Ethical and moral challenges of artificial intelligence in nursing

Background: The rapid integration of Artificial Intelligence (AI) in healthcare has transformed nursing practice, improving efficiency and quality of care, offering new possibilities in decision support. However, the integration of AI in nursing raises important ethical, deontological and legal issues that need to be carefully addressed to ensure its responsible and equitable utilization.  

Aim: This literature review explores the ethical issues and challenges arising from the use of AI in nursing and suggests ways to manage these challenges.

Methodology: The literature review search was conducted from 2019 to 2025, in English, in PubMed, Scopus, EMBASE databases. Research studies and reviews with index words: artificial intelligence, clinical ethics, explainability, transparency, bias and combinations of these or their synonyms were included.

Results: Algorithms often function as “black boxes”, which makes it difficult for healthcare professionals to justify their decisions, leading to a lack of trust and difficulty in their acceptance by patients. The allocation of liability in cases of medical errors related to the use of AI remains unclear and may be shared between healthcare professionals, software development companies and healthcare organizations.

Conclusions: The use of AI in nursing requires a balanced approach that combines technological innovation with ethical responsibility. It must be done with care, ensuring that it serves as a tool to support, not replace, nurses. Involving nurses in the development, testing, and training of AI-based systems is not only beneficial but essential. Incorporating nursing knowledge into AI tools ensures that they will be more accurate, effective, ethical, ultimately leading to better outcomes for patients.

Keywords: Artificial intelligence, ethics, explainability, transparency, privacy, bias.