中国医学伦理学2026，Vol.39Issue(5)：656-662,7.DOI:10.12026/j.issn.1001-8565.2026.05.14
人工智能介入失能老人照护决策的挑战与伦理对策探析
Exploration on the challenges and ethical countermeasures of artificial intelligence intervening in the care decision-making of older adults with disabilities
摘要
Abstract
Artificial intelligence(AI)is gradually being applied in the field of decision-making support for the daily care of the disabled elderly.However,due to their limited cognitive functions,information asymmetry with medical staff and technical parties,and a certain degree of emotional deprivation,the disabled elderly are in a structurally vulnerable position.Against this background,several ethical dilemmas arise when AI technology intervenes in care decision-making.First,the informed consent process is difficult to genuinely implement.Second,algorithms based on average models tend to ignore individual differences,leading to"de-personalization"of services.Third,over-reliance on technology may further weaken humanistic care,thereby undermining the individual dignity of the disabled elderly.Fourth,in the care decision-making involving the joint participation of the disabled elderly,caregivers,medical teams,and AI systems,the boundaries of responsibility among all parties remain unclear,making it difficult to assign accountability when adverse outcomes occur.Drawing on the theories of vulnerability ethics,interactive ethics,and care ethics,this paper proposes a"vulnerability-interaction-care"path and put forward three-tiered countermeasures.The first was baseline safeguards,preventing the exploitation of the vulnerability of the disabled elderly and their caregivers,and requiring further safeguards for their dignity.The second was process protection,enhancing transparency and accountability within the human-machine collaboration framework,as well as establishing a multi-party consultation mechanism.The third was capacity empowerment,improving the subjectivity of the disabled elderly through age-appropriate interaction,structured expression of intentions,and caregiver participation.关键词
失能老人/人工智能/照护决策/伦理对策Key words
artificial intelligence/care decision-making/ethical countermeasure分类
医药卫生引用本文复制引用
王润莹,张艺耀,杜欢,彭迎春..人工智能介入失能老人照护决策的挑战与伦理对策探析[J].中国医学伦理学,2026,39(5):656-662,7.基金项目
国家自然科学基金面上项目"内在能力—虚弱双轨迹监测下的老年健康风险评估及梯次应对研究"(72474141) （72474141）
