Lameck Mbangula Amugongo

Karim Lekadir, Aasa Feragen, Abdul Joseph Fofanah et al. · eth-zurich

Despite major advances in artificial intelligence (AI) for medicine and healthcare, the deployment and adoption of AI technologies remain limited in real-world clinical practice. In recent years, concerns have been raised about the technical, clinical, ethical and legal risks associated with medical AI. To increase real world adoption, it is essential that medical AI tools are trusted and accepted by patients, clinicians, health organisations and authorities. This work describes the FUTURE-AI guideline as the first international consensus framework for guiding the development and deployment of trustworthy AI tools in healthcare. The FUTURE-AI consortium was founded in 2021 and currently comprises 118 inter-disciplinary experts from 51 countries representing all continents, including AI scientists, clinicians, ethicists, and social scientists. Over a two-year period, the consortium defined guiding principles and best practices for trustworthy AI through an iterative process comprising an in-depth literature review, a modified Delphi survey, and online consensus meetings. The FUTURE-AI framework was established based on 6 guiding principles for trustworthy AI in healthcare, i.e. Fairness, Universality, Traceability, Usability, Robustness and Explainability. Through consensus, a set of 28 best practices were defined, addressing technical, clinical, legal and socio-ethical dimensions. The recommendations cover the entire lifecycle of medical AI, from design, development and validation to regulation, deployment, and monitoring. FUTURE-AI is a risk-informed, assumption-free guideline which provides a structured approach for constructing medical AI tools that will be trusted, deployed and adopted in real-world practice. Researchers are encouraged to take the recommendations into account in proof-of-concept stages to facilitate future translation towards clinical practice of medical AI.

Andrew Smart, Ben Hutchinson, Lameck Mbangula Amugongo et al.

Large Language Models (LLMs) have rapidly increased in size and apparent capabilities in the last three years, but their training data is largely English text. There is growing interest in multilingual LLMs, and various efforts are striving for models to accommodate languages of communities outside of the Global North, which include many languages that have been historically underrepresented in digital realms. These languages have been coined as "low resource languages" or "long-tail languages", and LLMs performance on these languages is generally poor. While expanding the use of LLMs to more languages may bring many potential benefits, such as assisting cross-community communication and language preservation, great care must be taken to ensure that data collection on these languages is not extractive and that it does not reproduce exploitative practices of the past. Collecting data from languages spoken by previously colonized people, indigenous people, and non-Western languages raises many complex sociopolitical and ethical questions, e.g., around consent, cultural safety, and data sovereignty. Furthermore, linguistic complexity and cultural nuances are often lost in LLMs. This position paper builds on recent scholarship, and our own work, and outlines several relevant social, cultural, and ethical considerations and potential ways to mitigate them through qualitative research, community partnerships, and participatory design approaches. We provide twelve recommendations for consideration when collecting language data on underrepresented language communities outside of the Global North.

Lameck Mbangula Amugongo, Tutaleni Asino, Nicola J Bidwell

Dominant approaches, e.g. the EU's "Trustworthy AI framework", treat trust as a property that can be designed for, evaluated, and governed according to normative and technical criteria. They do not address how trust is subjectively cultivated and experienced, culturally embedded, and inherently relational. This paper proposes some expanded principles for trust in AI that can be incorporated into common development methods and frame trust as a dynamic, temporal relationship, which involves transparency and mutual respect. We draw on relational ethics and, in particular, African communitarian philosophies, to foreground the nuances of inclusive, participatory processes and long-term relationships with communities. Involving communities throughout the AI lifecycle can foster meaningful relationships with AI design and development teams that incrementally build trust and promote more equitable and context-sensitive AI systems. We illustrate how trust-enabling principles based on African relational ethics can be operationalised, using two use-cases for AI: healthcare and education.

Lameck Mbangula Amugongo, Nicola J Bidwell, Joseph Mwatukange

The trustworthiness of AI is considered essential to the adoption and application of AI systems. However, the meaning of trust varies across industry, research and policy spaces. Studies suggest that professionals who develop and use AI regard an AI system as trustworthy based on their personal experiences and social relations at work. Studies about trust in AI and the constructs that aim to operationalise trust in AI (e.g., consistency, reliability, explainability and accountability). However, the majority of existing studies about trust in AI are situated in Western, Educated, Industrialised, Rich and Democratic (WEIRD) societies. The few studies about trust and AI in Africa do not include the views of people who develop, study or use AI in their work. In this study, we surveyed 157 people with professional and/or educational interests in AI from 25 African countries, to explore how they conceptualised trust in AI. Most respondents had links with workshops about trust and AI in Africa in Namibia and Ghana. Respondents' educational background, transnational mobility, and country of origin influenced their concerns about AI systems. These factors also affected their levels of distrust in certain AI applications and their emphasis on specific principles designed to foster trust. Respondents often expressed that their values are guided by the communities in which they grew up and emphasised communal relations over individual freedoms. They described trust in many ways, including applying nuances of Afro-relationalism to constructs in international discourse, such as reliability and reliance. Thus, our exploratory study motivates more empirical research about the ways trust is practically enacted and experienced in African social realities of AI design, use and governance.