Ethical Considerations In AI-Driven Orthodontic Treatments

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Artificial intelligence is the modern way to do everything. This is the age of technology that we always aimed to enter. AI is heavily influencing fields like manufacturing, agriculture, autonomous driving, and healthcare. The benefits of this application are multifold. However, some experts believe that the role of AI in the medical systems can be a dual-ended sword.

Despite the development of artificial and convolutional neural networks that mimic a working human brain, AI systems are devoid of emotions and feelings. This lack puts AI-based healthcare in legal and ethical dilemmas. Healthcare professionals aim to consider all the medical ethics in healthcare, before handing over patients to robots, including:

  • Autonomy: informed consent, confidentiality, and truth-telling to the patient is ensured.
  • Beneficence: decisions of the doctor are always in the favour of the patient.
  • Nonmaleficence: the physician is bound not to harm the patient at any cost.
  • Justice: the provision of fair, appropriate, and equitable treatment to everyone is ensured.

Ethical Considerations In Implementing AI In Orthodontics

Privacy And Data Protection

Orthodontic data is sensitive and patients have all the right to keep their data private and protected. As AI is a deep learning program it needs to feed on a plethora of different scenarios. Thus, ensuring data privacy and secrecy might not be the ideal case scenario when it comes to obtaining help from AI in orthodontics.

All dentists must take into account these ethical considerations (regarding data privacy) before riding the bandwagon of AI-driven orthodontics:

  1. Currently, there are no laws to protect patient’s data in the field of medicine/dentistry.
  2. Though rare, there are chances of patient data hacking from machines. This data can then be used for malicious purposes or negative gains.
  3. When uploading your data to AI-based software, data may be illegally gathered by social media platforms and used for advertising/marketing.
  4. Loosely monitored bioinformatics companies may sell patient data to biotech companies.

Health professionals must ensure data privacy before using AI in orthodontics. Robust data encryption and anonymization techniques and protocols must be adopted to safeguard patient data (including high-quality images and radiographs).

Autonomy

Autonomy in healthcare relies on informed consent which is the process of communication between the doctor and the patient. An informed consent is an ethical and legal fundamental of medical treatment. In taking informed consent, orthodontists are supposed to:

  • Assess the patient’s capacity to understand relevant dental terms and treatment options.
  • Present information (regarding diagnosis, nature, and expected side effects, etc.) most accurately and sensitively possible.
  • Document all the informed consent conversations, including the patient’s decision in the medical record.

Therefore, based on the autonomy principle, AI should do the following:

  1. Provide any information the patient asks for because all individuals have the right to information.
  2. Make patients aware of the treatment process, and potential errors/drawbacks while safeguarding the private data.
  3. Appreciate the patient’s right to refuse as patients can refuse treatment at any point they deem appropriate.

In addition to these considerations, the orthodontist dealing with the system must provide a name of who should be responsible if the AI-based treatment fails. This is crucial for patient’s rights. Transparent decision-making is vital in the orthodontic field. As the patient invests a lot of time and money in the treatment process, the treatment plan offered by the orthodontist and the AI system should foster trust and accountability.

Empathy And Sympathy

The evolution of robots in the field of orthodontic diagnosis and treatment planning is commendable. However, AI programs are unable to carry out consultations with medical peers as humans do. It has been observed that discussions between professionals can sometimes, generate unique ideas and treatment plans. Professionals relying on help from AI tend to follow it religiously. Thus, there are fewer chances for discussion and consultation.

With more and more automation in the healthcare world, there is a shift toward automated robotics. We have medical robots carrying out activities during the COVID-19 days. If, in the near future, we incorporate AI-driven robots for intraoral scans and X-rays, there is no doubt that the precision levels will increase. But we will have to face another dilemma i.e., lack of empathy and sympathy.

Doctors and other associated healthcare professionals (especially nursing staff) are trained to treat people with empathy and compassion. As machines are void of emotions and feelings, we don’t expect them to develop healthy relationships with the patients.

Kindness and empathy from the health provider fortify the patient-doctor relationship and improve trust. It has been observed that the “physical touch” of a chiropractor/physical therapist can alleviate pain and anxiety. “Machine-human” medical relations can never be as good as “human-human relations”.

Social Gap

Another issue linked with the ethical implications of AI is the social gap that artificial intelligence can create. With AI taking over tasks like data-keeping, etc, there is a replacement of healthcare workers. This can lead to an increase in unemployment and a further hike in the social gap.

Do People Trust AI-Based Treatments?

Even despite the high efficiency and efficacy of AI-based treatments, people are skeptical of letting a machine treat them. According to a recent report, more than 60% are uncertain about AI in healthcare. This lack of trust stems from concerns like data privacy, potential bias, and the sheer lack of transparency in AI decision-making. Therefore, dentists/orthodontists must try to counter all the ethical challenges before going for AI-driven orthodontic treatment.

Final Word

AI-based orthodontics is a new, highly efficient, and time-saving way of treating patients. However, the introduction of AI in healthcare has brought a number of ethical challenges to the forefront of medicine/dentistry. Reports suggest that the vast majority of Americans do not trust AI-based healthcare systems due to ethical challenges. These include a lack of autonomy and informed consent. Orthodontic patients are also very concerned about the privacy and safety of their data (which also includes high-quality photographs). Moreover, AI-based orthodontics is prone to bias and the transparency in decision-making is low. Medical robots running on AI are devoid of human feelings/emotions. Therefore, a lack of empathy and sympathy can also be a challenge for both the doctors and the patients.

References

  1. Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28.
  2. Rajkomar, A., Hardt, M., Howell, M. D., Corrado, G., & Chin, M. H. (2018). Ensuring fairness in machine learning to advance health equity. Annals of internal medicine, 169(12), 866-872.
  3. Price, W. N., & Cohen, I. G. (2019). Privacy in the age of medical big data. Nature medicine, 25(1), 37-43.
  4. https://www.businesswire.com/news/home/20231012647360/en/Carta-Healthcare-survey-results-indicate-that-education-around-AI-may-improve-consumer-trust

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