Ethical Imperatives for Retrieval-Augmented Generation in Clinical Nursing: Viewpoint on Responsible AI Use

Retrieval-augmented generation (RAG) systems have emerged as a powerful technique to enhance the capabilities of large language models by enabling them to access external, up-to-date knowledge in real time, and RAG systems are being increasingly adopted by researchers in the medical field. In this viewpoint article, we explore the ethical imperatives for implementing RAG systems in clinical nursing environments, with particular attention to how these technologies affect patient care quality and safety. The purpose of this paper is to examine the ethical risks introduced by RAG-enhanced large language models in clinical nursing and to propose strategic guidelines for their responsible implementation. Key considerations include ensuring accuracy, fairness, transparency, and accountability, as well as maintaining essential human oversight, as discussed through a structured analysis. We argue that robust data governance, explainable artificial intelligence (AI) techniques, and continuous monitoring are critical components of a responsible RAG implementation strategy. Ultimately, realizing the benefits of RAG while mitigating ethical concerns requires sustained collaboration among health care professionals, AI developers, and policymakers, fostering a future where AI supports patient safety, reduces disparities, and improves the quality of nursing care.