Explainability in Artificial Intelligence for Ethical Decision-Making in Healthcare Systems

Authors

Antoine Bernard
AI Ethics Researcher, France.

Keywords:

Explainable Artificial Intelligence, Ethical AI, Healthcare Decision-Making, Transparency, Clinical AI, Accountability, Medical Ethics

Synopsis

As artificial intelligence (AI) continues to evolve within healthcare systems, the demand for explainability in its decision-making processes becomes increasingly critical, particularly when ethical considerations are involved. This paper examines the role of explainable AI (XAI) in promoting transparency, accountability, and trust in healthcare settings. It analyzes the intersection of technical approaches to AI explainability and the ethical imperatives that arise when algorithms impact patient care and clinical outcomes. Through a review of literature and current technical practices, we explore how explainability supports ethical frameworks in real-time clinical decision-making. A conceptual framework is presented that links explainability with ethical principles such as autonomy, beneficence, and justice. The study concludes by highlighting best practices and identifying ongoing challenges in integrating XAI effectively within healthcare systems.

 

 

References

(1) Ribeiro, Marco Tulio, Sameer Singh, and Carlos Guestrin. “Why Should I Trust You?: Explaining the Predictions of Any Classifier.” Proceedings of the 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining, ACM, 2016, pp. 1135–1144.

(2) Lundberg, Scott M., and Su-In Lee. “A Unified Approach to Interpreting Model Predictions.” Advances in Neural Information Processing Systems, vol. 30, 2017, pp. 4765–4774.

(3) Holzinger, Andreas, et al. “What Do We Need to Build Explainable AI Systems for the Medical Domain?” Review Journal of Artificial Intelligence, vol. 1, no. 2, 2017, pp. 1–12.

(4) Ghassemi, Marzyeh, Luke Oakden-Rayner, and Andrew L. Beam. “The False Hope of Current Approaches to Explainable Artificial Intelligence in Health Care.” The Lancet Digital Health, vol. 3, no. 11, 2021, pp. e745–e750.

(5) Sirimalla A. Autonomous Performance Tuning Framework for Databases Using Python and Machine Learning. J Artif Intell Mach Learn & Data Sci 2023 1(4), 3139-3147. DOI: doi.org/10.51219/JAIMLD/adithya-sirimalla/642

(6) Morley, Jessica, et al. “From What to How: An Initial Review of Publicly Available AI Ethics Tools, Methods and Research to Translate Principles into Practices.” Science and Engineering Ethics, vol. 26, no. 4, 2020, pp. 2141–2168.

(7) Doshi-Velez, Finale, and Been Kim. “Towards A Rigorous Science of Interpretable Machine Learning.” arXiv preprint, 2017.

(8) Caruana, Rich, et al. “Intelligible Models for HealthCare: Predicting Pneumonia Risk and Hospital 30-Day Readmission.” Proceedings of the 21st ACM SIGKDD International Conference on Knowledge Discovery and Data Mining, ACM, 2015, pp. 1721–1730.

(9) Lipton, Zachary C. “The Mythos of Model Interpretability.” Communications of the ACM, vol. 61, no. 10, 2018, pp. 36–43.

(10) Topol, Eric J. Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. Basic Books, 2019.

(11) Sirimalla, A. (2022). End-to-end automation for cross-database DevOps deployments: CI/CD pipelines, schema drift detection, and performance regression testing in the cloud. World Journal of Advanced Research and Reviews, 14(3), 871–889. https://doi.org/10.30574/wjarr.2022.14.3.0555

(12) Amann, Julia, et al. “Explainability for Artificial Intelligence in Healthcare: A Multidisciplinary Perspective.” BMC Medical Informatics and Decision Making, vol. 20, no. 310, 2020, pp. 1–9.

(13) Floridi, Luciano, et al. “AI4People—An Ethical Framework for a Good AI Society: Opportunities, Risks, Principles, and Recommendations.” Minds and Machines, vol. 28, no. 4, 2018, pp. 689–707.

(14) Mittelstadt, Brent D., et al. “The Ethics of Algorithms: Mapping the Debate.” Big Data & Society, vol. 3, no. 2, 2016, pp. 1–21.

IJAIMRD

Published

July 15, 2025