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在姑息治疗中使用人工智能的伦理维度。

The ethical dimensions of utilizing Artificial Intelligence in palliative care.

作者信息

Oh Oonjee, Demiris George, Ulrich Connie M

机构信息

School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.

Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Nurs Ethics. 2025 Jun;32(4):1285-1296. doi: 10.1177/09697330241296874. Epub 2024 Nov 17.

Abstract

Palliative care aims to improve the quality of life for seriously ill individuals and their caregivers by addressing their holistic care needs through a person- and family-centered approach. While there have been growing efforts to integrate Artificial Intelligence (AI) into palliative care practice and research, it remains unclear whether the use of AI can facilitate the goals of palliative care. In this paper, we present three hypothetical case examples of using AI in the palliative care context, covering machine learning algorithms that predict patient mortality, natural language processing models that detect psychological symptoms, and AI chatbots addressing caregivers' unmet needs. Using these cases, we examine the ethical dimensions of utilizing AI in palliative care by applying five widely accepted moral principles that guide ethical deliberations in AI: beneficence, nonmaleficence, autonomy, justice, and explicability. We address key ethical questions arising from these five core moral principles and analyze the potential impact the use of AI can have on palliative care stakeholders. Applying a critical lens, we assess whether AI can facilitate the primary aim of palliative care to support seriously ill individuals and their families. We conclude by discussing the gaps that need to be further addressed in order to promote ethical and responsible AI usage in palliative care.

摘要

姑息治疗旨在通过以患者和家庭为中心的方法满足他们的整体护理需求,从而提高重症患者及其护理人员的生活质量。虽然将人工智能(AI)整合到姑息治疗实践和研究中的努力不断增加,但使用AI是否能促进姑息治疗的目标仍不明确。在本文中,我们展示了在姑息治疗背景下使用AI的三个假设案例,涵盖预测患者死亡率的机器学习算法、检测心理症状的自然语言处理模型以及满足护理人员未满足需求的AI聊天机器人。通过这些案例,我们应用指导AI伦理审议的五个广泛接受的道德原则: beneficence(行善)、nonmaleficence(不伤害)、autonomy(自主)、justice(公正)和explicability(可解释性),来审视在姑息治疗中使用AI的伦理维度。我们探讨了由这五个核心道德原则引发的关键伦理问题,并分析了使用AI对姑息治疗利益相关者可能产生的影响。通过批判性视角,我们评估AI是否能促进姑息治疗支持重症患者及其家庭的主要目标。最后,我们讨论为促进在姑息治疗中道德且负责任地使用AI需要进一步解决的差距。

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