1- School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
2- Department of Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
2- Department of Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract: (23 Views)
Dear Editor
The increasing integration of artificial intelligence (AI) into healthcare systems has introduced both technological advancement and ethical transformation in nursing practice. While AI-based tools enhance clinical efficiency, documentation accuracy, and decision-support processes, their ethical implications regarding patient privacy, professional accountability, and ethical decision-making remain critically debated. In this systematic examination of empirical studies published between 2015 and 2025, key ethical dimensions of AI application in nursing were analyzed. Findings indicate persistent concerns about data confidentiality, ambiguity in responsibility boundaries, and potential over-reliance on algorithmic recommendations. At the same time, AI-assisted education demonstrates positive effects on ethical reasoning and professional self-awareness. However, the absence of clear governance frameworks and explicit accountability policies limits the safe and ethically grounded implementation of AI in nursing practice. Strengthening digital ethics education, clarifying shared accountability between clinicians and intelligent systems, and conducting longitudinal clinical research are essential priorities for advancing ethical AI integration in nursing.
The increasing integration of artificial intelligence (AI) into healthcare systems has introduced both technological advancement and ethical transformation in nursing practice. While AI-based tools enhance clinical efficiency, documentation accuracy, and decision-support processes, their ethical implications regarding patient privacy, professional accountability, and ethical decision-making remain critically debated. In this systematic examination of empirical studies published between 2015 and 2025, key ethical dimensions of AI application in nursing were analyzed. Findings indicate persistent concerns about data confidentiality, ambiguity in responsibility boundaries, and potential over-reliance on algorithmic recommendations. At the same time, AI-assisted education demonstrates positive effects on ethical reasoning and professional self-awareness. However, the absence of clear governance frameworks and explicit accountability policies limits the safe and ethically grounded implementation of AI in nursing practice. Strengthening digital ethics education, clarifying shared accountability between clinicians and intelligent systems, and conducting longitudinal clinical research are essential priorities for advancing ethical AI integration in nursing.
Keywords: Artificial Intelligence, Nursing Ethics, Patient Privacy, Professional Responsibility, Ethical Decision Making
Subject:
Helath Services Management
Received: 2025/12/22 | Accepted: 2026/02/17 | ePublished ahead of print: 2026/09/20
Received: 2025/12/22 | Accepted: 2026/02/17 | ePublished ahead of print: 2026/09/20
References
1. Wei Q, Pan S, Liu X, Hong M, Nong C, Zhang W. The integration of AI in nursing: addressing current applications, challenges, and future directions. Frontiers in Medicine 2025;12:1545420 [DOI:10.3389/fmed.2025.1545420]
2. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. British Medical Journal 2021;372:1-9 [DOI:10.1186/s13643-021-01626-4]
3. Rony MK, Numan SM, Akter K, Tushar H, Debnath M, tuj Johra F, Akter F, Mondal S, Das M, Uddin MJ, Begum J. Nurses' perspectives on privacy and ethical concerns regarding artificial intelligence adoption in healthcare. Heliyon 2024;10:1-16 [DOI:10.1016/j.heliyon.2024.e36702]
4. Wang X, Fei F, Wei J, Huang M, Xiang F, Tu J, Wang Y, Gan J. Knowledge and attitudes toward artificial intelligence in nursing among various categories of professionals in China: a cross-sectional study. Frontiers in Public Health 2024;12:1433252 [DOI:10.3389/fpubh.2024.1433252]
5. Kwak Y, Ahn J-W, Seo YH. Influence of AI ethics awareness, attitude, anxiety, and self-efficacy on nursing students' behavioral intentions. BioMed Central Nursing 2022;21:267 [DOI:10.1186/s12912-022-01048-0]
6. Yıldız E. Artificial intelligence in mental health nursing: Balancing clinical efficiency and the human touch:A quest for a new synthesis. Journal of Psychiatric and Mental Health Nursing 2025;32:946-52 [DOI:10.1111/jpm.13173]
7. Watson AL. Ethical considerations for artificial intelligence use in nursing informatics. Nursing Ethics 2024 Sep;31:1031-40 [DOI:10.1177/09697330241230515]
8. Stokes F, Palmer A. Artificial intelligence and robotics in nursing: ethics of caring as a guide to dividing tasks between AI and humans. Nursing Philosophy 2020;21:e12306 [DOI:10.1111/nup.12306]
9. Hesjedal MB, Lysø EH, Solbjør M, Skolbekken JA. Valuing good health care: How medical doctors, scientists and patients relate ethical challenges with artificial intelligence decision‐making support tools in prostate cancer diagnostics to good health care. Sociology of Health & Illness 2024;46:1808-27 [DOI:10.1111/1467-9566.13818]
10. Benfatah M, Youlyouz-Marfak I, Saad E, Hilali A, Nejjari C, Marfak A. Impact of artificial intelligence-enhanced debriefing on clinical skills development in nursing students: A comparative study. Teaching and Learning in Nursing 2024;19:e574-9. [DOI:10.1016/j.teln.2024.04.007]
11. Shin H, De Gagne JC, Kim SS, Hong M. The impact of artificial intelligence-assisted learning on nursing students' ethical decision-making and clinical reasoning in pediatric care: a quasi-experimental study. CIN: Computers, Informatics, Nursing 2024;42:704-11 [DOI:10.1097/CIN.0000000000001177]
12. Penner SB, Mercado NR, Bernstein S, Erickson E, DuBois MA, Dreisbach C. Fostering informed consent and shared decision-making in maternity nursing with the advancement of artificial intelligence. MCN: The American Journal of Maternal/Child Nursing 2025;50:78-85 [DOI:10.1097/NMC.0000000000001083]
13. Badawy W, Zinhom H, Shaban M. Navigating ethical considerations in the use of artificial intelligence for patient care: A systematic review. International Nursing Review 2025;72:e13059 [DOI:10.1111/inr.13059]
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