Elgin Cansu Yüksel, Elgin Ceyhun
Department of Ophthalmology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Bogazici University, Istanbul, Turkey.
BMC Med Ethics. 2024 Dec 21;25(1):148. doi: 10.1186/s12910-024-01151-8.
Artificial intelligence-driven Clinical Decision Support Systems (AI-CDSS) are increasingly being integrated into healthcare for various purposes, including resource allocation. While these systems promise improved efficiency and decision-making, they also raise significant ethical concerns. This study aims to explore healthcare professionals' perspectives on the ethical implications of using AI-CDSS for healthcare resource allocation.
We conducted semi-structured qualitative interviews with 23 healthcare professionals, including physicians, nurses, administrators, and medical ethicists in Turkey. Interviews focused on participants' views regarding the use of AI-CDSS in resource allocation, potential ethical challenges, and recommendations for responsible implementation. Data were analyzed using thematic analysis.
Participant responses are clustered around five pre-determined thematic areas: (1) balancing efficiency and equity in resource allocation, (2) the importance of transparency and explicability in AI-CDSS, (3) shifting roles and responsibilities in clinical decision-making, (4) ethical considerations in data usage and algorithm development, and (5) balancing cost-effectiveness and patient-centered care. Participants acknowledged the potential of AI-CDSS to optimize resource allocation but expressed concerns about exacerbating healthcare disparities, the need for interpretable AI models, changing professional roles, data privacy, and maintaining individualized care.
The integration of AI-CDSS into healthcare resource allocation presents both opportunities and significant ethical challenges. Our findings underscore the need for robust ethical frameworks, enhanced AI literacy among healthcare professionals, interdisciplinary collaboration, and rigorous monitoring and evaluation processes. Addressing these challenges proactively is crucial for harnessing the potential of AI-CDSS while preserving the fundamental values of equity, transparency, and patient-centered care in healthcare delivery.
人工智能驱动的临床决策支持系统（AI-CDSS）正越来越多地出于各种目的被整合到医疗保健中，包括资源分配。虽然这些系统有望提高效率和改善决策，但它们也引发了重大的伦理问题。本研究旨在探讨医疗保健专业人员对使用AI-CDSS进行医疗资源分配的伦理影响的看法。
我们对23名医疗保健专业人员进行了半结构化定性访谈，其中包括土耳其的医生、护士、管理人员和医学伦理学家。访谈聚焦于参与者对在资源分配中使用AI-CDSS的看法、潜在的伦理挑战以及负责任实施的建议。使用主题分析法对数据进行了分析。
参与者的回答集中在五个预先确定的主题领域：（1）在资源分配中平衡效率与公平；（2）AI-CDSS中透明度和可解释性的重要性；（3）临床决策中角色和责任的转变；（4）数据使用和算法开发中的伦理考量；（5）平衡成本效益与以患者为中心的护理。参与者认可AI-CDSS在优化资源分配方面的潜力，但对加剧医疗保健差距、对可解释的人工智能模型的需求、职业角色的变化、数据隐私以及维持个性化护理表示担忧。
将AI-CDSS整合到医疗资源分配中既带来了机遇，也带来了重大的伦理挑战。我们的研究结果强调了需要强大的伦理框架、提高医疗保健专业人员的人工智能素养、跨学科合作以及严格的监测和评估过程。积极应对这些挑战对于发挥AI-CDSS的潜力，同时在医疗服务中维护公平、透明和以患者为中心的护理等基本价值观至关重要。
