The implementation of AI in medicine: ethical and legal considerations regarding the black box dilemma

Artificial Intelligence (AI) is becoming increasingly prevalent in various aspects of our lives, promising to transform the way we live in the long term. The exploration of potential applications of AI systems is also underway in the healthcare sector. While this new technology has the potential to improve medical care, it is important not to become overly enthusiastic and focus solely on the opportunities it offers. Nevertheless, using such technology is not without risks. This article provides a comprehensive overview of the technological fundamentals and considers the ethical and legal implications of using artificial intelligence in healthcare. Additionally, it deals with the question of who can be held liable for damages caused by automated systems in the sensitive field of medicine, and how the diffusion of responsibility can be effectively addressed. The article also focuses on the central issue of explainability in relation to AI and so-called “black box” systems. Attributing liability unilaterally to the physician as the final decision-maker may be insufficient, as this could undermine the trust of patients and medical professionals, hindering the adoption of AI systems. A collaborative approach that integrates everyone involved in the decision-making process – from system developers to patients – into an ongoing transformation process should be pursued instead.