JMIR Publications

ABSTRACT

Background:

Artificial intelligence (AI) is increasingly integrated into palliative medicine, offering opportunities to improve quality, efficiency, and patient-centeredness in end-of-life care. However, its use raises complex ethical issues, including privacy, equity, dehumanization, and decision-making dilemmas.

Objective:

To critically analyse the main ethical implications of AI in end-of-life palliative care and examine the benefits and risks. Propose strategies for ethical and responsible implementation.

Methods:

We conducted an integrative review of studies published from 2020–2025 in English, Portuguese, and Spanish, identified through systematic searches in PubMed, Scopus, and Google Scholar. Inclusion criteria were studies addressing AI in palliative medicine focusing on ethical implications or patient experience. Two reviewers independently performed study selection and data extraction, resolving discrepancies by consensus. The quality of the articles was assessed using the CASP checklist and the Hawker et al. tool.

Results:

Six key themes emerged: 1) practical applications of AI, 2) communication and AI tools, 3) patient experience and humanization, 4) ethical implications, 5) quality of life perspectives, and 6) challenges and limitations. While AI shows promise for improving efficiency and personalization, consolidated real-world examples of efficiency and equity remain scarce. Key risks include algorithmic bias, cultural insensitivity, and the potential for reduced patient autonomy.

Conclusions:

AI can transform palliative care, but implementation must be patient-centred and ethically grounded. Robust policies are needed to ensure equity, privacy, and humanization. Future research should address data diversity, social determinants, and culturally sensitive approaches.