In a recent Nature article, researchers introduced a novel ethical framework for using artificial intelligence (AI) in public health, aiming to ensure that AI tools are developed and deployed in ways that uphold human dignity, accountability, and community trust.
Study: Reason and responsibility as a path toward ethical AI for (global) public health. Image Credit: Antonio Marca/Shutterstock.com
Background
Public health has long focused on improving health outcomes at the population level and advancing equity across communities. As digital technologies take hold, AI is playing an increasingly central role—especially in the emerging field of Precision Public Health (PPH), which applies data and genomics to target interventions more effectively.
The World Health Organization defines PPH as delivering “the right intervention at the right time, every time, to the right population.” AI enables many of these capabilities, supporting disease surveillance, emergency preparedness, and health promotion on a large scale.
But alongside this growing influence comes a wave of ethical challenges. Public health operates under a different set of priorities than clinical care, emphasizing collective well-being, social justice, and community engagement rather than individual autonomy alone. Many existing ethical frameworks don’t fully address this broader, systemic context, often falling short when applied to AI-driven, population-level interventions.
To address this gap, the researchers developed a new ethical framework grounded in human reasoning and moral reflection. It is designed not just to evaluate AI after the fact, but to embed ethical thinking throughout the entire AI lifecycle—shaping how technologies are co-designed, implemented, and overseen in real-world public health settings.
Bridging AI Potential with Human-Centered Ethics
The framework focuses on how AI can be ethically integrated into the dual roles of PPH: gathering data (“hunter-gatherer”) and translating that knowledge into effective interventions (“ripple-maker”). This two-way process—data collection, interpretation, and public communication—often involves ethical trade-offs. For example, how can public health authorities remain transparent during a crisis without sparking unnecessary fear?
AI can help navigate these situations, but it also introduces risks that require thoughtful governance. The researchers advocate for a human-centered approach that upholds dignity, justice, and autonomy. Their framework mirrors stages of human cognition, including experience, understanding, judgment, and decision, offering a structured way to reflect on ethical implications at each point in the AI development process.
This approach rests on several key assumptions: that decisions in public health affect diverse communities and must be made with care; that while AI can mimic certain types of reasoning, it lacks the moral depth and contextual awareness of human judgment; and that ethical principles like transparency, accountability, and community involvement must guide AI from initial design through deployment.
By integrating public health expertise and lived experience into AI development, the framework ensures that these technologies serve as tools to augment—not replace—human insight, especially in complex or uncertain scenarios.
Ethical Reasoning in Action
The researchers draw from Aristotelian and Kantian traditions to guide the ethical use of AI, combining phronesis (practical wisdom) with the idea of a universal moral duty. This philosophical grounding supports five core ethical principles:
- Respect for autonomy
- Nonmaleficence (do no harm)
- Beneficence (promote good)
- Justice
- Explicability (clear, accountable decision-making)
These principles are not just abstract ideals; they are operationalized through an iterative reasoning cycle that mirrors how humans make sense of complex situations. From analyzing disease patterns to determining how best to allocate scarce resources, this structure helps ensure that ethical reflection keeps pace with rapid technological change.
A key insight from the paper is that while AI can enhance decision-making, it cannot replicate the full scope of human creativity, empathy, or contextual understanding. Public health professionals must apply practical wisdom to avoid either overreliance on AI or dismissing its potential. This balance is critical for ensuring that AI tools remain adaptable, fair, and aligned with the values of the communities they serve.
Transparent communication is especially emphasized as a foundation for public trust, particularly when AI is used to shape messaging during crises. Embedding ethical principles across the AI lifecycle is not just good practice—it’s essential for building technologies that genuinely support public health goals.
Conclusion
The study offers a compelling roadmap for ethically integrating AI into global public health. By rooting AI development in human reasoning, accountability, and inclusive design, the proposed framework ensures that digital tools serve to strengthen, not sideline, public health values.
As AI becomes more embedded in decision-making, maintaining transparency, fostering community engagement, and applying moral judgment throughout the process will be crucial. This framework provides practical, philosophically grounded guidance for navigating those responsibilities, helping public health systems use AI in ways that are not only effective but also equitable and trustworthy.
Journal Reference
Antao, E.-M., Rasheed, A., Anatol-Fiete Näher, & Wieler, L. H. (2025). Reason and responsibility as a path toward ethical AI for (global) public health. Npj Digital Medicine, 8(1). DOI:10.1038/s41746-025-01707-x. https://www.nature.com/articles/s41746-025-01707-x
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