The Emergence of AI in Public Health Is Calling for Operational Ethics to Foster Responsible Uses

This paper discusses the responsible use of artificial intelligence (AI) in public health and in medicine, and questions the development of AI ethics in international guidelines from a public health perspective. How can a global ethics approach help conceive responsible AI development and use for improving public health? By analysing key international guidelines in AI ethics (UNESCO, WHO, European High-Level Expert Group on AI) and the available literature, this paper advocates conceiving proper ethical and legal frameworks and implementation tools for AI in public health, based on a pragmatic risk-based approach. It highlights how ethical AI principles meet public health objectives and focuses on their value by addressing the meaning of human-centred innovations, transparency, accountability, diversity, equity, privacy protection, technical robustness, environmental protection, and post-marketing surveillance. It concludes that AI technology can reconcile individual and collective ethical approaches to public health, but requires specific legal frameworks and interdisciplinary efforts. Prospects include the development of supporting data infrastructures, of stakeholders' involvement to ensure long-term commitment and trust, of the public's and users' education, and of international organisations' capacity to coordinate and monitor AI developments. It formulates a proposal to reflect on an integrated transparent public health functionality in digital applications processing data.