Conscience, Care, and Code: Moral Theology, AI, and Ethical Decision-Making at the Thresholds of Life

Healthcare decisions at the beginning and end of life pose enduring moral challenges that are increasingly intensified by the integration of artificial intelligence (AI) into clinical practice. This article examines these challenges through a moral-theological understanding of conscience, emphasizing human dignity, moral agency, and responsibility. Drawing primarily from Catholic moral theology, I examine how AI-driven tools in prenatal screening, reproductive technologies, end-of-life care, and prognostic decision-making can influence, constrain, or supplant conscientious judgment among healthcare professionals and patients. While AI offers significant benefits in efficiency and accuracy, it also risks fostering moral distancing, automation bias, and reducing ethical discernment to algorithmic outputs. I argue that conscience must remain a critically formed and relational capacity rather than a function delegated to technology. The article proposes a theologically grounded framework for integrating AI into healthcare that preserves moral discernment, safeguards vulnerable human life, and promotes ethically humane care.