对将基于人工智能的技术应用于老年患者治疗和连续性护理中所涉及的关注点、机会和限制的专业意见进行伦理评估。
An ethical assessment of professional opinions on concerns, chances, and limitations of the implementation of an artificial intelligence-based technology into the geriatric patient treatment and continuity of care.
机构信息
Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Oberberghof 7, 89081, Ulm, Baden-Wuerttemberg, Germany.
出版信息
Geroscience. 2024 Dec;46(6):6269-6282. doi: 10.1007/s11357-024-01229-6. Epub 2024 Jun 4.
With the introduction of an artificial intelligence-based dashboard into the clinic, the project SURGE-Ahead responds to the importance of improving perioperative geriatric patient treatment and continuity of care. The use of artificial intelligence to process and analyze data automatically, aims at an evidence-based evaluation of the patient's health condition and recommending treatment options. However, its development and introduction raise ethical questions. To ascertain professional perspectives on the clinical use of the dashboard, we have conducted 19 semi-structured qualitative interviews with head physicians, computer scientists, jurists, and ethicists. The application of a qualitative content analysis and thematic analysis enabled the detection of main ethical concerns, chances, and limitations. These ethical considerations were categorized: changes of the patient-physician relationship and the current social reality are expected, causing de-skilling and an active participation of the artificial intelligence. The interviewees anticipated a redistribution of human resources, time, knowledge, and experiences as well as expenses and financing. Concerns of privacy, accuracy, transparency, and explainability were stated, and an insufficient data basis, an intensifying of existing inequalities and systematic discrimination considering a fair access emphasized. Concluding, the patient-physician relationship, social reality, redistribution of resources, fair access, as well as data-related aspects of the artificial intelligence-based system could conflict with the ethical principles of autonomy, non-maleficence, beneficence, and social justice. To respond to these ethical concerns, a responsible use of the dashboard and a critical verification of therapy suggestions is mandatory, and the application limited by questions at the end of life and taking life-changing decisions.
随着基于人工智能的仪表盘在临床中的引入,SURGE-Ahead 项目响应了改善围手术期老年患者治疗和护理连续性的重要性。使用人工智能自动处理和分析数据,旨在对患者的健康状况进行基于证据的评估,并推荐治疗方案。然而,它的开发和引入引发了伦理问题。为了确定专业人员对该仪表盘临床应用的看法,我们对主治医生、计算机科学家、法学家和伦理学家进行了 19 次半结构化定性访谈。采用定性内容分析和主题分析的方法,检测到主要的伦理关注点、机会和限制。这些伦理考虑因素被分类为:预计会改变医患关系和当前的社会现实,导致技能下降和人工智能的积极参与。受访者预计会重新分配人力资源、时间、知识和经验以及费用和融资。还提到了对隐私、准确性、透明度和可解释性的担忧,并强调了数据基础不足、现有不平等加剧以及考虑公平准入的系统歧视。综上所述,基于人工智能的系统的医患关系、社会现实、资源重新分配、公平准入以及与数据相关的方面可能与自主、不伤害、受益和社会公正的伦理原则相冲突。为了应对这些伦理问题,必须负责任地使用仪表盘,并对治疗建议进行批判性验证,同时将应用限制在生命末期的问题和改变生活的决策上。