Artificial intelligence and bioethics: human dignity, autonomy and responsibility in contemporary medicine

Abstract

Introduction: This article investigates the ethical and epistemological limits of the use of artificial intelligence (AI) in contemporary medicine, examining the tensions between the automation of clinical decisions, patient autonomy and the preservation of human dignity. Methodology: The study adopts a hybrid approach, combining a systematic literature review, guided by the PRISMA 2020 protocol, with a theoretical-conceptual and hermeneutic analysis grounded in contemporary bioethics and the philosophy of technology. Empirical mapping in the Scopus database yielded 487 initial records; after removing duplicates (n = 96) and applying rigorous eligibility criteria (n = 327 excluded), 64 articles were read in full, culminating in the inclusion and qualitative synthesis of 20 eligible studies. Discussion and Results: The theoretical framework integrates principlist bioethics and the ethics of the digital society (Beneficence, Non-Maleficence, Autonomy, Justice and Explainability) with postulates from the ontology of organic intelligence, contributions from classical and contemporary philosophy (Schopenhauer, Kahneman, Heidegger, Jung, Jonas, Mumford), and institutional humanist guidelines (Magnifica Humanitas). Conclusion: The results and discussion reveal two critical dimensions: the epistemic order, marked by “black box” algorithmic opacity, data bias and the risk of a veiled return to medical paternalism; and the normative-regulatory order, characterized by the absence of independent audits, uncertainty of legal accountability, and blind spots in national governance. It concludes that artificial intelligence, while enhancing diagnostic accuracy and operational efficiency, is incapable of replicating the moral clinical judgment, empathy and acceptance of vulnerability intrinsic to the physician-patient relationship. Technological advancement in healthcare is legitimate only when strictly subordinate to human dignity, requiring continuous ethical governance, independent algorithmic audits and rigorous regulatory frameworks.