By Stacey Kusterbeck
The integration of telemedicine and the use of artificial intelligence (AI) in the specialty of pain medicine poses some unique ethical challenges, according to a recent paper.1
“Ethical principles and perspectives apply to various iterations of similar events and circumstances, and transcend the myriad permutations and combinations presented by rapidly advancing technology,” says Larry C. Driver, MD, one of the paper’s authors. Driver is a professor in the Department of Pain Medicine and Section of Integrated Ethics, and an adjunct ethicist for clinical ethics consultation at the University of Texas MD Anderson Cancer Center.
The use of telemedicine, which many pain medicine providers shifted to during the pandemic, has continued. This has resulted in benefits for patients and providers, in terms of cost savings and scheduling flexibility. However, fraud is a significant ethical concern, the authors reported. In 2023, the Justice Department criminally charged 78 defendants with healthcare fraud with more than $2 billion in fraudulent claims for orthotic braces and pain creams, including illegal bribes and kickbacks to telemedicine companies.2
As with telemedicine, the use of AI also is a double-edged sword. “Clinical care may be informed by input derived from large datasets mined by AI-powered processing,” notes Driver. Ethical principles of beneficence and nonmaleficence, and equitable and just allocation of limited resources, are all important considerations with the use of AI in pain care, Driver says. “We may risk overlooking or ignoring the individual experiences and needs of autonomous persons,” says Driver. “On the other hand, machine learning and large dataset processing may lead to enhancement of personalized care.”
- Ye AL, Javed S, Driver L. Navigating the evolving post-pandemic ethics of chronic pain care. Pain Manag 2024;14:49-52.
- Office of Public Affairs, U.S. Department of Justice. National enforcement action results in 78 individuals charged for $2.5B in health care fraud. June 28, 2023. https://www.justice.gov/opa/pr/national-enforcement-action-results-78-individuals-charged-25b-health-care-fraud
