Catholic Medical Quarterly Volume 73(2) May 2023


The CMA UK symposium 2023 - ‘Ethical questions on AI in Healthcare’

By Dr Caroline Zdziarska - President of Nottingham CMA

Conference photo

As a Nottingham lass, I was delighted this year's annual conference was in my hometown, the last occasion being in the 1990’s. The theme was on Artificial Intelligence (AI) with respect to healthcare, considering the many ethical questions. AI has become without doubt one of the biggest headline-makers of 2023, with Elon Musk leading a multitude of others writing an open letter questioning .. are we “locked in an out-of-control race?”

The symposium was held in the hall of the Church of the Good Shepherd. A lovely modern venue in many ways, but it posed a lot more logistical challenges in terms of AV, and live-streaming than our previous venue of St Mary’s, Twickenham. The “lockdowns” introduced us all to hybrid meetings, a great means to make events more accessible. After much deliberation, and extensive testing, our President purchased equipment for the sound in the hall and simultaneous live-stream. This will be a good investment for the future, usable for both future local and national meetings.

Content-wise, we “punched above our weight”, as one of our speakers said. We had 5 diverse and knowledgeable speakers over the course of the day, each offering a different perspective on this now accelerating revolution.

Our first speaker was Mr Alex Wee, consultant Trauma and Orthopaedic surgeon at Frimley Health Foundation NHS Trust. He was almost unable to come in person, due to a complex case arising the day before, but we were most relieved, he did make it. Alex who is currently studying Bioethics and Medical Law gave an excellent introductory run-through of AI especially within healthcare. He gave an amusing and very informative talk "Privacy or Progress: Ethical governance of AI in medicine" outlining with multiple examples the benefits and concerns on AI’s burgeoning progress. He explained how ‘big data’ is powerful, but that systems build in bias and privacy issues become more pressing. The UK Government seems to favour ‘light touch’regulation, in contrast with the EU’s central-clearance approach.

Next up was one of our own CMA council members, Dr Michal Pruski, who works as a senior Clinical Scientist in the department of Medical Physics and Clinical Engineering at the Cardiff and Vale University Health Board. He is currently involved in the work of the UK Clinical Ethics Network. Michal’s talk "AI Enhanced Healthcare: not a new paradigm for informed consent", with a smattering of Sci Fi images, con­sidered the question of informed consent, where current legislation requires explicit disclosure of automated processing. He argued that it seems AI does not create any new issues in relation to patient consent, but just brings old issues to our attention in a new frame. Michal proposed that we do though need good regulation of healthcare AI, as patients need to be protected but consent is not the tool for that.

After a delicious buffet lunch, we resumed the talks. Dr Shirin Elizabeth Khorsandi presented via Zoom, as she was unable to attend in person. Shirin is a Senior Lecturer and Principal Investigator at King’s College London studying primary liver cancer and the application of AI in managing that disease. Her talk "The application of AI in health (with a focus on liver disease)” explained the science and process of how AI is being used in practice to develop therapies for management of primary liver cancer, with the aim to provide “truly personalised medicine”. Shirin’s work uses computer-based algorithms and machine learning to rank drugs, based on their efficacy in reducing cancer cell growth.

The next talk, very different, was considering AI from the perspective of bioethics. Dr Chris Wojtulewicz is the Education and Research Officer at the Anscombe Bioethics Centre in Oxford. In his talk "Friend or Foe? On the Challenges and Possibilities of AI in Healthcare", Chris spoke about the two sides of the AI coin. On the one hand AI can of course benefit humanity, but on the other, it risks blurring the distinction between human and machine, not just in physical terms, but in subtly but pervasively changing our self-understanding. Chris proposed the technology should be used in a way which is commensurate with our humanity as spiritual beings rather than as human machines. He quoted from St Thomas Aquinas, the great 13th century philosopher and Doctor of the Church. Chris also referenced Pope Francis’ encyclical and the Vatican’s ‘Rome calls for AI Ethics’ forum - encouraging a commitment to develop AI that serves humanity as a whole in our true nature.

After a tea break, we had our final speaker, Prof Michel Valstar, who is the founding CEO of BlueSkeye AI and an honorary professor at the University of Nottingham. He is an expert in the fields of computer vision and pattern recognition. His world-leading work is in automatic recognition of human behaviour, specialising in the analysis of facial expressions. Michel’s talk “Automatic depression recognition from face and voice: the ethics of Behaviomedics” outlined how his company BlueSkeye AI uses AI to automatically measure facial muscle actions, gaze direction, tone of voice, and words used: all to estimate indicators of depression. He described how this is being used in perinatal depression recognition, now being trialled in the NHS. Michel also described the company’s ethical approach, for eg all algorithms run only on a person’s mobile device, no audio or video leaves it.

Following each talk, we had questions from the audience in the hall and those live-streaming. After the last talk, we held a panel discussion with all our speakers considering various questions, including where AI will be in the coming years. Immediately afterwards, not forgetting the ‘C’ in CMA, we were so grateful to have the opportunity to attend a Sunday Vigil Mass next door. Then a mixed group of Nottingham and national members hit the town for a Polish dinner.

Feedback from the conference has been very positive indeed, commentimg “a very successful day. I really enjoyed it - a nice, friendly, welcoming atmosphere, excellent speakers who left us with much to ponder about.” And “we both really enjoyed it and found it very thought provoking”. One of our speakers said he “enjoyed the day immensely”, and another speaker said “I came away with new thoughts and I'll definitely look up Thomas Aquinas”!

Personally, I found it a steep learning curve, having never organised any conference before. Very many thanks to Mike Delaney who stepped in when the water got too deep, working extremely hard on different fronts to complete the project. And thanks to Dominic Whitehouse, as chair for the speakers and Adrian Farrall who chaired the panel discussion. Also thanks to Anuli for helping greatly with the registration/welcoming and setting out and clearing the food, and to Mark Coley operating Zoom on the day. My biggest thanks go to my husband, Jacek who did a lot of work finding what tech gear was needed, site testing with Mike, and supporting me throughout.

We were really very pleased how the day went, and that both the audience in the hall and live-stream­ing had a good experience. We even had a live-streamer from the Philippines. We had hoped to record the talks .. but sadly, there the tech let us down. But we do have the slides from all our speakers, and Chris’ text, which will be posted on the CMA website in the coming weeks. So if you were there and want to remind yourself, or if you couldn’t make it, please do check out the website towards the end of May.