The ethical challenges of artificial intelligence-driven digital pathology

Digital pathology - the digitalisation of clinical histopathology services through the scanning and storage of pathology slides - has opened up new possibilities for health care in recent years, particularly in the opportunities it brings for artificial intelligence (Al)-driven research. Recognising, however, that there is little scholarly debate on the ethics of digital pathology when used for Al research, this paper summarises what it sees as four key ethical issues to consider when deploying Al infrastructures in pathology, namely, privacy, choice, equity, and trust. The themes are inspired from the authors' experience grappling with the challenge of deploying an ethical digital pathology infrastructure to support Al research as part of the National Pathology Imaging Cooperative (NPIC), a collaborative of universities, hospital trusts, and industry partners largely located across the North of England. Though focusing on the UK case, internationally, few pathology departments have gone fully digital, and so the themes developed here offer a heuristic for ethical reflection for other departments currently making a similar transition or planning to do so in the future. We conclude by promoting the need for robust public governance mechanisms in Al-driven digital pathology.