{"title":"Artificial Intelligence and Decision-Making in Oncology: A Review of Ethical, Legal, and Informed Consent Challenges.","authors":"Eliza-Maria Froicu, Ioana Creangă-Murariu, Vlad-Adrian Afrăsânie, Bogdan Gafton, Teodora Alexa-Stratulat, Lucian Miron, Diana Maria Pușcașu, Vladimir Poroch, Gema Bacoanu, Iulian Radu, Mihai-Vasile Marinca","doi":"10.1007/s11912-025-01698-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Artificial Intelligence (AI) integration in oncology is transforming therapeutic decision-making by providing clinical decision support. AI may improve treatment precision, but it raises ethical, legal, and informed consent issues. This review examines these paramount AI implementation issues in cancer care. This systematic review followed the PRISMA 2020 guidelines and was prospectively registered in the PROSPERO (CRD420251046482) database. A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane CENTRAL Library to identify studies published between January 2015 and May 2025. AI-supported oncology therapeutic decision-making studies with ethical, legal, or informed consent implications were eligible.</p><p><strong>Recent findings: </strong>Fifteen studies met the inclusion criteria. AI applications were found to support treatment recommendations, personalize drug dosing, and improve adherence and patient management. Despite these benefits, the review highlighted key concerns, including algorithmic transparency, unclear accountability in AI-guided decisions, data privacy, and gaps in patient understanding of AI's role in their care. AI has the potential to enhance oncological care, but ethical and legal issues must be addressed for safe and equitable implementation. Emphasis should be placed on developing robust informed consent models, mitigating algorithmic bias, and establishing clear legal accountability. Future research must establish ethical frameworks and regulatory mechanisms to protect patient autonomy and responsibly integrate AI into oncology.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":" ","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Oncology Reports","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11912-025-01698-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose of review: Artificial Intelligence (AI) integration in oncology is transforming therapeutic decision-making by providing clinical decision support. AI may improve treatment precision, but it raises ethical, legal, and informed consent issues. This review examines these paramount AI implementation issues in cancer care. This systematic review followed the PRISMA 2020 guidelines and was prospectively registered in the PROSPERO (CRD420251046482) database. A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane CENTRAL Library to identify studies published between January 2015 and May 2025. AI-supported oncology therapeutic decision-making studies with ethical, legal, or informed consent implications were eligible.
Recent findings: Fifteen studies met the inclusion criteria. AI applications were found to support treatment recommendations, personalize drug dosing, and improve adherence and patient management. Despite these benefits, the review highlighted key concerns, including algorithmic transparency, unclear accountability in AI-guided decisions, data privacy, and gaps in patient understanding of AI's role in their care. AI has the potential to enhance oncological care, but ethical and legal issues must be addressed for safe and equitable implementation. Emphasis should be placed on developing robust informed consent models, mitigating algorithmic bias, and establishing clear legal accountability. Future research must establish ethical frameworks and regulatory mechanisms to protect patient autonomy and responsibly integrate AI into oncology.
综述目的：人工智能（AI）在肿瘤学中的整合正在通过提供临床决策支持来改变治疗决策。人工智能可能会提高治疗精度，但它会引发伦理、法律和知情同意问题。这篇综述探讨了这些重要的人工智能在癌症治疗中的实施问题。该系统评价遵循PRISMA 2020指南，并在PROSPERO （CRD420251046482）数据库中前瞻性注册。在PubMed、Embase和Cochrane CENTRAL Library进行了全面的文献检索，以确定2015年1月至2025年5月之间发表的研究。具有伦理、法律或知情同意意义的人工智能支持的肿瘤治疗决策研究符合条件。最新发现：15项研究符合纳入标准。人工智能应用程序支持治疗建议，个性化药物剂量，并改善依从性和患者管理。尽管有这些好处，但审查强调了一些关键问题，包括算法透明度、人工智能指导决策的问责不明确、数据隐私以及患者对人工智能在其护理中的作用的理解存在差距。人工智能具有加强肿瘤护理的潜力，但必须解决伦理和法律问题，才能安全和公平地实施。重点应放在建立健全的知情同意模型、减轻算法偏见和建立明确的法律责任上。未来的研究必须建立伦理框架和监管机制，以保护患者的自主权，并负责任地将人工智能纳入肿瘤学。
期刊介绍：
This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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