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To do no harm — and the most good — with AI in health care

Nature Medicine volume 30, pages 623–627 (2024)Cite this article

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Drawing from real-life scenarios and insights shared at the RAISE (Responsible AI for Social and Ethical Healthcare) conference, we highlight the critical need for AI in health care (AIH) to primarily benefit patients and address current shortcomings in health care systems such as medical errors and access disparities.

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Acknowledgements

The RAISE symposium was supported by grants from the Harvard Medical School Center for Bioethics, the Harvard Medical School Office of the Dean, the Gordon and Betty Moore Foundation, The Health Foundation, Microsoft Corporation, and Apple.

Author information

Authors and Affiliations

  1. Massachusetts Institute of Technology, Cambridge, MA, USA

    Carey Beth Goldberg

  2. National Academy of Medicine, Washington, DC, USA

    Laura Adams

  3. Department of Health Policy and Management, Harvard University, T.H. Chan School of Public Health, Boston, MA, USA

    David Blumenthal

  4. National Library of Medicine, Bethesda, MD, USA

    Patricia Flatley Brennan

  5. University of Wisconsin–Madison, Madison, WI, USA

    Patricia Flatley Brennan

  6. Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA

    Noah Brown, Sara M. Hoffman, Arjun Kumar Manrai, Isaac S. Kohane, William Gordon & Amelia Li Min Tan

  7. Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA

    Atul J. Butte

  8. Warren Alpert Medical School of Brown University, Providence, RI, USA

    Morgan Cheatham

  9. e-Patient Dave, LLC, Nashua, NH, USA

    Dave deBronkart

  10. Society for Participatory Medicine, Pembroke, MA, USA

    Dave deBronkart

  11. The Health Foundation, London, UK

    Jennifer Dixon

  12. NEJM Group, Waltham, MA, USA

    Jeffrey Drazen & Arjun Kumar Manrai

  13. Levin College of Law and Wertheim College of Engineering, University of Florida, Gainesville, FL, USA

    Barbara J. Evans

  14. Department of Statistics and Nuffield Department of Medicine, University of Oxford, Oxford, UK

    Chris Holmes

  15. The Alan Turing Institute, London, UK

    Chris Holmes

  16. Microsoft Corporation, Redmond, WA, USA

    Peter Lee

  17. University of Michigan Health System, University of Michigan, Ann Arbor, MI, USA

    Gilbert S. Omenn

  18. The Joint Commission, Oakbrook Terrace, IL, USA

    Jonathan B. Perlin

  19. U.S. Department of Veterans Affairs, Washington, DC, USA

    Rachel Ramoni

  20. Duke University, Durham, NC, USA

    Guillermo Sapiro

  21. Apple, New York, NY, USA

    Guillermo Sapiro

  22. The Lancet Ltd., Lancet Digital Health, London, UK

    Rupa Sarkar

  23. National Health Service England, Hurley Group, Redditch, UK

    Harpreet Sood

  24. Huma, London, UK

    Harpreet Sood

  25. ETH Zurich, Zurich, Switzerland

    Effy Vayena

  26. Brigham and Women’s Hospital, Boston, MA, USA

    Emily Alsentzer & Lisa Soleymani Lehmann

  27. Harvard Medical School, Boston, MA, USA

    Emily Alsentzer, Michael Chernew, Alexander Hoffmann & Lisa Soleymani Lehmann

  28. MITRE Corporation, Bedford, MA, USA

    Brian Anderson

  29. Coalition for Health AI, Boston, MA, USA

    Brian Anderson

  30. The Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School, Boston, USA

    Ran D. Balicer

  31. Clalit Research Institute, Innovation Division, Clalit Health Services, Tel Aviv, Israel

    Ran D. Balicer & Reut Ohana

  32. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Andrew L. Beam

  33. Wyss Center for Bio and Neuroengineering, Geneva, Switzerland

    Erwin Bottinger

  34. Harvard Medical School Center for Bioethics, Boston, MA, USA

    Rebecca W. Brendel & Edward M. Hundert

  35. Harvard-MIT Program in Health Sciences and Technology, Cambridge, MA, USA

    Payal Chandak & Elizabeth Healey

  36. TriNetX, Cambridge, MA, USA

    Arnaub Chatterjee

  37. Healthcare Performance Lab INSERM U1290 Lyon 1 University, Lyon, France

    Antoine Duclos

  38. Health Data Department Lyon University Hospital, Lyon, France

    Antoine Duclos

  39. Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, MA, USA

    Antoine Duclos

  40. Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA

    Lee A. Fleisher

  41. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    William Gordon

  42. University of Antioquia, Alma Máter Hospital, Medellín, Colombia

    Alejandro Hernández-Arango

  43. Undiagnosed Diseases Network Foundation, Washington, DC, USA

    Michele Kathleen Herndon

  44. BMJ Leader, London, UK

    Indra Joshi

  45. Palantir, London, UK

    Indra Joshi

  46. Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland

    Tobias Kowatsch

  47. School of Medicine, University of St. Gallen, St. Gallen, Switzerland

    Tobias Kowatsch

  48. Centre for Digital Health Interventions, Department of Management, Technology, and Economics at ETH Zurich, Zurich, Switzerland

