School of Rural Health (Dubbo/Orange), Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Sydney Health Ethics, School of Public Health, University of Sydney, Sydney, Australia.
J Bioeth Inq. 2021 Mar;18(1):121-139. doi: 10.1007/s11673-020-10080-1. Epub 2021 Jan 7.
The rapid adoption and implementation of artificial intelligence in medicine creates an ontologically distinct situation from prior care models. There are both potential advantages and disadvantages with such technology in advancing the interests of patients, with resultant ontological and epistemic concerns for physicians and patients relating to the instatiation of AI as a dependent, semi- or fully-autonomous agent in the encounter. The concept of libertarian paternalism potentially exercised by AI (and those who control it) has created challenges to conventional assessments of patient and physician autonomy. The unclear legal relationship between AI and its users cannot be settled presently, an progress in AI and its implementation in patient care will necessitate an iterative discourse to preserve humanitarian concerns in future models of care. This paper proposes that physicians should neither uncritically accept nor unreasonably resist developments in AI but must actively engage and contribute to the discourse, since AI will affect their roles and the nature of their work. One's moral imaginative capacity must be engaged in the questions of beneficence, autonomy, and justice of AI and whether its integration in healthcare has the potential to augment or interfere with the ends of medical practice.
人工智能在医学中的快速采用和实施，相较于以往的医疗模式，产生了一种本体论上截然不同的情况。这种技术在推进患者利益方面既有潜在的优势，也有潜在的劣势，这给医生和患者带来了与人工智能作为一种依赖、半自主或全自主代理在医疗过程中实施相关的本体论和认识论问题。人工智能（以及控制它的人）可能实施的自由意志家长主义概念，对传统的患者和医生自主权评估提出了挑战。人工智能及其使用者之间的法律关系目前尚不清楚，随着人工智能的发展及其在患者护理中的应用，未来的护理模式将需要进行迭代讨论，以保护人道主义关注。本文提出，医生既不应盲目接受，也不应不合理地抵制人工智能的发展，而必须积极参与并为讨论做出贡献，因为人工智能将影响他们的角色和工作性质。人们的道德想象力必须参与到人工智能的功利、自主和正义问题中，以及其在医疗保健中的整合是否有可能增强或干扰医疗实践的目的。
