Allen, J., Earp, B., Koplin, J. J., & Wilkinson, D.
(July 25, 2023). http://dx.doi.org/10.2139/ssrn.4520613
Abstract
Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (e.g. junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence (AI) using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making.
In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices.
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Here are some additional points from the article:
- The authors argue that the current system of delegating procedural consent to human consent-takers is not always effective, as consent-takers may lack sufficient time or clinical knowledge to adequately promote patient autonomy and informed decision-making.
- They suggest that LLMs could be used to provide patients with more comprehensive and accurate information about procedures, and to answer patients' questions in a way that is tailored to their individual needs.
- However, the authors also acknowledge that there are a number of ethical concerns that need to be addressed before LLMs can be used for procedural consent. These include concerns about bias, accuracy, and patient trust.
