Examining the ethics of AI in nursing

Artificial intelligence (AI) isn’t new to nursing. Nurses regularly use AI tools for clinical decision support, patient monitoring and alerts, and scheduling.

But as generative AI becomes increasingly easier to use and as the buzz around AI reaches a fever pitch, the implications of its use and what it means for patient care has some nurses wary. In an effort to address those concerns and empower nurses to better utilize it, the School of Nursing recently announced the launch of an initiative to examine the ethical implications of the use of AI in nursing.

“Artificial intelligence has the potential to revolutionize the care nursing provides; however without a better understanding of its implications and unintended consequences it also has the potential to cause tremendous harm,” says Dean Connie White Delaney, PhD, RN, FAAN, FACMI, FNAP. “Now is the time to develop a framework for the future use of AI in nursing and this initiative, along with others who will join, has the breadth and depth of knowledge to lead this effort.”

Steering committee named

The initiative’s steering committee, which features national and international experts with nursing and industry expertise, is co-chaired by Professor Jenna Marquard, PhD, the Cora Meidl Siehl Chair in Nursing Research at the University of Minnesota, and Associate Professor Martin Michalowski, PhD, FAMIA, a senior member in the Association for the Advancement of Artificial Intelligence (AAAI). Additional steering committee members include:

Constantin Aliferis, MD, PhD, MS, FACMI, director of the Institute for Health Informatics;
Kathy Chappell, PhD, RN, FNAP, FAAN, senior vice president of Accreditation, Certification, Measurement, Quality and Research, American Nurses Credentialing Center;
Pamela Cipriano, PhD, RN, NEA-BC, FAAN, president of the International Council of Nurses;
Tracee M. Coleman, MS, RN-BC, CPHIMS, Clinical Informatics Consultant, Optum Health;
Peter Klein, BA, CEO and founder of Educated Change;
Joyce Sensmeier, MS, RN-BC, CPHIMS, FAAN, senior advisor of informatics for HIMSS (retired);
Bill Torvund, Quantum Futurist;
Martha Turner, PhD, RN-BC, FAAN, historian & code scholar, American Nurses Association Code of Ethics for Nurses;
Ian Wolfe, PhD, MA, RN, HEC-C, clinical ethicist, Children's Minnesota;
Olga Yakusheva, PhD, MSE, economist and a professor of Nursing and Public Health at the University of Michigan.

“Nurses are very ethical creatures and know that any technology can be highjacked for sinister use,” says Pamela Cipriano, PhD, RN, NEA-BC, FAAN, president of the International Council of Nurses. “Nurses are eager to further understand AI’s positive applications as well as limitations. Ensuring there are guardrails that lead to virtuous use of this powerful technology is a necessary first step to embracing the benefits of AI for nursing.”

Developing a framework

The work group has been charged with producing a strategy or framework, including partnerships and engagement with Nursing Knowledge Big Data Science (NKBDS) Initiative leadership, to inform and expand scholarship in the profession’s adoption of new AI technology.

For its first step, the steering committee is analyzing existing research at the intersection of nursing, AI and ethics. It’s also developing a better understanding of the current AI landscape in terms of what’s already developed. “There’s been quite a bit of work looking at existing frameworks around ethics and AI in health care, but not much has been nursing-centric,” says Marquard. “Nurses play a unique role in care teams, and their use of AI will be different than that of other clinicians.”

Looming questions about who’s in charge of making decisions – the technology or the human – and around what data sets the systems are building on will also be addressed.

“The issue of ethical use of AI is not specific to nursing. AI as a whole is going through a period of reflection on its role and use in society,” says Michalowski. “There are no easy solutions to ethical issues surrounding AI that can be applied to address those concerns in nursing. Therefore, it is important that ethical concerns about using AI in nursing are centered on nursing principles to ensure that AI’s use aligns with nursing’s goal of optimizing patient outcomes.”

Recommendations will be shared, implemented in 2024

The steering committee began meeting this fall and expects that recommendations can be shared and implemented by nursing schools, nurse scientists, practitioners, health systems and nursing-related organizations in 2024.

“Without a better understanding of AI’s implications and unintended consequences, it has the potential to cause tremendous harm,” says Peter Klein, BA, CEO and founder of Educated Change. “Therefore, a cautious and informed approach, ongoing evaluation, robust training, and ethical considerations are vital to ensure that the deployment of AI upholds the standards and values of health care and nursing education.”