Artificial Intelligence-Based Clinical Decision Support Systems in Geriatrics: An Ethical Analysis.

Area of Science:

• Medical Ethics
• Geriatric Medicine
• Artificial Intelligence

Background:

• The integration of artificial intelligence-supported clinical decision support systems (AI-CDSS) into geriatric care presents novel ethical challenges.
• Existing literature often focuses on the technical utility of AI-CDSS, with limited systematic ethical analysis concerning older adults.

Purpose of the Study:

• To conduct a comprehensive ethical analysis of AI-CDSS usage in geriatrics.
• To evaluate AI-CDSS implications through the lens of established medical ethics principles.

Main Methods:

• A systematic literature search identified 29 relevant articles on AI-CDSS in geriatrics.
• Qualitative analysis of identified articles examined ethical considerations.
• Ethical arguments were discussed using Beauchamp and Childress's 4 principles of medical ethics, focusing on frail older adults' needs.

Main Results:

• A review of 5089 articles yielded 29 for analysis, revealing a lack of systematic ethical examination of AI-CDSS in geriatrics.
• Current ethical discussions are fragmented and overshadowed by a technical focus on AI-CDSS utility.
• The study systematically addresses the ethical implications of AI-CDSS in geriatric care.

Conclusions:

• AI-CDSS can be valuable in geriatrics, particularly for patients with cognitive impairments.
• Ethical concerns include the potential for overlooking older patients' values and beliefs.
• The use of AI-CDSS may negatively impact the doctor-patient relationship, potentially compromising adherence to core ethical principles.