Public governance of medical artificial intelligence research in the UK: an integrated multi-scale model

There is a growing consensus among scholars, national governments, and intergovernmental organisations of the need to involve the public in decision-making around the use of artificial intelligence (AI) in society. Focusing on the UK, this paper asks how that can be achieved for medical AI research, that is, for research involving the training of AI on data from medical research databases. Public governance of medical AI research in the UK is generally achieved in three ways, namely, via lay representation on data access committees, through patient and public involvement groups, and by means of various deliberative democratic projects such as citizens' juries, citizen panels, citizen assemblies, etc.-what we collectively call "citizen forums". As we will show, each of these public involvement initiatives have complementary strengths and weaknesses for providing oversight of medical AI research. As they are currently utilized, however, they are unable to realize the full potential of their complementarity due to insufficient information transfer across them. In order to synergistically build on their contributions, we offer here a multi-scale model integrating all three. In doing so we provide a unified public governance model for medical AI research, one that, we argue, could improve the trustworthiness of big data and AI related medical research in the future.