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Review
. 2025;12(1):13.
doi: 10.1007/s40471-025-00362-w. Epub 2025 Jul 9.

AI-Y: An AI Checklist for Population Ethics Across the Global Context

Yulin Hswen  1 , John A Naslund  2 , Margaret Hurley  1 , Bart Ragon  3 , Margaret A Handley  1 , Fang Fang  4 , Emily E Haroz  5 , Joyce Nakatumba-Nabende  6 , Alastair van Heerden  7 , Elaine O Nsoesie  8
Affiliations
Review

AI-Y: An AI Checklist for Population Ethics Across the Global Context

Yulin Hswen et al. Curr Epidemiol Rep. 2025.

Abstract

Purpose of review: The goal of this narrative review is to introduce and apply Hswen's AI Checklist (AI-Y) for Population Ethics, a structured ethical framework created to evaluate the development and deployment of artificial intelligence (AI) technologies in public health. The review addresses key questions: How can AI be ethically assessed across global healthcare contexts and what principles are needed to ensure contextually appropriate AI use in population health.

Recent findings: Recent research highlights a significant disconnect between AI development and ethical implementation, especially in low-resource settings. Studies reveal issues such as homogeneity in the training data, and limited accessibility. Through six global case studies-spanning dementia care in Sweden, environmental forecasting in Europe, suicide prevention in Native American communities, schizophrenia care in India and the U.S., and cervical cancer and tuberculosis diagnosis in Low- and Middle-Income Countries-researchers demonstrate AI's promise in enhancing preparedness diagnosis, screening, and care delivery while also underscoring ethical gaps in accountability, and governance.

Summary: Our examination using the AI-Y Checklist found that ethical blind spots are widespread in the development and deployment of AI tools for population health-particularly in areas of model generalizability, accountability, and transparency of AI decision-making. Although AI demonstrates strong potential to enhance disease detection, resource allocation, and preventive care across diverse global settings, most systems evaluated in our six case studies did not meet key ethical criteria such as access, and localized validation and development. The major takeaway is that technical excellence alone is insufficient; ethical alignment is critical to the responsible implementation of AI in public health. The AI-Y Checklist provides a scalable framework to identify risks, guide ethical decision-making, and foster global accountability. For future research, this framework enables standardized evaluation of AI systems, encourages community co-design practices, and supports the creation of policy and governance structures that ensure AI technologies advance health ethics.

Keywords: AI Governance; Accountability; Artificial Intelligence; Digital Health; Ethics; Population Health; Public Health; Transparency.

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Conflict of interest statement

Conflicts of InterestNone to declare.Competing InterestsNone to declare.

Figures

Fig. 1
Fig. 1
Hswen's AI Checklist (AI-Y) for Population Ethics
See this image and copyright information in PMC

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