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<p>The use of Artificial Intelligence (AI) in healthcare is increasing in Indonesia, but faces challenges related to Indonesia’s communal and hierarchical cultural context. Ethical issues are becoming increasingly complex, not only in terms of the principles of beneficence and non-maleficence, but also in relation to humanization and care in doctor-patient relationships. The position of AI in healthcare is determined by doctors’ perceptions. This study captures doctors’ perceptions of the use of AI in healthcare services in relation to the principles of bioethics and ethics of care, within the context of Indonesia’s culture. The study used a descriptive qualitative approach through in-depth semi-structured interviews with twenty-five doctor participants practicing emergency services in Indonesia. The results revealed four spectrums of AI integration within the clinical autonomy of doctor: (1) as a doctor’s assistant/tool, (2) as a co-pilot with a specific role, (3) as a doctor’s discussion partner, and (4) as a reinforcement of doctor recommendations. These four spectrums reflect ethical issues between the basic principles of bioethics and the humanism of doctor-patient relationships influenced by communal and hierarchical culture. A collaborative approach between the basic principles of bioethics and the ethics of care is seen as more contextual to Indonesia’s communal and hierarchical culture, to minimize the risk of dehumanization. The practical implication of these findings is the need for training for doctors, not only about AI, but also ethics of care and empathetic communication.</p>

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Spectrums of AI Integration in Doctor’s Clinical Autonomy: Integrating Ethics of Care and Bioethical Principles, within Indonesia’s Communal and Hierarchical Context

  • 期刊论文

  • 发表日期：

    2026年4月25日

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  • Hwian Christianto,
  • Ervin Dyah Ayu Masita Dewi,
  • Risma Ikawaty,
  • Kate Rossie

摘要

The use of Artificial Intelligence (AI) in healthcare is increasing in Indonesia, but faces challenges related to Indonesia’s communal and hierarchical cultural context. Ethical issues are becoming increasingly complex, not only in terms of the principles of beneficence and non-maleficence, but also in relation to humanization and care in doctor-patient relationships. The position of AI in healthcare is determined by doctors’ perceptions. This study captures doctors’ perceptions of the use of AI in healthcare services in relation to the principles of bioethics and ethics of care, within the context of Indonesia’s culture. The study used a descriptive qualitative approach through in-depth semi-structured interviews with twenty-five doctor participants practicing emergency services in Indonesia. The results revealed four spectrums of AI integration within the clinical autonomy of doctor: (1) as a doctor’s assistant/tool, (2) as a co-pilot with a specific role, (3) as a doctor’s discussion partner, and (4) as a reinforcement of doctor recommendations. These four spectrums reflect ethical issues between the basic principles of bioethics and the humanism of doctor-patient relationships influenced by communal and hierarchical culture. A collaborative approach between the basic principles of bioethics and the ethics of care is seen as more contextual to Indonesia’s communal and hierarchical culture, to minimize the risk of dehumanization. The practical implication of these findings is the need for training for doctors, not only about AI, but also ethics of care and empathetic communication.