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Artificial intelligence poses new challenges for doctor-patient relationships – MHH team develops recommendations for action
Artificial intelligence (AI) is increasingly changing the healthcare system. With the help of AI, diagnoses are made, therapy decisions are made, robot-assisted surgeries are performed, data is evaluated and much more. The new technologies have great potential in many areas of medicine, but they also raise ethical, legal and practical questions. AI is a particular challenge for the doctor-patient relationship. The Institute for Ethics, History and Philosophy of Medicine at the Hannover Medical School (MHH) has been addressing this topic in the project “My Doctor, AI and I”. The result is four recommendations for patients and four for doctors. These are intended to provide both groups with practical guidance on how to deal with AI-based systems. The project was funded by the Lower Saxony Ministry of Science and Culture as part of the “zukunft.niedersachsen” program.
“My Doctor, AI and I” is a discourse project. More than 170 citizens, doctors and experts took part in the project. In several different events, they expressed hopes regarding AI, such as increased efficiency, relief for medical professionals, and better availability of information, but also fears such as data misuse, lack of reliability and lack of transparency. The participants discussed ethical, legal and practical questions and jointly developed initial solutions. “The recommendations for action are based on an intensive dialog process,” explains project manager Dr. Frank Ursin, research associate at the Institute for Ethics, History and Philosophy of Medicine. “With these recommendations, we want to contribute to patient well-being, autonomy and trust in medical care – also in an increasingly digital world.” In addition to Dr. Ursin, the project team includes the director of the institute, Professor Dr. Dr. Sabine Salloch, and research associate Pranab Rudra.
Recommendations for patients
Understanding AI: Patients should be able to demand information from doctors about how AI works. They should be supported in actively engaging with the potential benefits and limitations of AI. Thanks to a better understanding, they can strengthen their autonomy in the treatment process.
Questioning the specific use of AI: Patients should be able to ask doctors for explanations regarding the specific use of AI in their treatment. This means asking targeted questions such as “How does AI support my treatment?” or “How reliable are the results of AI?” Comprehensible explanations are a prerequisite for understanding decisions and processes.
Data protection and security: Patients should receive information from their doctors about how their personal health data is handled when AI is used.
Needs orientation: Patients should be able to exercise their right to know and not know vis-à-vis their doctor according to their individual needs. After all, some want to be fully informed, while others find too much information stressful.
Recommendations for doctors
Responsibility and liability: As part of their duty of care, doctors should take responsibility for AI-based decisions. AI does not relieve them of their duty of care, but rather supplements their decisions with data-based recommendations. The results of the AI should be placed in a clinical context and critically evaluated.
Transparency and explainability: Physicians should understand how AI systems work and be able to explain them to their patients in a way that they can understand. Transparency and explainability build trust in the doctor-patient relationship and ensure physicians' autonomy in an increasingly digitalized healthcare system.
Patient communication and informed consent: Doctors should be able to educate their patients not only about how AI works, but also about the opportunities, risks and limitations of its use. They should actively ask whether patients understand the information.
Further training: Physicians should have the opportunity to receive further training on the latest developments in the field of AI. With further training, they can strengthen their own competence and integrate AI systems into medical care in a responsible and patient-centered way.
In addition, the discourse project resulted in fundamental recommendations for action concerning both target groups. One of these relates to responsibility. The participants believe that doctors bear the main responsibility when using AI. At the same time, however, patients also bear some responsibility, especially when they use AI-supported tools such as self-diagnosis apps. The participants also agreed that AI should be seen as a support system that complements human action, but does not replace it.
More information about the discourse project “My doctor, AI and I” is available here: https://www.mhh.de/institute-zentren-forschungseinrichtungen/institut-fuer-gesch...
This includes graphic recordings, which are visualizations of the workshop and discourse station protocols.
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For further information, please contact Dr. Frank Ursin, ursin.frank@mh-hannover.de.
AI as an ‘omniscient colleague’ – this is not how doctors should understand the new technology.
Copyright: Tanja Föhr
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