Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
Care and Public Health Research Institute, Universiteit Maastricht, Maastricht, The Netherlands.
Bioethics. 2023 Jun;37(5):424-429. doi: 10.1111/bioe.13158. Epub 2023 Mar 25.
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.
人工智能（AI）为基础的临床决策支持系统（CDSS）在医疗保健领域日益普及，可能在诊断和治疗过程中发挥重要作用。基于此，人工智能为基础的 CDSS 对医患关系产生影响，其建议影响着医生的决策。我们可能正处于一个范式转变的边缘，医患关系不再是一种二元关系，而是一种三元关系。本文分析了人工智能为基础的 CDSS 在共同决策中的作用，以更好地理解其承诺和相关的伦理问题。此外，还研究了某些人工智能的实施方式如何反而助长了不恰当的家长主义范式。理解人工智能与医生的关系以及对医患沟通的影响，对于促进更符合伦理的医疗实践至关重要。在人工智能的背景下，需要考虑医生和患者的自主权。
