Pediatric Bioethics: Exploring Artificial Intelligence in Health Care: First Look

Column Author: Vanessa S. Watkins, MPH, FACHE, CHES | Bioethics Program Manager; Certificate Program Administrative Director

Column Editor: Brian Carter, MD | Neonatal/Perinatal Medicine, Bioethics; Neonatologist; Pediatric Bioethicist; Interim Director, Pediatric Bioethics | Professor of Pediatrics, University of Missouri-Kansas City School of Medicine

Presently, a search of artificial intelligence (AI) in health care on the Google search engine returns about 693,000,000 results. Daily notifications indicate new uses for AI in health care. Recently, the health care consulting firm the Advisory Board Company published a story headlined “AI nurses? Inside Nvidia, Hippocratic AI’s new partnership.”The March/April 2024 issue of the American College of Healthcare Executives’ publication Healthcare Executive also addressed AI in its cover story, “Improving Patient Care and Safety with AI.”[2] In addition, innumerable webinars, podcasts and conferences have incorporated AI as part of their discussions and learning.

This spring, in the Children’s Mercy Certificate Program in Pediatric Bioethics, a week on AI in health care was added. Some recurrent themes in the literature review revealed:

1) AI is a tool that can supplement but not fully replace health care workers (administrators, clinicians, etc.).

2) Wise organizations are incorporating AI with proper oversight and safeguards.

3) AI in health care is being applied broadly to diagnostic testing and interpretation, patient and clinician communication, and the process of deriving diagnoses.

The use of AI as a tool to supplement – not replace – health care workers is already underway. With workforce shortages, AI could provide a less expensive alternative. However, these virtual clinical providers must be supervised and regulated by their human counterparts to ensure patient safety and equitable care. In other words, there is a space for ethical management of AI applications. These ethical considerations will require new educational venues in the development, application and management of AI in health care.

AI is a part of our society and is already incorporated into autonomous vehicles navigating with machine learning and vision, large language models that power chatbots (e.g., ChatGPT), the military, the financial sector, and more. The California Institute of Technology has a website that provides a nice overview of how AI is used in our daily lives: https://scienceexchange.caltech.edu/topics/artificial-intelligence-research/artificial-intelligence-everyday-life-uses. Wise organizations recognize the need to innovate and thus may take advantage of AI to obtain a competitive advantage. Proper oversight and safeguards will be required to maintain an ethical climate.

Some of the readings on AI from the certificate program are included below.  

1. Alowais SA, Alghamdi SS, Alsuhebany N, et al. Revolutionizing healthcare: the role of artificial intelligence in clinical practice. BMC Medical Education. 2023;23(1):689. https://doi.org/10.1186/s12909-023-04698-z
2. Barile J, Margolis A, Cason G, et al. Diagnostic accuracy of a large language model in pediatric case studies. JAMA Pediatr.2024;178(3):313-315. https://doi.org/10.1001/jamapediatrics.2023.5750
3. 3.       Sullivan BA, Beam K, Vesoulis ZA, et al. Transforming neonatal care with artificial intelligence: challenges, ethical consideration, and opportunities. J Perinatol. 2024;44(1):1-11.  
4. The ethics of using artificial intelligence (AI) in healthcare with Professor Wendy Rogers. In the CAVE: An Ethics Podcast. February 2022. https://open.spotify.com/episode/7pOrnkNaxZ2PtZ2xHL3SCl?si=zVWC9bG0TTmCIK82NLjN5w