Specific challenges posed by artificial intelligence in research ethics.

Background: The twenty first century is often defined as the era of Artificial Intelligence (AI), which raises many questions regarding its impact on society. It is already significantly changing many practices in different fields. Research ethics (RE) is no exception. Many challenges, including responsibility, privacy, and transparency, are encountered. Research ethics boards (REB) have been established to ensure that ethical practices are adequately followed during research projects. This scoping review aims to bring out the challenges of AI in research ethics and to investigate if REBs are equipped to evaluate them. Methods: Three electronic databases were selected to collect peer-reviewed articles that fit the inclusion criteria (English or French, published between 2016 and 2021, containing AI, RE, and REB). Two instigators independently reviewed each piece by screening with Covidence and then coding with NVivo. Results: From having a total of 657 articles to review, we were left with a final sample of 28 relevant papers for our scoping review. The selected literature described AI in research ethics (i.e., views on current guidelines, key ethical concept and approaches, key issues of the current state of AI-specific RE guidelines) and REBs regarding AI (i.e., their roles, scope and approaches, key practices and processes, limitations and challenges, stakeholder perceptions). However, the literature often described REBs ethical assessment practices of projects in AI research as lacking knowledge and tools. Conclusion: Ethical reflections are taking a step forward while normative guidelines adaptation to AI's reality is still dawdling. This impacts REBs and most stakeholders involved with AI. Indeed, REBs are not equipped enough to adequately evaluate AI research ethics and require standard guidelines to help them do so.

[Health care research within international normative frameworks and the literature : assessment, stakes and recommendations]. / Chapitre 8. La recherche en santé dans les cadres normatifs internationaux et la littérature : état des lieux, enjeux et recommandations.

Research in health occupies a central place in the elaboration of public policies and the interventions that aim to reduce inequality and make the right to health effective. However, research in health remains marked by inequalities which particularly affect developing countries. The objective of this critical recension of the international normative frameworks and the scientific literature is to present a summary of the assessment, underline the challenges and identify the main recommendations as well as the ethical principles that aim to reduce inequalities in the field of health research. The normative frameworks included in this recension have been adopted by the United Nations Organisation through its agencies specialised in the field of health and scientific research. Particular attention has also been given to the scientific literature concerned with the inequalities in health research. The results of this recension show us that inequalities in health research can be an impediment to the equitable distribution of healthcare services and to human development. With regard to this, these inequalities raise concerns about justice and equity for research institutions, researchers and communities in developing countries. The recommendations and ethical principles analysed here are therefore designed to reduce them and to promote access for developing countries to research and the consequent benefits. Finally, this recension emphasises the need to undertake research to understand the role of research practices in countries of the South in the emergence and persistence of these inequalities.

[POWER ASYMMETRY IN GLOBAL HEALTH RESEARCH, WHAT ARE THE ETHICAL STAKES? A PILOT STUDY WITH RESEARCHERS IN BENIN]. / ASYMÉTRIE DE POUVOIR DANS LA RECHERCHE EN SANTÉ MONDIALE, QUELS ENJEUX ÉTHIQUES? UNE ÉTUDE PILOTE AUPRÈS DE CHERCHEURS AU BÉNIN.

Global health research constitutes a driving force to achieve health justice and health equity in several countries around the world and more specifically in global South. However, these research raise significant ethical challenges. We have conducted a pilot study with researchers from Benin to better understand challenges associated with power asymmetry in global health research. The study highlights the complexity of the social context in which power asymmetry arises and the way it evolves. Moreover, it reveals the vulnerability of researchers who are working in such environments, where they are exposed to critical conditions that could affect the research process and jeopardize their moral values. Finally, these results suggest that there are innovative approaches coming from researchers facing these constraints.

Ethical considerations related to participation and partnership: an investigation of stakeholders' perceptions of an action-research project on user fee removal for the poorest in Burkina Faso.

BACKGROUND: Healthcare user fees present an important barrier for accessing services for the poorest (indigents) in Burkina Faso and selective removal of fees has been incorporated in national healthcare planning. However, establishing fair, effective and sustainable mechanisms for the removal of user fees presents important challenges. A participatory action-research project was conducted in Ouargaye, Burkina Faso, to test mechanisms for identifying those who are indigents, and funding and implementing user fee removal. In this paper, we explore stakeholder perceptions of ethical considerations relating to participation and partnership arising in the action-research. METHODS: We conducted 39 in-depth interviews to examine ethical issues associated with the action-research. Respondents included 14 individuals identified as indigent through the community selection process, seven members of village selection committees, six local healthcare professionals, five members of the management committees of local health clinics, five members of the research team, and four regional or national policy-makers. Using constant comparative techniques, we carried out an inductive thematic analysis of the collected data. RESULTS: The Ouargaye project involved a participatory model, included both implementation and research components, and focused on a vulnerable group within small, rural communities. Stakeholder perceptions and experiences relating to the participatory approach and reliance on multiple partnerships in the project were associated with a range of ethical considerations related to 1) seeking common ground through communication and collaboration, 2) community participation and risk of stigmatization, 3) impacts of local funding of the user fee removal, 4) efforts to promote fairness in the selection of the indigents, and 5) power relations and the development of partnerships. CONCLUSIONS: This investigation of the Ouargaye project serves to illuminate the distinctive ethical terrain of a participatory public health action-research project. In carrying out such projects, careful attention and effort is needed to establish and maintain respectful relationships amongst those involved, acknowledge and address differences of power and position, and evaluate burdens and risks for individuals and groups.