    Tobias Kowatsch

  49. Bessemer Venture Partners, New York, NY, USA

    Stephen Kraus

  50. Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Lisa Soleymani Lehmann

  51. Universitat de Barcelona, Artificial Intelligence in Medicine Lab, Department of Mathematics and Computer Science, Barcelona, Spain

    Karim Lekadir

  52. Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain

    Karim Lekadir

  53. Kaiser Permanente Division of Research, Oakland, CA, USA

    Vincent X. Liu

  54. MaineHealth, Portland, ME, USA

    Daniel J. Nigrin

  55. Tufts School of Medicine, Boston, MA, USA

    Daniel J. Nigrin

  56. Stanford Health Care, Palo Alto, CA, USA

    Nigam H. Shah

  57. Guy’s & St Thomas’ NHS Foundation Trust, London, UK

    Haris Shuaib

  58. Chan Zuckerberg Initiative, Melon Park, CA, USA

    Tania Simoncelli

  59. School of Law, University of KwaZulu-Natal, Durban, South Africa

    Donrich Thaldar

  60. Institute for Experiential AI and Bouve College of Health Sciences, Northeastern University, Boston, MA, USA

    Eugene Tunik

  61. Gordon and Betty Moore Foundation, San Francisco, USA

    Tommy Wang

  62. Milken Institute, Washington, USA, DC

    John Wilbanks

  63. Broad Institute, Cambridge, MA, USA

    John Wilbanks

  64. Shanghai Digital Medicine Innovation Center, Shanghai, China

    Yuchen Xu

  65. Ruijin Hospital, Shanghai, China

    Yuchen Xu

  66. Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Yuchen Xu

  67. NEJM AI, Boston, MA, USA

    Jianfei Zhao

  68. Jiahui Medical Research and Education, Shanghai, China

    Jianfei Zhao

Authors
  1. Carey Beth Goldberg
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  2. Laura Adams
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  3. David Blumenthal
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  4. Patricia Flatley Brennan
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  5. Noah Brown
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  6. Atul J. Butte
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  7. Morgan Cheatham
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  8. Dave deBronkart
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  9. Jennifer Dixon
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  10. Jeffrey Drazen
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  11. Barbara J. Evans
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  12. Sara M. Hoffman
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  13. Chris Holmes
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  14. Peter Lee
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  15. Arjun Kumar Manrai
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  16. Gilbert S. Omenn
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  17. Jonathan B. Perlin
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  18. Rachel Ramoni
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  19. Guillermo Sapiro
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  20. Rupa Sarkar
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  21. Harpreet Sood
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  22. Effy Vayena
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  23. Isaac S. Kohane
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Consortia

the RAISE Consortium

  • Carey Beth Goldberg
  • , Laura Adams
  • , David Blumenthal
  • , Patricia Flatley Brennan
  • , Noah Brown
  • , Atul J. Butte
  • , Morgan Cheatham
  • , Dave deBronkart
  • , Jennifer Dixon
  • , Jeffrey Drazen
  • , Barbara J. Evans
  • , Sara M. Hoffman
  • , Chris Holmes
  • , Peter Lee
  • , Arjun Kumar Manrai
  • , Gilbert S. Omenn
  • , Jonathan B. Perlin
  • , Rachel Ramoni
  • , Guillermo Sapiro
  • , Rupa Sarkar
  • , Harpreet Sood
  • , Effy Vayena
  • , Isaac S. Kohane
  • , Emily Alsentzer
  • , Brian Anderson
  • , Ran D. Balicer
  • , Andrew L. Beam
  • , Erwin Bottinger
  • , Rebecca W. Brendel
  • , Payal Chandak
  • , Arnaub Chatterjee
  • , Michael Chernew
  • , Antoine Duclos
  • , Lee A. Fleisher
  • , William Gordon
  • , Elizabeth Healey
  • , Alejandro Hernández-Arango
  • , Michele Kathleen Herndon
  • , Alexander Hoffmann
  • , Edward M. Hundert
  • , Indra Joshi
  • , Tobias Kowatsch
  • , Stephen Kraus
  • , Lisa Soleymani Lehmann
  • , Karim Lekadir
  • , Vincent X. Liu
  • , Daniel J. Nigrin
  • , Reut Ohana
  • , Nigam H. Shah
  • , Haris Shuaib
  • , Tania Simoncelli
  • , Amelia Li Min Tan
  • , Donrich Thaldar
  • , Eugene Tunik
  • , Tommy Wang
  • , John Wilbanks
  • , Yuchen Xu
  •  & Jianfei Zhao

Corresponding author

Correspondence to Isaac S. Kohane.

