Background and purpose:One of the most important ethical challenges in the use of artificial intelligence are ethical dilemma.. An ethical dilemma, a type of ethical conflict, refers to any incompatibility between motivations and desires, educational methods, values, and the fulfillment of moral duties and responsibilities. Ethical challenges associated with the use of artificial intelligence in nursing care include dilemmas related to patient privacy and data security, impact on patient autonomy, informed consent, safety and transparency in guidelines, privacy, accountability, and transparency. Additionally, artificial intelligence may have unintended effects on the provision of nursing care. The aim of this study was to examine the ethical dilemmas of using artificial intelligence in nursing through a systematic review.
Materials and methods:This study was conducted independently by two researchers based on the research objectives and the PRISMA checklist. A comprehensive search of articles was performed from January 2018 to the end of April 2025 in the PubMed, SCOPUS, ACM Digital Library, Medline, and Web of Science databases, as well as the SID and Magiran search engines, using the MeSH strategy and the keywords "artificial intelligence","ethics" and "nursing" along with the English keywords "Ethics","Artificial Intelligence" and "Nursing" combined with Boolean operators. The steps included designing the research question, searching and extracting research studies, selecting relevant studies, tabulating and summarizing the information, and reporting the results.
Results:Out of the 62 articles retrieved, 17 were reviewed and included in the study. The results showed that despite numerous benefits, the use of AI in healthcare presents several ethical challenges that need to be addressed. These include informed consent, safety and clarity of instructions, patient data privacy, accountability, and impact on patient autonomy. Establishing clear guidelines and regulations is essential to ensure the ethical and accountable development and implementation of artificial intelligence. The review showed that bias and discrimination were the most frequently reported issues, appearing in 14 studies (82%). This was followed by nurse autonomy and patient autonomy, reported in 13 studies (76%). Responsibility and accountability were addressed in 12 studies (71%). Algorithmic transparency and interpretability were examined in 10 studies (59%). Both security, privacy, and human rights, as well as the principles of non-maleficence and beneficence, were reported in 9 studies (53%). Justice and fairness were reported in 8 studies (47%), while regulatory and legal frameworks were reported in 5 studies (29%), representing the lowest frequency among ethical challenges.
ConclusionThis review shows that ethical challenges in using artificial intelligence in nursing care, particularly regarding justice, autonomy, non-maleficence, beneficence, and responsibility, are common. Careful evaluation and effective solutions are essential to ensure ethical and responsible AI implementation in healthcare.
Type of Study:
Systematic Review |
Subject:
Nursing Received: 25/04/2025 | Accepted: 17/09/2025 | Published: 1/03/2026