1 Institute for Biomedical Ethics, University of Basel, Switzerland
Artificial intelligence (AI) based clinical decision support systems (CDSS) are becoming ever more widespread in healthcare and could play an important role in diagnostic and treatment processes. For this reason, AI-based CDSS has an impact on the doctor-patient relationship, shaping their decisions with its suggestions. We may be on the verge of a paradigm shift, where the doctor-patient relationship is no longer a dual relationship, but a triad. This paper analyses the role of AI-based CDSS for shared decision-making (SDM) to better comprehend its promise and associated ethical issues. Moreover, it investigates how certain AI implementations may instead foster the inappropriate paradigm of paternalism. Understanding how AI relates to doctors and influences doctor-patient communication is essential to promote more ethical medical practice. Both doctors’ and patients’ autonomy need to be considered in the light of AI.