Should Artificial Intelligence be used to support clinical ethical decision-making? A systematic review of reasons.

Autor: Benzinger L; Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany. benzinger.lasse@mh-hannover.de., Ursin F; Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany., Balke WT; Institute for Information Systems, TU Braunschweig, Braunschweig, Germany., Kacprowski T; Division Data Science in Biomedicine, Peter L. Reichertz Institute for Medical Informatics of Technische Universität Braunschweig and Hannover Medical School, Braunschweig, Germany.; Braunschweig Integrated Centre for Systems Biology (BRICS), TU Braunschweig, Braunschweig, Germany., Salloch S; Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Jazyk: angličtina
Zdroj: BMC medical ethics [BMC Med Ethics] 2023 Jul 06; Vol. 24 (1), pp. 48. Date of Electronic Publication: 2023 Jul 06.
DOI: 10.1186/s12910-023-00929-6
Abstrakt: Background: Healthcare providers have to make ethically complex clinical decisions which may be a source of stress. Researchers have recently introduced Artificial Intelligence (AI)-based applications to assist in clinical ethical decision-making. However, the use of such tools is controversial. This review aims to provide a comprehensive overview of the reasons given in the academic literature for and against their use.
Methods: PubMed, Web of Science, Philpapers.org and Google Scholar were searched for all relevant publications. The resulting set of publications was title and abstract screened according to defined inclusion and exclusion criteria, resulting in 44 papers whose full texts were analysed using the Kuckartz method of qualitative text analysis.
Results: Artificial Intelligence might increase patient autonomy by improving the accuracy of predictions and allowing patients to receive their preferred treatment. It is thought to increase beneficence by providing reliable information, thereby, supporting surrogate decision-making. Some authors fear that reducing ethical decision-making to statistical correlations may limit autonomy. Others argue that AI may not be able to replicate the process of ethical deliberation because it lacks human characteristics. Concerns have been raised about issues of justice, as AI may replicate existing biases in the decision-making process.
Conclusions: The prospective benefits of using AI in clinical ethical decision-making are manifold, but its development and use should be undertaken carefully to avoid ethical pitfalls. Several issues that are central to the discussion of Clinical Decision Support Systems, such as justice, explicability or human-machine interaction, have been neglected in the debate on AI for clinical ethics so far.
Trial Registration: This review is registered at Open Science Framework ( https://osf.io/wvcs9 ).
(© 2023. The Author(s).)
Databáze: MEDLINE
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