Western University, London, ON, Canada.
Athabasca University, Athabasca, Alberta, Canada.
BMC Med Ethics. 2024 Nov 27;25(1):143. doi: 10.1186/s12910-024-01140-x.
Technological change is impacting the work of health professionals, especially with recent developments in artificial intelligence. Research has raised many ethical considerations respecting clinical applications of artificial intelligence, and it has identified a role for professional regulation in helping to guide practitioners in the ethical use of technology; however, regulation in this area has been slow to develop. This study seeks to identify the challenges that health professionals face in the context of technological change, and whether regulators' codes of ethics and guidance are sufficient to help workers navigate these changes.
We conducted mixed methods research in Ontario, Canada, using qualitative content analysis of regulators' codes of ethics and practice guidance (26 regulators, 63 documents analysed), interviews with 7 representatives from 5 health profession regulatory bodies, and focus groups with 17 healthcare practitioners across 5 professions in the province. We used thematic analysis to analyse the data and answer our core research questions.
We find that codes of ethics focus more on general principles and managing practitioners' relationships with clients/patients; hence, it is not clear that these documents can successfully guide professional practice in a context of rapid technological change. Practitioners and regulatory body staff express ambivalence and uncertainty about regulators' roles in regulating technology use. In some instances, health professionals experience conflict between the expectations of their regulator and their employer. These gaps and conflicts leave some professionals uncertain about how to practice ethically in a digital age.
There is a need for more guidance and regulation in this area, not only for practitioners, but with respect to the application of technology within the environments in which health professionals work.
技术变革正在影响医疗专业人员的工作，尤其是在人工智能方面的最新进展。研究提出了许多与人工智能在临床应用方面有关的伦理问题，并确定了专业监管在帮助指导从业者以合乎道德的方式使用技术方面的作用；然而，这一领域的监管发展缓慢。本研究旨在确定医疗专业人员在技术变革背景下面临的挑战，以及监管机构的道德规范和指导方针是否足以帮助工作人员应对这些变化。
我们在加拿大安大略省进行了混合方法研究，对监管机构的道德规范和实践指南（26 个监管机构，分析了 63 份文件）进行了定性内容分析，对来自 5 个健康专业监管机构的 7 名代表进行了访谈，并对全省 5 个专业的 17 名医疗保健从业者进行了焦点小组讨论。我们使用主题分析来分析数据并回答我们的核心研究问题。
我们发现，道德规范更多地关注一般原则和管理从业者与客户/患者的关系；因此，这些文件是否能够在快速技术变革的背景下成功指导专业实践尚不清楚。从业者和监管机构工作人员对监管机构在监管技术使用方面的角色表示矛盾和不确定。在某些情况下，医疗专业人员在其监管机构和雇主的期望之间感到冲突。这些差距和冲突使一些专业人员对如何在数字时代以合乎道德的方式实践感到不确定。
需要在这一领域制定更多的指导和监管措施，不仅是为了从业者，而且还需要规范技术在医疗专业人员工作环境中的应用。
