Artificial Intelligence in Medicine: Ethical Challenges in a Transforming Clinical Landscape

Dear Colleagues,

The rapid integration of artificial intelligence into healthcare is reshaping the landscape of medicine, offering unprecedented opportunities in diagnostics, prognostics, treatment personalization, and system efficiency. From machine learning systems capable of identifying pathologies in medical imaging to advanced language models supporting clinical documentation and patient communication, AI is increasingly being embedded in everyday clinical practice. However, this transformation is far from ethically neutral. Rather, it introduces novel ethical challenges that test the adequacy and application of established frameworks of medical ethics under increasingly complex conditions.

One of the central challenges concerns the opacity of many AI systems. When clinical recommendations emerge from models that are not easily interpretable, the very possibility of meaningful clinical justification and deliberation is called into question. The integration of AI into clinical workflows does not simply add a new tool but may subtly reshape how clinicians perceive, interpret, and prioritize information, thereby influencing their diagnostic and therapeutic reasoning. Closely related is the issue of responsibility: when harm occurs, the attribution of moral and legal accountability becomes blurred across developers, institutions, and clinicians. At the same time, the reliance on large datasets raises concerns about embedded biases, with the risk of reproducing or amplifying existing health disparities.

Beyond questions of responsibility and bias, AI challenges the very subjectivity of healthcare professionals. The increasing reliance on algorithmic outputs may affect clinicians’ confidence in their own judgment, potentially leading either to over-reliance on automated recommendations or to defensive skepticism. This evolving interaction between human and artificial agency also has implications for trust—both the clinician’s trust in the system and the patient’s trust in a form of care that is increasingly being mediated by opaque technologies.

The growing presence of AI also affects the nature of the patient–physician relationship. The increasing mediation of care through digital systems risks eroding the relational dimensions of medicine—trust, empathy, and moral judgment—that remain essential to good clinical practice. At the same time, it opens new questions about how these dimensions can be preserved, transformed, or even reconfigured within technologically augmented forms of care. Rather than replacing human agency, the challenge lies in integrating AI in ways that support, rather than diminish, these core elements.

This Special Issue seeks contributions from scholars across disciplines—including philosophy, medicine, data science, and law—to critically examine the ethical implications of AI in healthcare. We welcome original research articles, critical reviews, theoretical analyses, and case studies that explore both risks and opportunities. The aim is to foster a rigorous and plural dialogue capable of informing the responsible development, implementation, and governance of AI in medicine.

Prof. Dr. Vittoradolfo Tambone
Dr. Laura Campanozzi
Guest Editors

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• artificial intelligence
• medical ethics
• clinical reasoning
• trust
• responsibility
• patient–physician relationship
• digital health
• clinical expertise
• professional autonomy
• healthcare justice