Gianluca Montanari Vergallo, Laura Leondina Campanozzi, Matteo Gulino, Lorena Bassis, Pasquale Ricci, Simona Zaami, Susanna Marinelli, Vittoradolfo Tambone, Paola Frati
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引用次数: 0
Abstract
Background: This paper aims to outline an ethical overview of the potential challenges related to AI technologies in the doctor-patient relationship. Methods: This study is structured as a narrative review of the literature (2015-2025), based on searches conducted in the main scientific databases (PubMed, Scopus, Web of Science, Google Scholar), supplemented by official documents issued by the following international organizations: World Health Organization (WHO), United Nations Educational, Scientific and Cultural Organization (UNESCO), and the World Medical Association (WMA), as well as key regulatory frameworks of the European Union, China, and the United States. The selection included academic contributions, guidelines, and institutional reports relevant to the clinical applications of AI and their ethical and regulatory implications. Specifically, the analysis herein presented is grounded on four key aspects: the rationale for AI in patient care, informed consent about AI use, confidentiality, and the impact on the therapeutic alliance and medical professionalism. Results and Conclusions: Depending on their application, AI systems may offer benefits regarding the management of administrative burdens and in supporting clinical decisions. However, their applications in diagnostics, particularly in fields as radiology and dermatology, may also adversely impact the patient-doctor relationship and professional autonomy. Specifically, the implementation of these systems, including generative AI, may lead to increased healthcare costs and jeopardise the patient-doctor relationships by exposing patients' confidentiality to new risks and reducing space for healthcare empathy and personalisation. The future of the medical profession and the doctor-patient relationship will largely depend on the types of artificial intelligence that are integrated into clinical practice and how effectively such additions are reconciled with core ethical values on which healthcare rests within our systems and societies.
背景:本文旨在概述与人工智能技术在医患关系中相关的潜在挑战的伦理概述。方法:本研究采用叙述性文献综述(2015-2025)的结构,以主要科学数据库(PubMed、Scopus、Web of Science、b谷歌Scholar)的检索为基础,辅以以下国际组织发布的官方文件:世界卫生组织(世卫组织)、联合国教育、科学及文化组织(教科文组织)和世界医学会(世界医学会),以及欧盟、中国和美国的主要监管框架。入选内容包括与人工智能临床应用及其伦理和监管影响相关的学术贡献、指南和机构报告。具体而言,本文提出的分析基于四个关键方面:人工智能在患者护理中的基本原理、人工智能使用的知情同意、保密性以及对治疗联盟和医疗专业精神的影响。结果和结论:根据其应用,人工智能系统可能在管理行政负担和支持临床决策方面提供益处。然而,它们在诊断中的应用,特别是在放射学和皮肤病学领域,也可能对医患关系和专业自主产生不利影响。具体来说,这些系统的实施,包括生成式人工智能,可能会导致医疗成本的增加,并危及医患关系,因为患者的机密性暴露于新的风险中,并减少了医疗同理心和个性化的空间。医疗行业和医患关系的未来将在很大程度上取决于整合到临床实践中的人工智能的类型,以及这些附加功能如何有效地与我们系统和社会中医疗保健所依赖的核心道德价值观相协调。
期刊介绍:
Healthcare (ISSN 2227-9032) is an international, peer-reviewed, open access journal (free for readers), which publishes original theoretical and empirical work in the interdisciplinary area of all aspects of medicine and health care research. Healthcare publishes Original Research Articles, Reviews, Case Reports, Research Notes and Short Communications. We encourage researchers to publish their experimental and theoretical results in as much detail as possible. For theoretical papers, full details of proofs must be provided so that the results can be checked; for experimental papers, full experimental details must be provided so that the results can be reproduced. Additionally, electronic files or software regarding the full details of the calculations, experimental procedure, etc., can be deposited along with the publication as “Supplementary Material”.