Ethics declarations

Competing interests

The authors declare the following competing interests: L.A. reports a senior advisor contractor role with the National Academy of Medicine; consulting fees from the National Hospice & Palliative Care Organization, X4 Health, David Nagel, MD and Nagel Pain Community; speakers’ fee from Gotham Artists, Executive Speakers Bureau, St. Luke’s Health System and Salem Health; corporate board member or advisor or stock options at T2 Biosystems and TMA Precision Health. D.B. reports grants from the Commonwealth Fund; advisory role at Aledade, Carol Emmott Foundation, New England Journal of Medicine, New England Journal of Medicine AI and Josiah Macy Foundation; stock options at Aledade, Nova Cor and Xhale. A.J.B. reports grants from the National Institutes of Health, Merck, Genentech, Peraton, Priscilla Chan and Mark Zuckerberg and Bakar Family Foundation; royalties, licenses or consulting fees from NuMedii, Personalis, Progeny, Samsung, Gerson Lehman Group, Dartmouth, Gladstone Institute, Boston Children’s Hospital and Mango Tree Corporation; honoraria or speakers or expert testimony fees from Boston Children’s Hospital, Johns Hopkins University, Endocrine Society, Alliance for Academic Internal Medicine, Roche, Children’s Hospital of Philadelphia, University of Pittsburgh Medical Center, Cleveland Clinic, University of Utah, Society of Toxicology, Mayo Clinic, Pfizer, Cerner, Johnson and Johnson and The Transplantation Society; Foresight; patents issued or pending with Personalis, NuMedii, Carmenta, Progenity, Stanford, University of California, San Francisco; participation on a Data Safety Monitoring Board or Advisory Board at Washington University in Saint Louis, Regenstreif Institute. Geisinger and University of Michigan; Stock or stock options with Sophia Genetics, Allbirds, Coursera, Digital Ocean, Rivian, Invitae, Editas Medicine, Pacific Biosciences, Snowflake, Meta, Alphabet, 10x Genomics, Snap, Regeneron, Doximity, Netflix, Illumina, Royalty Pharma, Starbucks, Sutro Biopharma, Pfizer, Biontech, Advanced Micro Devices, Amazon, Microsoft, Moderna, Tesla, Apple, Personalis and Lilly. D. deB. reports speaker honorarium to IHI Leadership Summit. J. Drazen reports unpaid role as Member of the Board of Trustees of Nantucket Cottage Hospital. B.J.E. reports grants from National Institutes of Health Common Fund’s Bridge2AI Patient-Focused Collaborative Hospital Repository Uniting Standards (CHoRUS) for Equitable AI. NIH OT2OD0327 (9/1/2022-8/31/2026); speakers honoraria from American College of Legal Medicine, University of Minnesota, Columbia University School of Medicine; minor holdings of Amazon stock and Pfizer stock. S.M.H. reports support from Harvard Medical School and stock or stock options from PathAI, Inc. P.L. reports employment and stock options with Microsoft Corporation. G.S. reports support from Duke University and Apple; grants from the Simons Foundation, National Science Foundation and Office of Naval Research; stock or stock options with Apple. E.V. reports grants from the Swiss National Science Foundation and Botnar Foundation; consulting fees or other honoraria from Johns Hopkins University- consultant for Bioethics Academy and Roche diagnostics; participation on a Data Safety Monitoring Board or Advisory Board for Meck: Digital Ethics Advisory Panel and IQVIA: Ethics Advisory Panel; role as co-chair for WHO expert group on ethics and governance of AI in Health. M.C. reports a leadership or advisory role with Coalition for Health AI. C.H. reports grants or contracts with Novo Nordisk; participation on a Data Safety Monitoring Board or Advisory Board at Novo Nordisk Foundation, UK Biobank and MRC Advisory Board; leadership or advisory role at CRUK Data Science Advisory Board. A.K.M is a paid deputy editor at NEJM AI, a publication of the Massachusetts Medical Society. I.S.K is Editor-in-Chief at NEJM AI, a publication of the Massachusetts Medical Society; he reports honoraria for lectures or other educational activities at the University of Massachusetts (Amherst), Morehouse, Simons Foundation, Cincinnati Children’s Hospital and University of Pennsylvania; board membership with Canary Medical, Pulse Data and Inovalon. Authors may have received financial support from their institutions or the NEJM AI/MMS to attend the RAISE in person. C.B.G., P.F.B. J. Dixon, G.S.O., R.R., N.B., J.B.P. R.S. and H.S. report no conflicts of interest.

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Goldberg, C.B., Adams, L., Blumenthal, D. et al. To do no harm — and the most good — with AI in health care. Nat Med 30, 623–627 (2024). https://doi.org/10.1038/s41591-024-02853-7

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