Consider use of an AI in a hospital to make recommendations on a drug and dosage for a patient. The AI recommends a particular drug and dosage for patient A. The physician does not, however, understand how the AI reached its recommendation. The AI has a highly sophisticated algorithm and is thus a black box for the physician. Should the physician follow the AI’s recommendation? If patients were to find out that an AI or machine-learning system was used to recommend their care but no one had told them, how would they feel? Does the physician have a moral or even a legal duty to tell patient A that he or she has consulted an AI technology? If so, what essential information should the physician provide to patient A? Should disclosure of the use of AI be part of obtaining informed consent and should a lack of sufficient information incur liability?

Transparency is crucial to promoting trust among all stakeholders, particularly patients. Physicians should be frank with patients from the onset and inform them of the use of AI rather than hiding the technology. They should try their best to explain to their patients the purpose of using AI, how it functions and whether it is explainable. They should describe what data are collected, how they are used and shared with third parties and the safeguards for protection of patients’ privacy. Physicians should also be transparent about any weaknesses of the AI technology, such as any biases, data breaches or privacy concerns. Only with transparency
can the deployment of AI for health care and health science, including hospital practice and clinical trials, become a long-term success. Trust is key to facilitating the adoption of AI in medicine.