How Will AI Impact Dentistry Ethically?
How Will AI Impact Dentistry Ethically?
Ethics may have been originally defined by Aristotle but their relevance has never gone away: “ethics, the discipline concerned with what is morally good and bad and morally right and wrong. The term is also applied to any system or theory of moral values or principles.”
– Britannica.com
“Aristotle conceives of ethical theory as a field distinct from the theoretical sciences. Its methodology must match its subject matter—good action—and must respect the fact that in this field many generalisations hold only for the most part. We study ethics in order to improve our lives, and therefore its principal concern is the nature of human well-being. Aristotle follows Socrates and Plato in taking the virtues to be central to a well-lived life. “
– Stanford University
The Ethics Involved In AI Dental Care
Some of you reading this article may now be wondering what moral philosophy has got to do with going to see the dentist. Isn’t it just a case of open wide and get on with what you have to do to fix my teeth? Aren’t most dentists just drilling for gold, as they relieve their patients from the pain of tooth ache? Many consider visits to dental clinics as necessary evils to be borne with stoic resolve. Nobody loves the procedures but most end up grateful when the nerve pain is relieved. All of us, however, want to be able to look the practitioner in the eye when they are sticking sharp instruments inside our mouths. Someone must bear the responsibility if things go wrong. Will a machine, albeit a smart machine, provide that same level of trust? How will AI impact dentistry ethically? Does anyone yet know?
The Ramifications Of AI In The Dental Clinic
If something goes horribly wrong during your dental work procedure and AI has been involved – who is to blame? Who will bear the burden apart from you the patient? What oversights are in place, as the artificial intelligence transfer of power grows apace? AI-based decision making must be declared to patients prior to the procedures taking place. What is the regulatory policy for AI as defined by a state’s dentistry board, which governs all dentists and clinics in that state? These things must be made clear and widely known to the citizens of that state. There seems to be a mad rush to trumpet the benefits of AI technology without firstly putting the policy framework in place. We must protect patients from things that go wrong, as they invariably do. Technology is used in our Western democracies as a marketing tool. Businesses promote the use of AI technology as reason for potential patients to utilise their services over a competitor. AI is always about making things better. How this ‘better’ is employed and for what purposes are ethical questions above and beyond the simple acceptance of ‘better’.
“While the potential of AI to improve diagnostics and disease detection has been reported for some time, recent commentary has focused on the benefits for health practitioners for improved care and patient satisfaction, including reducing administrative burdens and health practitioner burnout. As new tools emerge, so do the unique practical and ethical issues associated with its use in a healthcare setting. AHPRA and the National Boards have developed principles for practitioners to consider when using or looking to integrate AI into their practice. These principles translate existing obligations in practitioner codes of conduct and reminds practitioners to consider these responsibilities when assessing the appropriate use of AI. Specific professional obligations to consider include accountability, an appropriate understanding of the tool, transparency of its use, informed consent and ethical and legal issues. “
– Australian Dental Board
Remember that term – informed consent – when it comes to AI in the health sector. The rapid integration of AI systems into dental care diagnostics, prognostics and treatment is presenting challenging ethical and legal questions for the sector. How many patients know that their oral health care is being determined by artificial intelligence? Do they give their informed consent to the designated procedure and treatment plan? The unwavering algorithm detected this issue and recommends this course of action. Is it appropriate in all situations and circumstances? Is there human oversight? Will that oversight responsibility be abrogated overtime through laziness and expediency? Will corners be cut in the human management of AI for cost cutting measures, as is the trend in ‘for profit’ healthcare occurring across the Western globe? AI is not a silver bullet for all our problems, as some overly enthusiastic marketers would have us believe.
Some Of The Ethical Concerns Facing AI In Dentistry
When should AI be applied in oral care?
‘Intervention’ is a term probably not debated enough in healthcare per se. Especially in a business model which obviously favours medical interventions because this is how practitioners derive their income. The medical model in the West is based on a narrative which tells us that intervention is invariably best for patient health and healing. The human body is designed to heal itself if supported in that intention by appropriate dietary and lifestyle factors. This basic fact should not be forgotten in this race to upscale technologically via AI. What about the idea that a principle of a desired oral health outcome with the least intervention should be pursued with AI in mind? This ethical question lies at the heart of our current medical model, as we face the AI application to healthcare in the 21C.
What does the data tell us about the claims supporting AI?
There is a famous quote about there being “three kinds of lies – lies, damned lies, and statistics.” Like many sayings this has been attributed to multiple authors. Apparently Mark Twain got it from British PM Benjamin Disraeli. Anyhow, the meaning of this statement is to cast doubt upon the use of statistical data to provide incontrovertible proof. Statistics can be utilised to tell whatever story you wish. It will be useful to keep this in mind when listening to the AI hype promising better in all things. Despite this, reputable data remains important in light of this caveat.
What are the legal regulations defining the use of AI in dental care?
“Some AI tools used in healthcare are regulated by the Therapeutics Goods Administration (TGA). The TGA regulates therapeutic goods that meet the definition of a medical device, which includes software (including AI-enabled software) if it has a therapeutic use and meets the definition. Generative AI tools used in clinical practice such as AI scribing are usually intended for a general purpose and do not have a therapeutic use or meet the definition of a medical device, and therefore are not regulated by the TGA. Health practitioners can contact the vendor or search the Australian Register of Therapeutic Goods (ARTG) to check if the tools they are using are registered. To find out more about the TGA and its regulation of AI software, see our Further information about AI page. “
– AHPRA.gov.au
Artificial intelligence will provide a better level of dental care to patients if it is employed responsibly and ethically. All practitioners and related folk within the oral care sector have a duty to address the queries raised in this article. AI is not a set and forget technology, rather it requires monitoring and vigilant interactivity by human dentists and the administrative bodies tasked with their oversight. It cannot become an excuse proffered by dentists to patients – “oh the AI recommended this treatment; therefore it must be right and your unfortunate outcome is neither here not there.” Machines making health calls are going to be a minefield for contentious stuff in the not too distant future. Let us be ready for this and not in a blinkered rush to ignore the signs.
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