By Stacey Kusterbeck
Artificial intelligence (AI) is expected to change pediatrics. “One major issue is privacy,” says Bryan A. Sisk, MD, assistant professor of pediatric hematology and oncology and director of research at the Bioethics Research Center at Washington University. Sisk says privacy-related ethical questions are:
• When a tool uses patient data, where do the data go and who can access it?
• Is the tool susceptible to cyberattacks that could jeopardize patient privacy?
• Should parents be able to risk their child’s privacy by using an AI tool?
An AI tool might be able to manage a child’s appointments, but only if parents permit the tool to access their child’s medical record. “Clinicians would need to find a way to respect the parent’s decision while protecting the child’s privacy,” says Sisk.
Another ethical concern is how much clinicians are obligated to tell patients and parents about using AI. Sisk says these are some important questions for clinicians to consider:
• Do parents have a right to know if clinicians are using AI to develop a list of possible diagnoses or possible treatments?
• What makes AI different than other algorithms used in pediatric care?
To help clinicians and technology developers to consider the breadth of ethical concerns that might arise from new AI-driven technologies in pediatrics, Sisk and colleagues developed an ethical framework.1 “By using this broader framework of truth, goodness, and wisdom, we hope clinicians will think deeply about the implications of technologies they incorporate into their practice,” says Sisk.
For example, there are new apps that can record clinical conversations, develop a list of possible diagnoses, and construct the outline of a note. “When approaching such a technology, we hope clinicians will think about the truth, goodness, and wisdom of this tool,” says Sisk. The authors suggest that clinicians reflect on whether the tool works reliably, where the recordings go, who might access the recordings, and whether incorporating the tool into their medical practice will, overall, improve or hinder the patient/physician relationship.
As healthcare institutions continue to adapt and incorporate novel AI-driven technologies, it is imperative to include ethicists in deliberations and policy development, urges Sisk. “Clinicians, ethicists, and administrators should work collaboratively to effectively and safely incorporate these new technologies into practice. And they should also work to reevaluate over time, to watch out for unintended consequences,” says Sisk.
Ethically, many of these questions are difficult to answer definitively. “The goal is to encourage clinicians and developers to think deeply about all of these aspects while incorporating new technologies into the healthcare system,” Sisk says.
- Sisk BA, Antes AL, DuBois JM. An overarching framework for the ethics of artificial intelligence in pediatrics. JAMA Pediatr 2024;178:213-214.
