On Assessing Trustworthy AI in Healthcare: Machine Learning as a Supportive Tool to Recognize Cardiac Arrest in Emergency Calls

Roberto Zicari
James Brusseau
Stig Blomberg, , Denmark
Helle Christensen, , Denmark
Sara Gerke, Penn State Dickinson Law
Megan Coffee
Marianna Ganapini
Thomas Gilbert
Eleanore Hickman, , United Kingdom
Elisabeth Hildt
Sune Holm, , Denmark
Ulrich Kühne, , Germany
Vince Madai, , Germany
Walter Osika, , Sweden
Andy Spezzatti
Eberhard Schnebel, , Germany
Jesmin Tithi
Dennis Vetter, , Germany
Magnus Westerlund, , Finland
Renee Wurth
Julia Amann, , Switzerland
Vegard Antun, , Norway
Valentina Beretta, , Italy
Frédérick Bruneault
Erik Campano
Boris Düdder, , Denmark
Alessio Gallucci, , Netherlands
Emmanuel Goffi
Christoffer Haase, , Denmark
Thilo Hagendorff, , Germany
Pedro Kringen, , Germany
Florian Möslein, , Germany
Davi Ottenheimer
Matiss Ozols
Laura Palazzani, , Italy
Martin Petrin
Karin Tafur, , Spain
Holger Volland
Georgios Kararigas, , Iceland


Artificial Intelligence (AI) has the potential to greatly improve the delivery of healthcare and other services that advance population health and wellbeing. However, the use of AI in healthcare also brings potential risks that may cause unintended harm. To guide future developments in AI, the High-Level Expert Group on AI set up by the European Commission (EC), recently published ethics guidelines for what it terms “trustworthy” AI. These guidelines are aimed at a variety o stakeholders, especially guiding practitioners toward more ethical and more robust applications of AI. In line with efforts of the EC, AI ethics scholarship focuses increasingly on converting abstract principles into actionable recommendations. However, the interpretation, relevance, and implementation of trustworthy AI depend on the domain and the context in which the AI system is used. The main contribution of this paper is to demonstrate how to use the general AI HLEG trustworthy AI guidelines in practice in the healthcare domain. To this end, we present a best practice of assessing the use of machine learning as a supportive tool to recognize cardiac arrest in emergency calls. The AI system under assessment is currently in use in the city of Copenhagen in Denmark. The assessment is accomplished by an independent team composed of philosophers, policy makers, social scientists, technical, legal, and medical experts. By leveraging an interdisciplinary team, we aim to expose the complex trade-offs and the necessity for such thorough human review when tackling socio-technical applications of AI in healthcare. For the assessment, we use a process to assess trustworthy AI, called 1Z-Inspection® to identify specific challenges and potential ethical trade-offs when we consider AI in practice.