Artificial Intelligence in Medical Care – Patients' Perceptions on Caregiving Relationships and Ethics: A Qualitative Study

Abstract

Introduction

Artificial intelligence (AI) offers several opportunities to enhance medical care, but practical application is limited. Consideration of patient needs is essential for the successful implementation of AI-based systems. Few studies have explored patients' perceptions, especially in Germany, resulting in insufficient exploration of perspectives of outpatients, older patients and patients with chronic diseases. We aimed to explore how patients perceive AI in medical care, focusing on relationships to physicians and ethical aspects.

Methods

We conducted a qualitative study with six semi-structured focus groups from June 2022 to March 2023. We analysed data using a content analysis approach by systemising the textual material via a coding system. Participants were mostly recruited from outpatient settings in the regions of Halle and Erlangen, Germany. They were enrolled primarily through convenience sampling supplemented by purposive sampling.

Results

Patients (N = 35; 13 females, 22 males) with a median age of 50 years participated. Participants were mixed in socioeconomic status and affinity for new technology. Most had chronic diseases. Perceived main advantages of AI were its efficient and flawless functioning, its ability to process and provide large data volume, and increased patient safety. Major perceived disadvantages were impersonality, potential data security issues, and fear of errors based on medical staff relying too much on AI. A dominant theme was that human interaction, personal conversation, and understanding of emotions cannot be replaced by AI. Participants emphasised the need to involve everyone in the informing process about AI. Most considered physicians as responsible for decisions resulting from AI applications. Transparency of data use and data protection were other important points.

Conclusions

Patients could generally imagine AI as support in medical care if its usage is focused on patient well-being and the human relationship is maintained. Including patients' needs in the development of AI and adequate communication about AI systems are essential for successful implementation in practice.

Patient or Public Contribution

Patients' perceptions as participants in this study were crucial. Further, patients assessed the presentation and comprehensibility of the research material during a pretest, and recommended adaptations were implemented. After each FG, space was provided for requesting modifications and discussion.