Bratan Tanja, Schneider Diana, Funer Florian, Heyen Nils B, Klausen Andrea, Liedtke Wenke, Lipprandt Myriam, Salloch Sabine, Langanke Martin
Competence Center Neue Technologien, Fraunhofer-Institut für System- und Innovationsforschung ISI, Breslauer Straße 48, 76139, Karlsruhe, Deutschland.
Institut für Ethik, Geschichte und Philosophie der Medizin, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 Sep;67(9):1039-1046. doi: 10.1007/s00103-024-03918-1. Epub 2024 Jul 17.
Clinical decision support systems (CDSS) based on artificial intelligence (AI) are complex socio-technical innovations and are increasingly being used in medicine and nursing to improve the overall quality and efficiency of care, while also addressing limited financial and human resources. However, in addition to such intended clinical and organisational effects, far-reaching ethical, social and legal implications of AI-based CDSS on patient care and nursing are to be expected. To date, these normative-social implications have not been sufficiently investigated. The BMBF-funded project DESIREE (DEcision Support In Routine and Emergency HEalth Care: Ethical and Social Implications) has developed recommendations for the responsible design and use of clinical decision support systems. This article focuses primarily on ethical and social aspects of AI-based CDSS that could have a negative impact on patient health. Our recommendations are intended as additions to existing recommendations and are divided into the following action fields with relevance across all stakeholder groups: development, clinical use, information and consent, education and training, and (accompanying) research.
基于人工智能（AI）的临床决策支持系统（CDSS）是复杂的社会技术创新，在医学和护理领域的应用日益广泛，旨在提高护理的整体质量和效率，同时应对有限的财力和人力。然而，除了这些预期的临床和组织效果外，基于AI的CDSS对患者护理和护理工作还可能产生深远的伦理、社会和法律影响。迄今为止，这些规范性社会影响尚未得到充分研究。由德国联邦教育与研究部（BMBF）资助的项目DESIREE（日常和紧急医疗保健中的决策支持：伦理和社会影响）已就临床决策支持系统的负责任设计和使用制定了建议。本文主要关注基于AI的CDSS可能对患者健康产生负面影响的伦理和社会方面。我们的建议旨在补充现有建议，并分为以下与所有利益相关者群体相关的行动领域：开发、临床应用、信息与同意、教育与培训以及（伴随）研究。
