The ethical-challenges of AI re-shaping the patient-doctor relationship

AI is increasingly ingrained in the activities of the health care sector. As the Council of Europe has recently observed, in clinical settings, “AI systems bear the potential of a considerable transformation of the patient-doctor relationship”. The potential offered by massive data availability is expressed in data-driven precision medicine, defined as the ability to predict and simulate individualized treatment strategies based on collected data within the framework of personalized, stratified, and precision medicine. Despite these opportunities, significant ethical challenges persist. Many technical issues may gradually be solved through technological progress, but behind them lie deeper ethical assumptions about who holds decision-making authority and the role assigned to AI within the informative model framing the current therapeutic relationship. Contrary to expectations of improving speed and precision, AI-assisted decisions could lead to diagnostic or therapeutic errors not attributable to medical negligence. Physicians, responsible for providing accurate information, must rely on unbiased outputs. This requires clean, high-quality data. Otherwise, even if AI is meant to assist and not replace the physician, it effectively does so, since decisions would depend on results beyond the doctor’s control. This undermines the legitimacy of medical judgment and the duty to present accurate diagnostic and prognostic assessments. In this paper, the focus will be on how AI data-based systems may contribute to re-shaping the communication process between the patient and the doctor, and the expression of informed consent as the final act of this process. The attention will be paid to the ethical questions raised by AI used as a mediator in the therapeutic relationship.