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A Justice-First Approach to Ambient Intelligence in Healthcare.

Jonathan Herington¹, Mildred K Cho²

¹University of Rochester.

The American Journal of Bioethics : AJOB

|May 9, 2025

Summary

This summary is machine-generated.

Ambient intelligence systems (AIS) in healthcare raise ethical concerns. A justice-first approach is proposed over traditional bioethics to address complex stakeholder conflicts and privacy risks associated with pervasive AI monitoring.

Keywords:

Artificial intelligence ambient documentation data ecosystems fairness justice privacy

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Area of Science:

Bioethics
Artificial Intelligence
Healthcare Technology

Background:

Ambient intelligence systems (AIS) offer persistent AI-driven monitoring in healthcare.
AIS introduce significant ethical challenges, including privacy violations, algorithmic bias, and conflicts among patients, families, and providers.

Purpose of the Study:

To evaluate the limitations of traditional bioethical frameworks in addressing AIS ethical issues.
To propose an alternative ethical framework for navigating the complexities of AIS in healthcare.

Main Methods:

Analysis of ethical challenges posed by AIS in healthcare settings.
Critique of traditional bioethical principles (e.g., patient autonomy) in the context of pervasive AI.
Argument for a public health ethics-inspired, justice-first approach.

Main Results:

Traditional bioethics, focused on individual patient autonomy, is insufficient for AIS.
AIS involve multiple, often conflicting, stakeholder interests in shared physical spaces.
Opting out of AIS interactions can be impractical or infeasible for individuals.

Conclusions:

A justice-first ethical framework is better suited for addressing the systemic ethical issues of AIS.
This approach prioritizes fairness and equitable distribution of benefits and burdens in AI-integrated healthcare.
Rethinking ethical governance is crucial for responsible AIS deployment in healthcare.