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Global: World Health Organization releases AI ethics and governance guidance for large multimodal models

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In brief

On 18 January 2024, the World Health Organization (WHO) issued new guidance on the ethics and governance of artificial intelligence (AI) for health, focusing on large multimodal models (LMMs). The WHO guidance summarizes the broad applications of LMMs in the healthcare industry and includes recommendations for governments, which have the primary responsibility of setting standards for the development and deployment of LMMs, and their integration and use for public health and medical purposes.

In more detail

Background

LMMs are a rapidly growing generative AI technology with applications across the healthcare industry. Specifically, LMMs can accept one or more types of data input and generate diverse outputs that are not limited to the type of data fed into the algorithm. LMMs are known as “general-purpose foundation models”, though it has not yet been proven whether LMMs can accomplish a wide range of tasks and purposes.

LMMs have been adopted faster than any consumer application in history. There is interest in LMMs as they can facilitate human-computer interaction to mimic human communication and generate responses to questions or data inputs that appear human-like and authoritative.

The WHO therefore issued guidance to assist member states in mapping the benefits and challenges associated with the use of LMMs for health, setting out over 40 recommendations aimed at various stakeholders, including governments, healthcare providers and technology companies, with the goal of ensuring responsible use of LMMs to safeguard and enhance public health.

Potential benefits and risks

The new WHO guidance sets out five primary applications and challenges of the use of LMMs in the healthcare industry:

1. Diagnosis and clinical care

LMMs may be used to assist diagnosis in fields like radiology and medical imaging, tuberculosis, and oncology. It had been hoped that clinicians could use AI to integrate patient records during consultation to identify at-risk patients, use it to aid in difficult treatment decisions and to catch clinical errors.

Risks arise from the use of LMMs in diagnosis and clinical care, such as inaccurate, incomplete, biased or false responses; data quality and data bias; automation bias; degradation of physicians’ skills; and informed consent.

2. Patient-centered applications

AI tools can be used to increase self-care, where patients can take responsibility for their own care, such as taking medicines, improving their nutrition and diet, engaging in physical activity, caring for wounds or delivering injections. This may be done through LMM-powered chatbots, health monitoring and risk prediction tools.

Risks arise from the use of LMMs in patient-centered applications, such as inaccurate, incomplete or false statements; risks of emotional manipulation of chatbots; data privacy concerns; degradation of interactions between clinicians, laypeople and patients; and delivery of healthcare outside the healthcare system, which is generally subject to greater regulatory scrutiny.

3. Clerical functions and administrative tasks

LMMs may be used to assist health professionals in the clerical, administrative and financial aspects of practising medicine.

Risks that arise from such use could be potential inaccuracies or inconsistencies of LMMs, where a slight change to a prompt or question can generate a completely different response.

4. Medical and nursing education

LMMs are also projected to play a role in medical and nursing education, potentially being used to create dynamic texts that, in comparison with generic texts, are tailored to the specific needs and questions of the student.

The risk arising from such use is that healthcare professionals could suspend their judgment or the judgment of a human peer in favor of that of a computer.

5. Scientific and medical research and drug development

LMMs can potentially extend the ways in which AI can be used to support scientific and medical research and drug discovery. For example, they can generate text to be used in a scientific article, summarize texts, edit texts, analyze scientific research, etc.

General concerns about the use of LMMs in scientific research include the lack of accountability, high-income country bias, and “hallucination” by summarizing or citing academic articles that do not exist.

Key recommendations

The WHO has included several recommendations for the development and deployment of LMMs, including the following:

  • Governments should invest in public infrastructure, enact laws and regulations to ensure that LMMs and healthcare applications meet ethical obligations and human rights standards, assign regulatory agencies to assess and approve LMMs, and implement mandatory post-release audits and impact assessments by independent third parties.
  • Developers of LMMs should engage diverse stakeholders from early stages of development and design LMMs to execute well-defined tasks with accuracy and reliability, thus enhancing the capabilities of healthcare systems and promoting patient welfare.

The WHO’s guidance on ethics and governance of AI, focusing on LMMs, can be found here.

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Andy Leck is the head of the Intellectual Property and Technology (IPTech) Practice Group and a member of the Dispute Resolution Practice Group in Singapore. He is a core member of Baker McKenzie's regional IP practice and also leads the Myanmar IP Practice Group. Andy is recognised by reputable global industry and legal publications as a leader in his field. He was named on "The A-List: Singapore's Top 100 lawyers" by Asia Business Law Journal 2018. In addition, Chambers Asia Pacific notes that Andy is "a well-known IP practitioner who is highlighted for his record of handling major trade mark litigation, as well as commercial exploitation of IP rights in the media and technology sectors. He's been in the industry for a long time and has always been held in high regard. He is known to be very fair and is someone you would like to be in the trenches with you during negotiations." Furthermore, Asian Legal Business acknowledges Andy as a leading practitioner in his field and notes that he “always gives good, quick advice, [is] client-focused and has strong technical knowledge for his areas of practice.” Andy was appointed by the Intellectual Property Office of Singapore (IPOS) as an IP Adjudicator to hear disputes at IPOS for a two-year term from April 2021. He has been an appointed member of the Singapore Copyright Tribunal since May 2010 and a mediator with the WIPO Arbitration and Mediation Center. He is also appointed as a Notary Public & Commissioner for Oaths in Singapore. He previously served on the International Trademark Association’s Board of Directors and was a member of the executive committee.

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Ren Jun Lim is a principal with Baker McKenzie Wong & Leow. He represents local and international clients in both contentious and non-contentious intellectual property matters. He also advises on a full range of healthcare, as well as consumer goods-related legal and regulatory issues. Ren Jun co-leads Baker McKenzie Wong & Leow's Healthcare as well as Consumer Goods & Retail industry groups. He sits on the Law Society of Singapore IP Committee and on the Executive Committee of the Association of Information Security Professionals. He is also a member of the Vaccines Working Group, Singapore Association of Pharmaceutical Industries, a member of the International Trademark Association, as well as a member of the Regulatory Affairs Professionals Association. Ren Jun is ranked in the Silver tier for Individuals: Enforcement and Litigation and Individuals: Prosecution and Strategy, and a recommended lawyer for Individuals: Transactions by WTR 1000, 2020. He is also listed in Asia IP's Best 50 IP Expert, 2020, recognised as a Rising Star by Managing IP: IP Stars, 2019 and one of Singapore's 70 most influential lawyers aged 40 and under by Singapore Business Review, 2016. Ren Jun was acknowledged by WTR 1000 as a "trademark connoisseur who boasts supplementary knowledge of regulatory issues in the consumer products industry." He was also commended by clients for being "very responsive to enquiries and with a keen eye for detail, he is extremely hands-on. His meticulous and in-depth approach to strategising is key to the excellent outcomes we enjoy."

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