirmation biases, leading to errors.”

This insight highlights the uncertainty surrounding AI radiology’s benefit and the potential downsides. While the technology holds great potential, it has yet to be integrated in societal guidelines and community standard of care. This raises concerns about the ethical implications of having patients pay for a technology that is not yet considered a component of the community standard of care.

Addressing Access and Justice

The issue at hand is whether AI radiology is a basic right to which everyone should have access or if it remains a “luxury elective service.” Dr. Keller pointed out two concerns that arise from the current situation.

The Ick Factor: Dr. Keller expressed discomfort with the direct-to-consumer sales approach. This approach may exploit patients’ fears of cancer and give rise to a false urge to make the extra payment. While this kind of strategy is already prevalent in healthcare, it highlights the ethical concerns surrounding a payment model that ultimately relies on the patient’s own decision-making.

Segregation and Inequity: Dr. Keller also raised concerns about the potential for segregating access to improved outcomes based on a patients’ ability to pay. If AI truly improves diagnostic accuracy and patient outcomes, those who cannot afford the technology might experience delays in detecting conditions like breast cancer with the technology further exacerbating existing healthcare disparities.

It’s obvious, the ethical implications of the direct-to-patient approach for AI radiology warrant careful consideration. We must reflect on whether cutting-edge medical technologies should be considered basic rights or luxury services. The uncertainties surrounding their benefits and potential biases raise concerns about payment models and equitable access. Striking a balance between innovation support and fairness is essential, emphasizing justice and patient rights in our evolving healthcare landscape.

In Part 2 of this blog series, we’ll explore one company that has taken the direct-to-patient approach to medical innovation. I’ll also share some potential solutions for payment models in AI radiology.

Picture of Brendan Ryu

Brendan Ryu

Brendan is a fourth year medical student applying to radiology residency. He aspires to accelerate MedTech innovation and to build a career integrating innovation into clinical practice.

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