Giorgia Lorenzini et al. examine the evolving nature of the doctor-patient relationship in the context of integrating artificial intelligence (AI) into healthcare. They focus on the shared decision-making (SDM) process between doctors and patients, a consensual partnership founded on communication and respect for voluntary choices. The authors argue that the introduction of AI can potentially enhance SDM, provided it is implemented with care and consideration. The paper addresses the communication between doctors and AI and the communication of this interaction to patients, evaluating its potential impact on SDM and proposing strategies to preserve both doctors’ and patients’ autonomy.
The authors explore the communication and autonomy challenges arising from AI integration into clinical practice. They posit that AI’s influence could unintentionally limit doctors’ autonomy by heavily guiding their decisions, which in turn raises questions about the balance of power in the decision-making process. The paper emphasizes the importance of doctors understanding AI’s recommendations and checking for errors while also being competent in working with AI systems. By examining the “black box problem” of AI’s opaqueness, the authors argue that explainability is crucial for fostering the AI-doctor relationship and preserving doctors’ autonomy.
The paper then investigates doctor-patient communication and autonomy within the context of AI integration. The authors argue that in order to promote patients’ autonomy and encourage their participation in SDM, doctors must disclose and discuss AI’s involvement in the clinical evaluation process. They also contend that AI should consider patients’ preferences and unique situations, thus ensuring that their values are respected and that they are able to participate actively in the SDM process.
In relating the research to broader philosophical issues, the authors’ examination of the AI-doctor-patient relationship aligns with questions surrounding the ethical and moral implications of AI in society. As AI increasingly permeates various aspects of our lives, its impact on human autonomy, agency, and moral responsibility becomes a focal point for philosophical inquiry. The paper contributes to this discourse by delving into the specific context of healthcare and the evolving dynamics of the doctor-patient relationship, providing a microcosm for understanding the broader implications of AI integration in human decision-making processes.
As the authors outline the potential benefits and challenges of incorporating AI into the SDM process, future research could investigate the practical implementation of AI in various clinical settings, evaluating the effectiveness of AI-doctor collaboration in promoting SDM. Further research might also address the training and education necessary for medical professionals to adapt to AI integration, ensuring a seamless transition that optimizes patient care. Additionally, exploring methods for incorporating patients’ values into AI algorithms could provide a path to more personalized and autonomy-respecting AI-assisted healthcare.
Abstract
Artificial intelligence (AI) based clinical decision support systems (CDSS) are becoming ever more widespread in healthcare and could play an important role in diagnostic and treatment processes. For this reason, AI-based CDSS has an impact on the doctor–patient relationship, shaping their decisions with its suggestions. We may be on the verge of a paradigm shift, where the doctor–patient relationship is no longer a dual relationship, but a triad. This paper analyses the role of AI-based CDSS for shared decision-making to better comprehend its promises and associated ethical issues. Moreover, it investigates how certain AI implementations may instead foster the inappropriate paradigm of paternalism. Understanding how AI relates to doctors and influences doctor–patient communication is essential to promote more ethical medical practice. Both doctors’ and patients’ autonomy need to be considered in the light of AI.
Artificial intelligence and the doctor–patient relationship expanding the paradigm of shared decision making
