Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 6;24(1):48.
doi: 10.1186/s12910-023-00929-6.

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

Lasse Benzinger  1 , Frank Ursin  2 , Wolf-Tilo Balke  3 , Tim Kacprowski  4   5 , Sabine Salloch  2
Affiliations

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

Lasse Benzinger et al. BMC Med Ethics. .

Abstract

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 ).

Keywords: Decision support systems, clinical; Decision-making, artificial intelligence; Ethics, Clinical; Systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the literature selection
Fig. 2
Fig. 2
Number of publications included per year
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Sorta-Bilajac I, Bazdarić K, Brozović B, et al. Croatian physicians’ and nurses’ experience with ethical issues in clinical practice. J Med Ethics. 2008;34:450–455. doi: 10.1136/jme.2007.021402. - DOI - PubMed
    1. Doran E, Fleming J, Jordens C, et al. Managing ethical issues in patient care and the need for clinical ethics support. Aust Health Rev. 2015;39:44–50. doi: 10.1071/AH14034. - DOI - PubMed
    1. Hurst SA, Perrier A, Pegoraro R, et al. Ethical difficulties in clinical practice: experiences of European doctors. J Med Ethics. 2007;33:51–57. doi: 10.1136/jme.2005.014266. - DOI - PMC - PubMed
    1. West J. Ethical issues and new nurses: preventing ethical distress in the work environment. Kans Nurse. 2007;82:5–8. - PubMed
    1. Flannery L, Ramjan LM, Peters K. End-of-life decisions in the Intensive Care Unit (ICU) – Exploring the experiences of ICU nurses and doctors – A critical literature review. Aust Crit Care. 2016;29:97–103. doi: 10.1016/j.aucc.2015.07.004. - DOI - PubMed

Publication types

LinkOut - more resources