Commentary: What should patients be told about the use of AI in their care?

A patient at the A&E department at Singapore General Hospital. in one of Singapore’s hospitals. Around you, dozens of patients are waiting to be triaged and seen by a doctor. The flow of incoming patients is constant: Some arrive by ambulance, their conditions appearing critical and dire, while others, with more minor complaints, wait to be seen in the waiting room.

Which of these two approaches is to be preferred will, in part, depend on how effective the AI triage scoring tool is compared to the judgment of expert clinicians. But both approaches also raise a further question: Do patients have the right to knowAn AI-based cardiac risk stratification tool called aiTriage is being used in a randomised controlled trial to triage patients with chest pain at Singapore General Hospital’s emergency room.

Does this mean that the doctor in the scenarios above is required, upfront, to inform the patient that the AI model is contributing to or making the decision? We think not. Consider some comparable examples: Doctors commonly seek the view of colleagues before making a treatment recommendation. At other times, they seek out information from an online resource or from the conclusions presented in a recent research paper to finalise their treatment plan.

In our view, there is nothing obvious in this ethical discussion that justifies changing existing information disclosure practices simply because an AI model is shaping or determining the doctors’ actions - in the absence of compelling population-level evidence that widespread worries, fears, misunderstandings, or mistrust exists about the varied roles that AI could play in healthcare decision-making.

Here, the ethical requirement to respect autonomy would indeed require the doctor to provide more detail about the process by which that judgment was made, and the role that the AI model played in this.

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