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Artificial intelligence and medical futility.

Sinead Prince1, Dominic J C Wilkinson2,3, G Owen Schaefer4

  • 1Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, #02-03 MD11, Singapore, 117597, Singapore. sprince@nus.edu.sg.

BMC Medical Informatics and Decision Making
|June 18, 2026
PubMed
Summary

Artificial intelligence (AI) may help resolve medical futility disputes, but risks like self-fulfilling prophecies exist. Ethical integration and regulation are key for AI to assist in end-of-life care decisions.

Keywords:
Artificial intelligenceBenefitsBioethicsDecision-makingEnd-of-lifeFutilityJusticeMedicinePreferences

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Area of Science:

  • Medical Ethics
  • Artificial Intelligence in Healthcare
  • End-of-Life Care

Background:

  • Medical futility determination is complex, involving conceptual, empirical, and ethical disputes.
  • These disputes create significant challenges for patients, families, healthcare providers, and legal systems.
  • There is a practical need to resolve futility questions in individual cases.

Purpose of the Study:

  • To explore the ethical and practical implications of using artificial intelligence (AI) in medical futility decisions.
  • To assess whether AI tools can ethically and effectively assist in resolving futility disputes.
  • To analyze the potential benefits and risks of AI in end-of-life care decision-making.

Main Methods:

  • A critical narrative review of existing scholarship on medical futility ethics.
  • Survey of current and potential medical AI applications relevant to futility.
  • Philosophical analysis of AI's ethical use, applying principles like autonomy, beneficence, and justice.

Main Results:

  • AI use in futility determination carries risks, such as exacerbating self-fulfilling prophecies.
  • Under specific conditions, medical AI can ethically aid in preventing or resolving futility disputes.
  • Careful consideration of AI's role is necessary to mitigate potential negative impacts.

Conclusions:

  • AI holds potential to ethically contribute to preventing and resolving medical futility disputes.
  • The ethical application of AI in this context depends heavily on its integration and regulation.
  • Responsible implementation is crucial for AI to support ethical end-of-life care decision-making.