Peer-Reviewed Publication
Patterns (N Y)2026;7(10):101662.October 9, 2026News
Ethical principles and considerations in health AI.
Yilin Ning1,2,3, Yian Ma1,2, Mingxuan Liu1,2, Gary S Collins4,5, Arun James Thirunavukarasu6, Melissa D McCradden7,8,9, Jasmine Chiat Ling Ong2,10, Yuhe Ke2,11,12, Daniel Shu Wei Ting13,14,15,16, Danielle S Bitterman17,18, Yih Chung Tham13,14,19,20, Alastair K Denniston4,5,21, Pearse A Keane22,23, Josip Car24,25, Patrick Tan26,27,28,29, Karel G M Moons30, Tien Yin Wong14,31,32, Eric J Topol33, Nan Liu1,2,3,34,35
1Centre for Biomedical Data Science, Duke-NUS Medical School, Singapore, Singapore.
2Duke-NUS AI + Medical Sciences Initiative, Duke-NUS Medical School, Singapore, Singapore.
3Programme in Health Services Research & Population Health, Duke-NUS Medical School, Singapore, Singapore.
4Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK.
5NIHR Biomedical Research Centre: Birmingham, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK.
6International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
7Australian Institute for Machine Learning, University of Adelaide, Adelaide, SA, Australia.
8Women's and Children's Health Network, Adelaide, SA, Australia.
9SickKids Research Institute, Toronto, ON, Canada.
10Division of Pharmacy, Singapore General Hospital, Singapore, Singapore.
11Department of Anaesthesiology, Singapore General Hospital, Singapore, Singapore.
12Data Science and Artificial Intelligence Lab, Singapore General Hospital, Singapore, Singapore.
13Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore.
14Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore.
15Artificial Intelligence Office, Singapore Health Services, Singapore, Singapore.
16Byers Eye Institute, Stanford University, Stanford, CA, USA.
17Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA.
18Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA, USA.
19Centre for Innovation and Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
20Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
21University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
22Institute of Ophthalmology, University College London, London, UK.
23NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, UK.
24School of Life Course and Population Health Sciences, King's College London, London, UK.
25King's Population Health Institute, King's College London, London, UK.
26Cancer and Stem Cell Biology Programme, Duke-NUS Medical School, Singapore, Singapore.
27Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore.
28SingHealth Duke-NUS Institute of Precision Medicine, Singapore, Singapore.
29Precision Health Research, Singapore, Singapore.
30Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
31Beijing Visual Science and Translational Eye Research Institute (BERI), Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China.
32School of Biomedical Engineering, Tsinghua Medicine, Tsinghua University, Beijing, China.
33Scripps Research Translational Institute, Scripps Research, La Jolla, CA, USA.
34Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
35NUS Artificial Intelligence Institute, National University of Singapore, Singapore, Singapore.
Abstract
Ethical principles are foundations of medicine and should guide the integration and implementation of health AI but are often considered in isolation, typically at deployment. The authors argue that ethical principles are fundamental constructs across the full AI development-deployment life cycle and show how trade-offs and dependencies between principles shape feasible and ethically robust develo…
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