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Should Watson Be Consulted for a Second Opinion?
Open accessAbstract
This article discusses ethical responsibility and legal liability issues regarding use of IBM Watson TM for clinical decision making.In a case, a patient presents with symptoms of leukemia.Benefits and limitations of using Watson or other intelligent clinical decision-making tools are considered, along with precautions that should be taken before consulting artificially intelligent systems.Guidance for health care professionals and organizations using artificially intelligent tools to diagnose and to develop treatment recommendations are also offered. CaseMs L is a 63-year-old woman who visits her primary care physician, Dr R, with newonset fatigue and gum bleeding.After a thorough history and physical examination, Dr R orders a complete blood count, the results of which show anemia, thrombocytopenia, and leukocytosis.Dr R urgently refers Ms L to Dr O in hematology-oncology.Following more testing, Dr O concludes that Ms L has acute myeloid leukemia, admits her to the hospital, and schedules her for induction chemotherapy.After several weeks of therapy, Ms L seems to be benefitting little from treatment and her condition has worsened since admission.Stumped by what once seemed like a routine case, Dr O recommends to Ms L genetic testing of her cancerous cells, which could offer additional information that could potentially lead to a different diagnosis or treatment plan.Dr O also considers consulting colleagues at the University of Tokyo, who recently used the IBM Watson TM artificial intelligence (AI) system to correctly diagnose a rare form of leukemia in a very similar case. 1 Dr O recalls Watson being able to sift through millions of pages of clinical literature as well as being able to incorporate a patient's genetic background and clinical history to come up with a diagnosis and treatment plan, all in a fraction of the time that it would take a physician to do.Dr O wonders: Perhaps Watson would come to the same conclusion I did.Or maybe Watson would find something I missed and help save Ms L's life.Or maybe Watson would be totally unhelpful and waste my and Ms L's time.Dr O also wonders whether to explain Watson to Ms L and invite her to consider these questions.
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Another aspect of liability risk refers to the situation where appropriate treatment options recommended by AI are mistakenly dismissed.
“Another aspect of liability risk refers to the situation where appropriate treatment options recommended by AI are mistakenly dismissed [21].”
From Use of AI-based tools for healthcare purposes: a survey study from consumers’ perspectives (2020) · cites this paper as [21]
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- IBM Watson hard at work: new breakthroughs transform quality care for patients [press release]. New York, NY: Memorial Sloan Kettering Cancer Center; February 8, 2013.
- IBM and Partners to Transform Personal Health with Watson and Open Cloud [press release]. Armonk, NY: IBM; April 13, 2015. https://www- 03.ibm.com/press/uk/en/pressrelease/46609.wss. Accessed on August 15, 2018.
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Metadata
- Authors
- Luxton, D. D.
- Affiliations
- University of Washington (US)
- Corresponding author
- David D. Luxton
- ORCID
- David D. Luxton
- Venue
- AMA Journal of Ethics
- Publisher
- American Medical Association (AMA)
- Published
- 2019-02-01
- Volume
- 21
- Issue
- 2
- Pages
- E131-137
- ISSN
- 1937-7010 (ISSN-L)
- 2376-6980
- OpenAlex
- W2916650597
- Cited by
- 33
- References
- 8
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 6 · 2023: 3 · 2022: 3 · 2021: 6 · 2020: 4 · 2019: 3
- FWCI
- 1.29
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The AMA Journal of Ethic (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Social Sciences › Law › Medical Malpractice and Liability Issues
- Social Sciences › Law › Artificial Intelligence in Law
- Keywords
- IBM Watson, artificial intelligence in clinical decision-making, second opinion, acute myeloid leukemia, ethical responsibility, legal liability, informed consent, genetic testing, treatment guidelines, physician-patient communication
- MeSH terms
- Clinical Decision-Making, Diagnosis, Computer-Assisted, Female, Humans, Middle Aged, Referral and Consultation, Leukemia, Myeloid, Acute
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