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| EDITORIAL |
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| Year : 2023 | Volume
: 2
| Issue : 1 | Page : 7-9 |
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The ethics of artificial intelligence in healthcare: Balancing innovation and patient autonomy
Sheikh Mohd Saleem1, S Muhammad Salim Khan2
1 Technical Expert EMTCT, Independent Public Health Consultant, New Delhi, India
2 Department of Community Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
| Date of Submission | 14-Mar-2023 |
| Date of Decision | 20-Mar-2023 |
| Date of Acceptance | 04-Apr-2023 |
| Date of Web Publication | 21-Aug-2023 |
Correspondence Address:
Dr. Sheikh Mohd Saleem
Technical Expert EMTCT, Independent Public Health Consultant, New Delhi
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JIMPH.JIMPH_2_23
How to cite this article:
Saleem SM, Salim Khan S M. The ethics of artificial intelligence in healthcare: Balancing innovation and patient autonomy. J Integr Med Public Health 2023;2:7-9 |
How to cite this URL:
Saleem SM, Salim Khan S M. The ethics of artificial intelligence in healthcare: Balancing innovation and patient autonomy. J Integr Med Public Health [serial online] 2023 [cited 2023 Sep 21];2:7-9. Available from: http://www.jimph.org/text.asp?2023/2/1/7/384121 |
| Introduction | |  |
Artificial intelligence (AI) has been an area of interest and development for several decades now. However, recent advancements in technology have made AI more prevalent across various industries, including healthcare. In healthcare, AI is primarily used for diagnosis, treatment, and patient management. The potential benefits of AI in healthcare are immense, including faster and more accurate diagnoses, personalized medicine, and improved patient outcomes.[1]
However, the integration of AI in healthcare also raises important ethical concerns that must be addressed to ensure that patients receive the best possible care while also respecting their autonomy and privacy.[2]
In this editorial, we discuss the ethical issues raised by the use of AI in healthcare, with a focus on balancing innovation and patient autonomy. We explore the potential benefits of AI in healthcare, as well as the ethical concerns that need to be considered when integrating AI into medical practice. In addition, we examine the role of healthcare providers in ensuring that AI is used in a responsible and ethical manner.
The benefits of artificial intelligence in healthcare
The integration of AI in healthcare has the potential to significantly improve patient outcomes. One of its most notable benefits is its ability to process vast amounts of data quickly and accurately. By analyzing patient data, including medical histories, laboratory results, and imaging studies, AI algorithms can identify patterns and trends that might be overlooked by human clinicians. This can lead to faster and more precise diagnoses, personalized treatment plans, and ultimately better patient outcomes. The use of AI in healthcare has the potential to transform the field and improve patient care on a large scale.
In addition to improving diagnosis and treatment, AI can also enhance patient management in healthcare. By monitoring patient vital signs in real time, AI systems can alert clinicians to potential issues before they become critical. This allows healthcare providers to intervene early and prevent adverse events, thus improving patient outcomes. Furthermore, AI can analyze patient data to identify those who are at higher risk of developing certain conditions, enabling more targeted interventions and preventive care. Thus, the use of AI in patient management has great potential to improve patient outcomes by enabling early intervention, reducing adverse events, and providing more personalized care.
AI can also enhance the efficiency of healthcare delivery by automating tasks like appointment scheduling and prescription refills. AI can save clinicians time, enabling them to focus more on patient care. Furthermore, AI-powered chatbots can triage patient inquiries, providing timely information to patients while freeing up healthcare providers to handle more complex cases. The use of AI in healthcare can enhance the productivity of healthcare providers, ultimately leading to improved patient care and better outcomes.
Ethical concerns raised by artificial intelligence in healthcare
Despite the potential benefits of AI in healthcare, its integration also raises important ethical concerns that must be addressed beforehand. One of the primary ethical concerns is the potential for bias. AI systems are only as objective as the data they are trained on, and if the data are biased in any way, the AI system will also be biased.[3] This can result in disparities in healthcare outcomes for different patient populations, particularly for marginalized communities. For instance, an AI system trained on data primarily from white patients based on sociodemographic, cultural, and economic dimensions may not be as effective in diagnosing illnesses in patients of color, potentially leading to suboptimal patient care. Addressing this ethical concern is crucial to ensure that AI in healthcare is used in a fair and equitable manner for all patients.
To prevent bias in AI systems, it is critical for healthcare providers to carefully consider the data used to train these systems and ensure it represents all patient populations globally. Moreover, healthcare providers must regularly monitor AI systems to ensure they function as intended and any biases are identified and promptly corrected. This requires a commitment to ongoing evaluation and improvement of AI systems to mitigate potential harm to patients. Ensuring that AI systems are used ethically and equitably in healthcare, requires a collaborative effort between healthcare providers, data scientists, and ethicists to establish best practices and guidelines for their development and implementation.
Another ethical concern regarding AI in healthcare is the potential loss of patient autonomy. As AI systems become more prevalent in healthcare, patients may feel as though they are no longer in control of their healthcare decisions, which can result in feelings of distrust and decreased patient satisfaction.[4] To address this issue, healthcare providers should ensure that patients are fully informed about the ways in which AI is being used in their care and should provide opportunities for patients to provide input into the decision-making process. In addition, healthcare providers should be transparent about the ethical concerns raised by AI in healthcare to build trust and ensure patients remain central to their own healthcare decisions. It is crucial for healthcare providers to prioritize patient autonomy and ensure that AI is used in a way that respects patients’ rights to informed consent, decision participation, and self-determination.
