Journal of Medical Ethics and History of Medicine

Why is the idea of AI completely replacing physicians a pseudo-problem? A philosophical analysis

Alireza Monajemi — Sun, 25 May 2025 12:02:08 +0430

Artificial intelligence (AI) has the potential to revolutionize healthcare, but is unlikely to fully replace human doctors. This paper explores the limitations of AI in healthcare, focusing on three key areas: lack of embodiment, limited understanding of meaning in everyday language, and the inability to exercise judgment and clinical reasoning. Recognizing these limitations enables us to use AI to enhance our capabilities rather than allowing it to substitute humans. Following this philosophical examination of AI's limitations, I will argue that the question of whether AI will replace doctors is a misleading one. Instead, this framework advocates for synergistic human-AI collaboration in health-care settingsIt necessitates the development of hybrid entities: a physician-AI partnership and a patient-AI interface. The overarching objective is to effectively address the core mission of medicine, which is providing optimal treatment and compassionate care for all patients. This hybrid model must proactively mitigate the risks of AI integration, such as exacerbation of existing health-care challenges and potential dehumanization of patient care. Within this framework, key objectives include: reducing medical errors, fostering humane doctor-patient relationships, mitigating the trend of medicalization, and ultimately improving overall public health outcomes.

Philosophy of medicine meets AI hallucination and AI drift: moving toward a more gentle medicine

Hamidreza Namazi, Mohammad Mahdi Radfar — Tue, 27 May 2025 11:31:32 +0430

The contemporary world is profoundly shaped by technological progress. Among the advancements of our era is the proliferation of artificial intelligence (AI). AI has permeated every facet of human knowledge, including medicine. One domain of AI development is the application of large language models (LLMs) in health-care settings. While these applications hold immense promise, they are not without challenges. Two notable phenomena, AI hallucination and AI drift, pose setbacks. AI hallucination refers to the generation of erroneous information by AI systems, while AI drift is the production of multiple responses to a single query. The emergence of these challenges underscores the crucial role of the philosophy of medicine. By reminding practitioners of the inherent uncertainty that underpins medical interventions, the philosophy of medicine fosters a more receptive stance toward these technological advancements. Furthermore, by acknowledging the inherent fallibility of these technologies, the philosophy of medicine reinforces the importance of gentle medicine and humility in clinical practice. Physicians must not shy away from embracing AI tools due to their imperfections. Acknowledgment of uncertainty fosters a more accepting attitude toward AI tools among physicians, and by constantly highlighting the imperfections, the philosophy of medicine cultivates a deeper sense of humility among practitioners. It is imperative that experts in the philosophy of medicine engage in thoughtful deliberation to ensure that these powerful technologies are harnessed responsibly and ethically, preventing the reins of medical decision-making from falling into the hands of those without the requisite expertise and ethical grounding.

The Relationship between moral resilience, moral distress, and second victim syndrome among Iranian ICU nurses: a cross-sectional correlational study

Zahra Asadi, Alun C. Jackson, Azam Jahangirimehr, Fatemeh Bahramnezhad — Sat, 07 Jun 2025 09:19:20 +0430

This cross-sectional study, conducted in 2023 on 386 ICU nurses from hospitals affiliated with Tehran University of Medical Sciences, investigated the relationships between moral resilience, moral distress, and second victim syndrome. Participants were selected through simple random sampling, and data were collected using Rushton’s Moral Resilience Scale, Hamric’s Moral Distress Questionnaire, and Burlison’s Second Victim Scale. Analysis was performed using descriptive statistics and Pearson’s correlation in SPSS v24. The results showed a significant positive correlation between second victim syndrome and moral distress, indicating that increased second victim experiences were associated with higher moral distress. There was also a significant negative correlation between moral resilience and second victim syndrome, confirmed by regression and structural equation modeling. However, no significant correlation was found between moral resilience and moral distress. Overall, the study highlights that second victim syndrome contributes to moral distress, while moral resilience acts as a protective factor. It is recommended that targeted interventions – such as resilience training, peer support groups, professional debriefing, and organizational mental health.initiatives -be implemented to mitigate these psychological challenges in high-stress ICU environments.

Beyond appearance: patient perspectives on the role of physician attire in trust

Mohammad Kazem Sarpoolaki, Hanieh Tavasoli, Amirali Sohrabpoor, Fariba Asghari — Sat, 19 Jul 2025 11:53:11 +0430

This study examines the role of physician attire in building patient trust compared to other professional behaviors, identifying key attire-related factors that influence this trust. The study consisted of two parts. In the first part, patients and their companions participated in in-depth interviews to identify factors affecting their trust in doctors, including appearance. The findings from these interviews were used to create a survey questionnaire. In the second part of the study, 120 patients and their companions from two teaching hospitals were surveyed about the importance of doctors' attire and professional behaviors identified earlier. Qualitative interviews revealed three trust-building themes: general behavior (honesty and kindness), providing information (about diseases and necessary measures), and appearance (white coat and cleanliness). Quantitatively, 120 participants rated providing information (81%) and honesty (74.2%) as the most important factors in building trust, with appearance rated as very important (40%) but less critical (P < 0.001). White coats were prioritized over hygiene and clothing cleanliness (P < 0.0001), while 37.5% noted that tattoos or bright clothing reduced trust.The findings show that several factors are more important than the type of a doctor's attire in maintaining the patient's trust, and the dress code should prioritize safety and infection prevention.

Compassionate care and moral distress in nursing: the mediating role of organizational citizenship behavior

Tue, 22 Jul 2025 11:25:07 +0430

Decline in compassionate care is potentially linked to moral distress and fostering different aspects of organizational citizenship behavior can reduce the outcome of moral distress. This study aimed to determine the mediating role of organizational citizenship behavior in the relationship between compassionate care and moral distress among nurses. For this purpose, a correlational study design using structural equation modeling was employed. Between December 2023 and March 2024, 300 nurses were selected through convenience sampling from hospitals in Fars Province, southern Iran. Data were collected using the Organizational Citizenship Behavior Questionnaire, the Compassionate Care Questionnaire for Nurses, and the Moral Distress Questionnaire. Data analysis was conducted using SPSS version 22 and Smart-PLS software.Our findings showed that compassionate care, combined with the mediating role of organizational citizenship behavior, significantly impacted moral distress (t = 2.442, P < 0.015, β = -0.071). Pearson’s correlation coefficients showed that compassionate care had a positive and significant relationship with organizational citizenship behavior (r = 0.444, P < 0.001) and a negative and significant relationship with moral distress (r = -0.353, P < 0.001).It is therefore recommended that managers in clinical systems focus on training nurses who exhibit appropriate organizational citizenship behavior in health-care settings.

Clearing the confusion about conflict of interest, conflict management and conflict resolution in educational settings

Fatemeh Mohseni, Mahboobeh Khabaz Mafinejad, Larry Gruppen — Wed, 16 Jul 2025 09:27:36 +0430

Conflict of interest, conflict management, and conflict resolution are often used interchangeably, leading to confusion and ineffective strategies in educational settings. Conflict of interest involves personal interests interfering with professional responsibilities. Conflict management focuses on minimizing negative impacts and fostering constructive outcomes, while conflict resolution addresses underlying issues for a final solution. Understanding these distinctions is essential for effective conflict handling, as conflating the terms can result in inappropriate strategies and ethical violations.