Cited by 68Ethics and Social Impacts of AIArtificial Intelligence in Healthcare and EducationExplainable Artificial Intelligence (XAI)

Operationalising AI ethics through the agile software development lifecycle: a case study of AI-enabled mobile health applications

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Amugongo, Lameck Mbangula, Kriebitz, Alexander, Boch, Auxane, Lütge, Christoph·2025·AI and Ethics

Abstract

Although numerous ethical principles and guidelines have been proposed to guide the development of artificial intelligence (AI) systems, it has proven difficult to translate these principles into actionable practices beyond mere adherence to ethical ideas. This is particularly challenging in the context of AI systems for healthcare, which requires balancing the potential benefits of the solution against the risks to patients and the wider community, including minorities and underserved populations. To address this challenge, we propose a shift from one-size-fits-all ethical principles to contextualized case-based ethical frameworks. This study uses an AI-enabled mHealth application as a case study. Our framework is built on existing ethical guidelines and principles, including the AI4People framework, the EU High-Level Expert Group on trustworthy AI, and wider human rights considerations. Additionally, we incorporate relational perspectives to address human value concerns and moral tensions between individual rights and public health. Our approach is based on ”ethics by design,” where ethical principles are integrated throughout the entire AI development pipeline, ensuring that ethical considerations are not an afterthought but implemented from the beginning. For our case study, we identified 7 ethical principles: fairness, agility, precision, safeguarding humanity, respect for others, trust and accountability, and robustness and reproducibility. We believe that the best way to mitigate and address ethical consequences is by implementing ethical principles in the software development processes that developers commonly use. Finally, we provide examples of how our case-based framework can be applied in practice, using examples of AI-driven mobile applications in healthcare.

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  • XAI can facilitate regulatory compliance by enabling audits and assessments of AI models to ensure fairness, accountability, and compliance with ethical standards.

    “Moreover, it can also facilitate regulatory compliance by enabling audits and assessments of AI models to ensure fairness, accountability, and compliance with ethical standards [29], [30].”

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  1. Berg, S.: “Nudge theory” explored to boost medication adherence (2018). https://www.ama-assn.org/delivering-care/patient-support-advocacy/nudge-theory-explored-boost-medication-adherence Accessed 27-07-2023
  2. European Commission and Directorate-General for Communications Networks, Content and Technology: Ethics Guidelines for Trustworthy AI. Publications Office, Brussels (2019). https://data.europa.eu/doi/10.2759/346720 · DOI
  3. Viljoen, S.: A relational theory of data governance. Yale Law J. 131, 573–654 (2021)
  4. Rao, V.N., Zhen, X., Hovsepian, K., Shen, M.: A first look: Towards explainable textvqa models via visual and textual explanations. In: NAACL 2021 Workshop on Multimodal Artificial Intelligence (2021). https://www.amazon.science/publications/a-first-look-towards-explainable-textvqa-models-via-visual-and-textual-explanations

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Authors
Amugongo, L. M., Kriebitz, A., Boch, A., & Lütge, C.
Affiliations
Technical University of Munich (DE)
Corresponding author
  • Amugongo, Lameck Mbangula
  • Kriebitz, Alexander
  • Boch, Auxane
  • Lütge, Christoph
Venue
AI and Ethics
Published
2023-08-15
Volume
5
Issue
1
Pages
227-244
ISSN
  • 2730-5953 (ISSN-L)
  • 2730-5961
OpenAlex
W4385835435
Cited by
68
References
81
Citations by year
2026: 13 · 2025: 31 · 2024: 21 · 2023: 3
FWCI
17.05
Type
journal article
Language
en
Open access
Locations
  • AI and Ethics (publishedVersion, cc-by)
  • mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion, other-oa)
Funders
Technische Universität München
Topics
  • Social Sciences › Safety Research › Ethics and Social Impacts of AI
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Physical Sciences › Computer Science › Artificial Intelligence › Explainable Artificial Intelligence (XAI)
Keywords
AI ethics, mobile health apps, mobile health, ethics by design, trustworthy AI, human rights, individual rights versus public health, fairness, accountability, underserved populations

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