Furthermore, healthcare organizations must prioritize protecting patient privacy and ensuring that any data collected are securely stored and used in compliance with applicable regulations and ethical standards. To promote trust among patients and healthcare providers and maximize the potential benefits of this technology for improving patient outcomes, maintaining transparency and accountability throughout the development and implementation of AI systems in healthcare is vital.[5] Healthcare providers must recognize that patient data are sensitive and should be treated with the utmost care to protect patient privacy and maintain trust. It is essential to establish clear policies and procedures for collecting, storing, and using patient data, and to ensure that patients have control over their own health information. By prioritizing ethical considerations and patient privacy, healthcare organizations can help ensure that the integration of AI in healthcare benefits patients while minimizing potential risks.
Another related ethical concern is the potential for AI to undermine the physician–patient relationship. With the increasing use of AI systems in healthcare, there is a risk that patients may view AI as their primary healthcare provider, rather than their human physician. This can lead to a breakdown in the trust and communication that is crucial to effective patient care. To prevent this, healthcare providers must ensure that AI is used to supplement, rather than replace, human interface of clinical decision-making. Patients should be informed that AI is just one tool in their healthcare provider’s arsenal, and that the ultimate decision-making authority still rests with their human physician. Healthcare providers must prioritize patient education and communication to ensure that patients understand the role of AI in their care and the importance of the physician–patient relationship in achieving optimal health outcomes. By doing so, healthcare providers can help ensure that AI is integrated into healthcare in a responsible and ethical manner.
In addition to these technical measures, healthcare providers should also consider the ethical implications of data collection and use in AI systems. Patients have a right to know what data are being collected about them and how they will be used for data mining. Healthcare providers must obtain informed consent from patients before collecting and using their personal data, and patients should be able to opt out of data collection if they choose so. In addition, healthcare providers should consider the long-term implications of data collection and use in AI systems, including potential discrimination, stigmatization, or loss of opportunities for patients whose data are collected and analyzed. By taking a proactive approach to addressing these ethical concerns, healthcare providers can ensure that AI is used responsibly and ethically to improve patient outcomes while protecting patient autonomy, privacy, and trust.
Balancing innovation and ensuring ethical artificial intelligence use
Balancing innovation in healthcare is a critical challenge that requires careful consideration of ethical principles and values. On the one hand, innovation is essential for advancing the field of healthcare, improving patient outcomes, and reducing costs. On the other hand, innovation can also introduce new risks and challenges that may threaten patient autonomy and well-being.
To strike a balance between innovation and patient autonomy in healthcare, it is important to consider the following principles:
Beneficence
Innovations in healthcare should aim to improve patient outcomes and promote well-being.
Non-maleficence
Innovations should not cause harm to patients, either directly or indirectly.
Autonomy
Patients have the right to make informed decisions about their health and well-being.
Justice
Innovations should be distributed equitably across different populations and communities.
To achieve a balance between innovation and patient autonomy, healthcare providers and researchers must prioritize the well-being and interests of patients above all else. Patients should be involved in the decision-making process and given the necessary information to make informed choices about their healthcare. Transparency and accountability should be prioritized in the development and deployment of new technologies, including AI. Healthcare providers and researchers must openly communicate the potential risks and benefits of new technologies and take responsibility for any negative consequences.
Objectivity and impartiality must be maintained while assessing new technologies, and any conflicts of interest must be avoided. To promote patient autonomy, healthcare providers should involve patients in decision-making and provide clear and transparent information about AI use in healthcare. Patients should be informed about how AI is used in diagnosis and treatment and given the opportunity to ask questions and provide feedback. To protect patient data privacy, healthcare providers should ensure secure data storage and transmission, regularly monitor for data breaches, and inform patients promptly if data are compromised. Data sharing should comply with ethical standards and regulations. To maintain patient control over healthcare decisions, providers should be transparent about AI use, provide clear information about data collection and purpose, and allow patients to contribute to the decision-making process. In addition, patient data privacy should be safeguarded through secure storage, monitoring, and notification of data breaches.
| Conclusion | | |
The use of AI in healthcare has the potential to transform patient care, but it also poses significant ethical concerns that must be addressed. Healthcare providers play a crucial role in preventing bias in AI systems, ensuring that patients retain control over their healthcare decisions, and safeguarding patient data privacy. By addressing these ethical issues, healthcare providers can leverage the potential of AI to enhance patient outcomes while upholding patient autonomy.
Financial support and sponsorship
Not applicable.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Thielman S, Herrmann D. The ethics of artificial intelligence in health care. AMA J Ethics 2019;21:E167-173.  |
| 2. | Davenport T, Kalakota R. The potential for artificial intelligence in healthcare. Future Healthc J 2019;6:94-8. |
| 3. | Nundy S, Montgomery T. Waking up from the AI dream: The need for due diligence and transparency in public health AI. Lancet Digital Health 2019;1:e5-7. |
| 4. | Mackenzie C, Rachul C. “To Be, or Not to Be,” in control of health-care decisions: Understanding when “Preferences” are talk and when they are action. AJOB Neuroscience 2018;9:118-20. |
| 5. | Karami A, Dahl AA. Artificial intelligence in healthcare: Ethical, legal, and social implications. Int J Med Inform 2021;150:104454. |
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