质疑医生必须告知患者使用医疗AI的伦理义务
Are clinicians ethically obligated to disclose their use of medical machine learning systems to patients?
- 逐条分析四种支持披露的伦理论据并指出其不足
- 认为强制披露可能反而掩盖系统误用的责任
- 适合关注医疗AI伦理与责任分配的研究者
目前普遍认为，临床医生有伦理义务向患者披露其使用医疗机器学习系统的情况，否则即构成道德过错。这一观点被称为“披露论题”。在伦理学文献中，支持该论题的四大论证包括风险论、权利论、重要性论和自主性论。本文指出，这四项论证均难以成立，因此应拒绝接受披露论题。此外，强制要求披露可能反而损害患者利益，使相关方借披露之名规避因系统误用所致伤害的责任。
原文摘要 · Abstract (English)
It is commonly accepted that clinicians are ethically obligated to disclose their use of medical machine learning systems to patients, and that failure to do so would amount to a moral fault for which clinicians ought to be held accountable. Call this "the disclosure thesis." Four main arguments have been, or could be, given to support the disclosure thesis in the ethics literature: the risk-based argument, the rights-based argument, the materiality argument, and the autonomy argument. In this article, I argue that each of these four arguments are unconvincing, and therefore, that the disclosure thesis ought to be rejected. I suggest that mandating disclosure may also even risk harming patients by providing stakeholders with a way to avoid accountability for harm that results from improper applications or uses of these systems.
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