Discursive Ethics as a Normative Foundation for Integrating Ethics into AI Clinical Decision Support Systems.

The rapid integration of Artificial Intelligence (AI) in critical sectors such as healthcare has raised significant concerns regarding human autonomy and the risk of delegating vital decisions to opaque artificial systems. This paper examines the normative foundations required for the responsible in...

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Publicado en:Science & Engineering Ethics Vol. 32; no. 5; pp. 1 - 25
Autor principal: Lozano, José-Félix
Formato: Artículo
Publicado: Springer Nature Oct2026
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Acceso en línea:Ver este registro en EBSCOhost
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        atl: Discursive Ethics as a Normative Foundation for Integrating Ethics into AI Clinical Decision Support Systems.
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        au: Lozano, José-Félix
        affil: https://ror.org/01460j859 Instituto Ingenio (CSIC - UPV), Universitat Politècnica de València, Camino de Vera S/N, 46022, Valencia, Spain
      su:
        Clinical decision support systems
        Artificial intelligence & ethics
        Communication ethics
        Habermas, Jürgen, 1929-2026
        Medical technology
        Moral judgment
        Agent (Philosophy)
        Rationalism
      sug:
        subj:
          Clinical decision support systems
          Artificial intelligence & ethics
          Communication ethics
          Habermas, Jürgen, 1929-2026
          Medical technology
          Moral judgment
          Agent (Philosophy)
          Rationalism
      keyword:
        AI ethics
        Communicative rationality
        Discursive ethics
        Human agency
        Philosophy and Religious Studies Philosophy
      ab: The rapid integration of Artificial Intelligence (AI) in critical sectors such as healthcare has raised significant concerns regarding human autonomy and the risk of delegating vital decisions to opaque artificial systems. This paper examines the normative foundations required for the responsible integration of ethical principles into AI-based Clinical Decision Support Systems. First, it reviews key descriptive models of human moral judgment—rationalist, intuitionist, and integrative approaches—and highlights their relevance for understanding how humans make ethical decisions under conditions of uncertainty. Particular attention is given to the Actor–Deed–Consequences (ADC) model, which captures the plural and intuitive structure of moral evaluation and offers a promising basis for informing ethical guidance functions in AI systems. Building on this analysis, the paper argues that descriptive models alone are insufficient to secure the legitimacy of AI-assisted clinical decisions. To address this gap, it proposes a discursive ethics framework grounded in the work of Karl-Otto Apel, Jürgen Habermas, and Adela Cortina. This framework emphasizes communicative rationality, stakeholder involvement, transparency, and accountability as essential conditions for ethically acceptable AI deployment. The paper concludes that AI-based CDSS should be developed as dialogical and process-oriented tools that support human judgment. Embedding discursive ethical procedures within AI architectures provides a robust normative pathway for ensuring that technological innovation in healthcare enhances human agency, safeguards dignity, and strengthens trust in clinical practice. Keywords: AI Ethics, Discursive Ethics, Clinical Decision Support Systems, Human Agency, AI Act, Communicative Rationality.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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