Dr Samuel Freeman completed his PhD in June 2023 at Monash University.

Thesis Title
Ethical implementation of AI in Australian healthcare

Summary
This research explores the ethical considerations and implementation challenges related to the integration and use of artificial intelligence (AI) technologies in Australian emergency medicine. Four case studies generated an in-depth, multi-faceted understanding from the perspective of emergency doctors, health consumers, hospital management and clinical staff, and health and technology industry stakeholders.

The studies offer insights into stakeholders’ perceptions of ethical AI and the challenges they anticipate during implementation and use. By incorporating diverse perspectives, this research aims to provide new considerations for the ethical and effective integration of AI in Australian emergency medicine.

Key findings found that healthcare industry stakeholders view the establishment of a national strategic approach and principles as essential for the ethical and effective clinical application of AI. This is similar to findings with hospital management and clinical staff, where robust governance polices and mechanisms appear to be a prerequisite for trust and acceptance of these tools at a national and state level, as well as within the hospital.

Respondents are acutely aware of the importance of responding to ethical issues that could arise from the use of AI in healthcare from a patient harm and risk mitigation perspective, but also to ensure that the transformative potential of these technologies can be realised and supported long term. While emergency doctors, health consumers, hospital management and clinical staff are somewhat supportive of AI-enabled decision support tools in emergency medicine, there is a high threshold for their acceptance including that AI-enabled tools must operate as decision support only, have proven effectiveness, and that ethical concerns are taken into consideration.

For ED doctors, AI must also be integrated effectively into workflow for it to be accepted as a new standard of practice. For hospital management and clinical staff there is an additional need to trial and test these tools in EDs with the support and involvement of all relevant staff to ensure buy-in and uptake. Health consumers are also concerned that AI could worsen health communication and reduce the already limited time they spend with doctors in the ED, a concern also shared by clinical ED staff. Key ethical principles of concern include autonomy, bias and discrimination, access, transparency and accountability.

Supervisors
Prof Mark Andrejevic, Monash University
Prof Jon McCormack, Monash University
Assoc Prof Tam C. Nguyen, St Vincent’s Hospital Melbourne