Ethical-Regulatory Guidelines for AI in Palliative Care Rehabilitation

The integration of artificial intelligence (AI) into rehabilitation practice has expanded rapidly, including its emerging application in palliative care contexts. Although international organisations have established ethical and governance frameworks for AI in healthcare, these initiatives remain largely high-level and are not specifically tailored to the clinical complexity, vulnerability, and relational dimensions of palliative care rehabilitation. The absence of context-specific ethical-regulatory guidance poses challenges for responsible implementation in ethically sensitive settings. This study aimed to consolidate ethically grounded regulatory guidance for the use of AI in palliative care rehabilitation by translating existing international principles into context-sensitive domains.

A qualitative documentary analysis with a normative ethical-regulatory orientation was conducted using the READ (Ready, Extract, Analyse, Distil) framework. Authoritative international policy, governance, and regulatory documents addressing AI in healthcare were identified and analysed. Data were extracted using a structured analytical table and coded according to predefined ethical-regulatory domains derived from previously published ethical guidelines and verified through documentary analysis.

The analysis identified five convergent ethical-regulatory domains recurrent across international governance frameworks: (1) Human oversight and clinical responsibility; (2) Patient autonomy, preferences, and proportionality; (3) Transparency and explainability; (4) Fairness, equity, and non-discrimination; and (5) Professional competence and ethical literacy. These domains were synthesised into practical ethical-regulatory considerations linking ethical principles with governance expectations and clinical implementation requirements.

This study provides context-sensitive ethical-regulatory guidance that bridges high-level AI governance principles with the operational realities of palliative care rehabilitation. By systematising and operationalising existing ethical norms, the proposed framework supports responsible clinical decision-making, strengthens institutional accountability, and safeguards patient dignity and autonomy in vulnerable care contexts.