Культура вины и ответственность врача при использовании систем поддержки принятия врачебных решений

Человек. 2023. Т. 34. № 3. С. 9–23.

Ugleva A. V.

The purpose of this article is to substantiate the need to revise the structure of moral and criminal responsibility of the physician in a social system in which a culture of guilt is imposed on him, that is, sole personal responsibility for any medical error committed, including with the participation of the clinical decision support system. From the paternalistic
model of the «doctor-patient» relationship, since the 1970s, there has been a transition to a model of collaborative responsible behavior, in which each party is obligated to know and understand the nature of clinical decisions,
which must also be supported by a special form of informed consent for both patient and physician, if AI technologies are included in diagnostic and treatment procedures. At the same time, in fact, there is no clear regulation
of the process of communication and work with information, as well as the personal responsibility of top management for the formation of a medical support system. Because of the fundamental opaqueness of the operation
of constantly developing artificial intelligence technologies (using neural networks as an example), the final decision must remain with the physician. However, justification of his responsibility in the new technological conditions
requires a new social contract within the professional environment regarding the conditions for implementing clinical decision support system into broad medical practice.

Keywords: искусственный интеллект, доверие, trust, autonomy, автономия, Medical errors, Clinical Decision Support Systems, аrtificial intelligence, physician responsibility, culture of guilt, медицинская ошибка, ответственность врача, система поддержки принятия врачебных решений, культура вины