Ethics and AI Use in Medical Practice: American College of Physicians Releases Position Statement

As artificial intelligence (AI) becomes increasingly integrated into clinical practice, including through documentation tools, clinical decision support, and image-based technologies relevant to dermatology, a new position paper from the American College of Physicians (ACP) provides guidance for its ethical use in patient care.¹

According to the paper, AI use should be guided by independent clinical judgment, tailored to patient needs, used to advance equitable distribution of care, and implemented in ways that respect patient autonomy. The authors position AI as “augmented” intelligence rather than a substitute for physician judgment, building on a 2024 ACP policy paper that took the same stance.²

3 Guideposts: Relationality, Self-Governance, and Competence

Under relationality, the paper notes that physicians should use AI in ways that preserve the patient-physician relationship, arguing that AI cannot be accountable to patients, appreciate individual patient values over time, or form a therapeutic alliance.

The authors raise particular concern about attention. Although ambient AI scribes have shown promise in reducing documentation burden and may allow physicians to focus more closely on patients during clinical encounters, the paper cites survey data indicating that nearly 60% of Americans are uncomfortable with the idea of a physician relying on AI in their own care.

Self-governance maintains that physicians should use independent clinical judgment and proactively identify potential bias rather than defer entirely to an AI-generated output. This consideration may be particularly relevant as AI-supported diagnostic and image-analysis technologies become more common in specialties such as dermatology, where performance across different skin tones and patient populations remains an important consideration.

Competence addresses the risk of deskilling. The paper warns that overreliance on AI tools could erode diagnostic and clinical skills, particularly among trainees and less experienced physicians. For clinicians incorporating AI into practice, the authors emphasize maintaining the underlying expertise necessary to independently assess an AI-generated recommendation.

Position Statements

The paper translates the 3 guideposts into 4 position statements: AI must support rather than weaken the patient-physician relationship; physicians and trainees must recommit to core competencies of caring while developing new competencies specific to AI; AI use should respect and promote physician-independent clinical judgment rather than replace it; and physicians, working with health systems, must actively identify and mitigate algorithmic bias, including its social and structural roots.

On transparency, the authors write that disclosure obligations should be tailored to the individual patient using clinical judgment, but that “the newness of AI and patient concerns suggest erring on the side of disclosure.” They point to standardized, updated summaries of how a model works as a promising tool for supporting patient-physician conversations about AI use.

These considerations may become increasingly relevant as dermatology practices adopt AI-enabled tools across clinical workflows, from documentation and administrative support to patient education, image analysis, and clinical decision support.

Broader Context

The paper also raises the environmental costs of AI, noting that AI-based queries consume more energy than conventional internet queries and that the placement of AI data centers in socially vulnerable communities raises additional equity concerns.

The authors call for local AI governance models spanning a project’s full life cycle, with obligations around transparency, disclosure, and fairness scaled to clinical risk. They also recommend that diverse teams—including patients—be involved in decisions about fairness and oversight.

For dermatology clinicians, the framework underscores that adoption of AI should extend beyond whether a technology improves efficiency or diagnostic performance. Its use also requires consideration of how a tool affects clinical judgment, patient trust, health equity, and the physician-patient relationship.

The paper, developed by ACP’s Ethics, Professionalism and Human Rights Committee (EPHRC), was approved by the ACP Board of Regents and appears in Annals of Internal Medicine.

References

1. DeCamp M, Sulmasy LS, Karches KE, et al. Ethics and professionalism in artificial intelligence and medical practice: a position paper from the American College of Physicians. Ann Intern Med. 2026.
2. Daneshvar N, Pandita D, Erickson S, et al; ACP Medical Informatics Committee and the Ethics, Professionalism and Human Rights Committee. Artificial intelligence in the provision of health care: an American College of Physicians policy position paper. Ann Intern Med. 2024;177(7):964-967.