As clinical AI systems develop and are carefully introduced into EM, emergency-department patients will undoubtedly benefit from the breadth and depth of knowledge they provide to emergency physicians. Preserving ethical and high-quality EM practice will require understanding the AI systems’ limitations and keeping emergency-department patients well-informed.
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ACEP Now: Vol 43 – No 01 – January 2024Dr. Iserson is professor emeritus in the Department of Emergency Medicine at the University of Arizona, Tucson, Arizona.
Dr. Baker is an emergency medicine specialist practicing in Perrysburg, Ohio.
Dr. Bissmeyer is a fourth year student at Kansas City University College of Osteopathic Medicine.
Dr. Derse is director of the Center for Bioethics and Medical Humanities and Professor of Bioethics and Emergency Medicine at the Medical College of Wisconsin.
Dr. Sauder is a board certified emergency medicine physician in Dayton, OH.
Dr. Walters is an emergency medicine specialist in Royal Oak, MI.
References
- Iserson KV. Informed consent for artificial intelligence in emergency medicine: a practical guide. Am J Emerg Med. 2023;ISSN 0735-6757. Published online ahead of print. doi: 10.1016/j.ajem.2023.11.022. Accessed December 8, 2023.
- Tsipursky G, We will inevitably lose skills to AI, but do the benefits outweigh the risks? Entrepreneur website. Published July 26, 2023. Accessed December 8, 2023.
- Rinta-Kahila T, Penttinen E, Salovaara A, et al. The vicious circles of skill erosion: a case study of cognitive automation. J Assoc Information Syst. 2023;24(5):1378-1412.
- Mahendra S. Dangers of AI—dependence on AI. Artificial Intelligence + website. Published August 31, 2023. Accessed December 8, 2023.
- Faustinella F, Jacobs RJ. The decline of clinical skills: a challenge for medical schools. Int J Med Educ. 2018;9:195-197.
- Dam TR, Leaston JI, Hla DA, et al. Could AI cause burnout in medicine? Some concern that new technology could be more of a problem than a solution. Medpage Today website. Published July 29, 2023. Accessed December 8, 2023.
- Chenais G, Lagarde E, Gil-Jardiné C. Artificial intelligence in emergency medicine: viewpoint of current applications and foreseeable opportunities and challenges. J Med Internet Res. 2023;25:e40031. doi: https://doi: 10.2196/40031.
- Manz CR, Zhang Y, Chen K, et al. Long-term effect of machine learning-triggered behavioral nudges on serious illness conversations and end-of-life outcomes among patients with cancer. JAMA Oncol. 2023;9:414-418.
- Wilson PM, Ramar P, Philpot LM, et al. Effect of an artificial intelligence decision support tool on palliative care referral in hospitalized patients: a randomized clinical trial. J Pain Symptom Manage. 2023:66:24-32.
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One Response to “Artificial Intelligence in the ED: Ethical Issues”
January 8, 2024
Todd B Taylor, MD, FACEPAnalysis presented in this article is germane to healthcare for the half of the world’s population that has access to it. For the other 4.5 billion people, AI may become their sole source for the full spectrum of healthcare services, including preventative, diagnostic, therapeutic, and behavioral heath healthcare. To withhold this emerging technology from those who might otherwise have none, seems narrow minded & unwarranted. As is a common consequence of American healthcare, forcing the “perfect be the enemy of the good” need not be perpetuated to all populations.
To that end, one can imagine “proceduralists” (doing the necessary hands on work) aided by AI bringing healthcare to underserved & unserved individuals. Perhaps sooner than later, healthcare kiosks will have the ability to perform even sophisticated diagnostics & then deliver therapy (e.g. medication) even without the benefit of a human practitioner. Certainly some will suffer from incorrect diagnosis or prescribed therapy. But, that also happens on a regular basis in all sorts of healthcare settings today.
Technology continues to eliminate entire swaths of the services industry. Trucking & transportation will soon no longer require a human. AI will also give you that perfect haircut. Traditional grocery stores will soon be replaced by machine picked items, delivered to your door by autonomous vehicles in less than an hour.
As usual, healthcare will lag behind other industries, but technology will slowly chip away at services where AI advancements provide superior results. Diagnostic radiology & pathology are ripe for the picking.
Emergency Medicine may be further down that list, but automated triage & other parts of the ED process will make what we do now look like the typewriter . . . “type-what” said “Gen Alpha”. And, who knows what Gen Beta (2025-2039) will have never heard of. As a “Boomer” myself I’ll probably be dead by then, but hopefully not a victim of MedAI.