Governments and corporations are critical actors in AI governance, but we need civil society at the center. Civil society organizations’ (CSOs)main purpose is to advocate for and protect the public interest by actively engaging with those powers and exercising oversight. Civil society voices can have a powerful role in counterbalancing government and corporations’ positions by expanding the dialogue to include broader societal interests, including the rule of law, and factor in developing legal and regulatory frameworks that will shape AI governance. We need diverse voices to scrutinize how foundation models and generative AI intersect with our legal, judicial, and regulatory systems.

Artificial Intelligence (AI) in medicine promises to revolutionize healthcare, offering tools that can enhance diagnostics, streamline patient care, and even predict health outcomes. But with this promise comes profound ethical, societal, and governance challenges. As we stand at the intersection of medicine and technology, one thing becomes increasingly clear: civil society must be at the heart of medical AI governance. Here’s why.

• AI in healthcare is not just a technological issue; it’s a societal one. It affects everyone – patients, healthcare providers, and the general public. Therefore, decisions about its use and governance should not be left solely to technologists, physicians or policymakers. Civil society, representing the interests of the public, has a vital role to play.
• Medical AI, while technologically advanced, operates in a domain deeply rooted in human values, trust, and ethics. Whether it’s diagnosing diseases or recommending treatments, the decisions made by AI have direct human implications. Civil society, representing diverse voices and ethical considerations, can ensure that AI solutions are not just technically sound but morally justifiable. Civil society can advocate for ethical AI use, ensuring that AI applications respect human rights and are used for public good. They can raise awareness about the implications of AI, educating the public about their rights and potential risks.
• The rapidly evolving landscape of medical AI requires agile policy frameworks. Civil society, with its pulse on societal needs and challenges, can influence policy-making, ensuring that regulations are both progressive and protective of patient rights. Civil society organizations can influence policy-making, ensuring that regulations protect public interests. They can provide valuable insights from the ground level, helping to shape policies that are practical and effective.
• As AI models become intricate, there’s a growing need for transparency. Civil society can act as a watchdog, ensuring that AI developers and healthcare institutions remain accountable. By demanding clear explanations for AI decisions, they can ensure that the technology remains comprehensible and accountable. Civil society plays a crucial role in holding stakeholders accountable. They can monitor AI applications in healthcare, report unethical practices, and ensure that those responsible are held accountable.
• AI in medicine should be equitable, catering to the needs of all sections of society. Civil society can play a pivotal role in ensuring that AI solutions are inclusive, addressing the needs of marginalized communities and ensuring that biases, often inherent in datasets, don’t perpetuate healthcare disparities.
• While technologists and medical experts bring vital domain-specific knowledge, civil society brings a broader perspective. They can bridge the gap between technical jargon and real-world implications, ensuring that the wider public understands the potential risks and benefits of medical AI. Civil society can advocate for ethical AI use, ensuring that AI applications respect human rights and are used for public good. They can raise awareness about the implications of AI, educating the public about their rights and potential risks.

Here are some examples of how CSOs are already working to promote responsible AI in medicine:

• The Algorithmic Justice League is a CSO that works to ensure that algorithms are used in a fair and just way. They have developed a number of resources to help policymakers and the public understand the potential for bias in AI systems.
• The Center for Democracy and Technology is a CSO that works to promote responsible innovation in technology. They have published a number of reports on the ethical implications of AI in healthcare.
• The Partnership on AI is a non-profit organization that brings together companies, universities, and nonprofits to work on the responsible development and use of AI. They have developed a number of resources to help organizations implement responsible AI practices.

There are a number of ways to incorporate civil society organizations (CSOs) in medical AI governance. Here are a few suggestions:

• Establish CSOs as members of medical AI governance bodies: CSOs should have a seat at the table when it comes to making decisions about how medical AI is developed, deployed, and used. This will help to ensure that the voices of the public are heard and that ethical concerns are taken into account.
• Provide funding for CSOs to work on medical AI governance: CSOs need resources to be able to do the important work of educating the public, advocating for responsible AI policies, monitoring the use of medical AI, and developing and promoting ethical guidelines. Governments and philanthropic organizations can provide funding to support this work.
• Partner with CSOs on medical AI governance initiatives: Governments, policymakers, and other stakeholders can partner with CSOs on specific medical AI governance initiatives. For example, they could work with CSOs to develop ethical guidelines for medical AI or to monitor the use of medical AI for bias.

Here are some specific examples of how CSOs are being incorporated in medical AI governance today:

• In the United Kingdom, the National Health Service (NHS) has established a Centre for AI in Healthcare. The Centre has a CSO advisory group that provides input on the ethical and social implications of AI in healthcare.
• In the United States, the Food and Drug Administration (FDA) has established a Digital Health Center of Excellence. The Center has a CSO engagement program that works with CSOs to get their input on the development and regulation of digital health technologies, including AI-powered medical tools.
• The European Commission has established a High-Level Expert Group on Artificial Intelligence. The Group includes representatives from CSOs, industry, academia, and government. The Group is tasked with developing recommendations on the responsible development and use of AI in Europe.

The fusion of AI and medicine is not just a technological transformation but a societal one. While AI developers and medical experts lay the technical groundwork, civil society is the bridge connecting this technology to the people it serves. By placing civil society at the heart of medical AI governance, we ensure that the technology serves humanity in the truest sense, governed by principles of ethics, equity, and empathy. As we move forward, let’s champion a collaborative approach, ensuring that the future of medical AI is shaped by diverse voices, working in harmony for the collective good.