Ethical challenges and evolving strategies in the integration of artificial intelligence into clinical practice.

PLOS digital health Pub Date : 2025-04-08 eCollection Date: 2025-04-01 DOI:10.1371/journal.pdig.0000810
Ellison B Weiner, Irene Dankwa-Mullan, William A Nelson, Saeed Hassanpour
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Abstract

Artificial intelligence (AI) has rapidly transformed various sectors, including healthcare, where it holds the potential to transform clinical practice and improve patient outcomes. However, its integration into medical settings brings significant ethical challenges that need careful consideration. This paper examines the current state of AI in healthcare, focusing on five critical ethical concerns: justice and fairness, transparency, patient consent and confidentiality, accountability, and patient-centered and equitable care. These concerns are particularly pressing as AI systems can perpetuate or even exacerbate existing biases, often resulting from non-representative datasets and opaque model development processes. The paper explores how bias, lack of transparency, and challenges in maintaining patient trust can undermine the effectiveness and fairness of AI applications in healthcare. In addition, we review existing frameworks for the regulation and deployment of AI, identifying gaps that limit the widespread adoption of these systems in a just and equitable manner. Our analysis provides recommendations to address these ethical challenges, emphasizing the need for fairness in algorithm design, transparency in model decision-making, and patient-centered approaches to consent and data privacy. By highlighting the importance of continuous ethical scrutiny and collaboration between AI developers, clinicians, and ethicists, we outline pathways for achieving more responsible and inclusive AI implementation in healthcare. These strategies, if adopted, could enhance both the clinical value of AI and the trustworthiness of AI systems among patients and healthcare professionals, ensuring that these technologies serve all populations equitably.

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