谷歌醫療數據交易引發質疑
This is the story of two deals and the future of healthcare in the UK.
這是一個關於兩筆交易以及英國醫療衛生事業未來的故事。
The first was made in September 2015, under which three UK hospitals in the Royal Free NHS Trust handed the identifiable patient records of more than 2m Londoners to DeepMind, an artificial intelligence company wholly owned by Google.
第一筆交易完成於2015年9月，根據這項交易，三家隸屬英國皇家自由NHS信託基金會(Royal Free NHS Trust)的醫院將超過200萬名倫敦市民的可識別個人身份的病歷交給了DeepMind，谷歌(Google)全資擁有的一家人工智能公司。
With the company riding high on breakthroughs in the fields of game play and image recognition, DeepMind Health was launched in February.
隨着DeepMind在遊戲競技以及圖像識別領域不斷取得重大突破，DeepMind Health在今年2月應運而生。
Strangely for an AI company with no healthcare experience, DeepMind Health’s inaugural project claimed it had nothing to do with AI.
而對一家沒有醫療經驗的人工智能公司來說頗爲奇怪的是，DeepMind Health的首個項目號稱與人工智能沒有任何關係。
Rather, it involved developing Streams, a mobile app, to integrate data and co-ordinate push alerts concerning acute kidney injury,
相反，該項目涉及開發一款名爲Streams的移動應用，用於有關急性腎臟損傷的整合數據以及協調推送通知。
a serious condition affecting up to one in six National Health Service patients.
在英國國家醫療服務體系(NHS)的病人中，存在這一嚴重病情的病人比例高達六分之一。
In April, an investigation by New Scientist revealed the scale of DeepMind’s data hoard — a five-year superset, covering almost every patient passing through Royal Free — as well as the commercial terms: essentially, that there were none.
今年4月，由《新科學家》(New Scientist)進行的一項調查揭示了DeepMind海量數據的規模——這是一個時間跨度長達5年的超大集合，涵蓋了皇家自由基金會系統內的幾乎所有病人——調查還揭示了這些數據的商業條款：基本上沒有任何商業條款。
The claimed basis for sharing the data was implied consent for direct clinical care for kidney injury.
這一數據共享的公開依據是對腎臟損傷進行直接臨牀救治的默示同意。
The problem is that the data set extended well beyond those who will be monitored or treated for this condition: it extended hospital-wide, raising issues about proper compliance with data protection, privacy and medical confidentiality rules.
問題在於，數據集的覆蓋面遠遠超過了因這一病症而被監測或治療的羣體：數據延伸至整個醫院，由此引出了有關如何恰當遵守數據保護、隱私以及醫療保密等方面規定的問題。
Perhaps even more importantly, engaging with citizens about the deal and exploring the desirability of open, competitive, forward-looking service procurement beyond Google, seemed not to enter consideration.
或許更重要的是，與市民接觸、交流對於此項交易的看法，以及在谷歌之外探索公開、競爭性、前瞻的服務採購的可取程度，似乎並未被納入考慮範圍。
The second deal was rather more proactive.
第二項交易更加主動積極。
Last month, perhaps in anticipation of regulatory action after a year of silence (the first deal is the subject of an investigation by the UK Information Commissioner’s Office and a review by the National Data Guardian, plus DeepMind’s self-styled independent reviewers), a five-year agreement was signed.
上月，或許是預見到了在一年的沉寂之後將有監管舉措出臺（第一筆交易受到了英國信息專員辦公室(UK Information Commissioner’s Office)的調查以及國家健康和醫療數據守護者(National Data Guardian)的評估，DeepMind自詡的獨立評估方也參與了評估），雙方進一步簽署了一項爲期五年的合作協議。
This accord contains a remarkable pivot.
這項協議包含了一個值得關注的轉折。
After a year of structuring the whole Trust-wide data set, DeepMind has developed a software interface that allows multiple conditions to be monitored and provides a platform for an open innovation ecosystem.
在花費了一年時間設計整個基金會系統的數據集結構之後，DeepMind開發了一個軟件界面，可用於監測多種病情，併爲開放創新的生態系統提供一個平臺。
Open, that is, except that the platform is strictly owned and controlled by DeepMind under a time-bound licence that prevents the Royal Free hospital working directly with any other provider.
不過，這種開放是有限度的——整個平臺由DeepMind根據一項有時間限制的許可協議（阻止皇家自由醫院與其他任何提供商直接合作）嚴格擁有和掌控。
DeepMind, for its part, wishes to enable a community of innovators to develop niche applications over the top of data acquired through the first deal.
DeepMind希望藉此形成一個創新者社區，在通過第一項交易獲得的數據基礎上開發細分應用。
Many of DeepMind’s aspirations are laudable, particularly its promises to bring cutting-edge provenance, transparency and audit to data flows.
DeepMind有不少值得讚許的抱負，特別是該公司承諾將把尖端的來源鑑定、透明化以及審計技術應用到數據流上。
However, it is critical that this company’s dealmaking does not involve special treatment, particularly given it can only do much of what it does because of the money and power of Google, its patron, which has long coveted the healthcare market.
但有一點非常關鍵，該公司的商業交易不應牽涉特殊待遇，尤其是考慮到該公司之所以能開展其目前進行的絕大部分業務，靠的是來自其母公司谷歌的資金和影響力，而谷歌長期以來一直對醫療衛生市場垂涎三尺。
Until now, DeepMind’s deals have attracted no comment from those with oversight of sensitive data processing, despite clear questions about both the direct care justification for processing and where the control of data-processing lies.
直到現在，負責監督敏感數據處理的相關部門也沒有對DeepMind的交易發表評論，儘管在兩方面（以直接救治爲理由的數據處理，以及對數據處理的管控從何體現）明顯存在問題。
These deals matter as a litmus test of our institutions and our instincts, and whether we can advance technologically without evading due process and hard-earned rights.
這些交易意義重大，是檢驗我們的機構、我們的直覺、以及我們能否取得技術進步而不迴避正當程序和來之不易的權利的試金石。
The primary limits to promising advances in machine learning are access to data and computing power.
機器學習取得重大發展所面臨的主要限制在於數據的可獲得性以及計算能力。
The Royal Free deals do a civic disservice if they undervalue publicly funded data sets, while failing to consider the long-term consequences of giving advance access to powerful private prospectors.
皇家自由基金會的交易對公衆不利——如果它們低估了源於公共資金支持的數據集的價值，同時也未考慮到給予實力強勁的私營開拓企業先入優勢的長期後果。
DeepMind may be a worthy partner but it must prove itself as such so that the future of healthcare is genuinely competitive, open, fair and in the public interest.
DeepMind或許是一個有價值的合作伙伴，但該公司必須證明自己確實如此，以確保醫療衛生事業的未來真正具有競爭性、開放、公平以及符合公衆利益。
