Medical Ethics in Terminal Patients: Dilemmas in the Use of AI for End-of-Life Decisions

Medical ethics in terminal patients faces unprecedented challenges with the integration of artificial intelligence (AI) in end-of-life decision-making. This article aims to analyze the ethical dilemmas arising from the use of AI in this context by exploring its implications for autonomy, dignity, and the humanization of palliative care. To this end, a literature review was conducted of articles in Spanish and English indexed in Scopus between 2018 and 2022, selecting studies that addressed the intersection of AI, bioethics, and palliative medicine. The results were organized into four thematic axes: patient autonomy and informed consent, algorithmic biases and equity in recommendations, dehumanization versus optimization of care, and legal and moral responsibility in automated decisions. It was identified that, although AI can improve the accuracy of forecasts and treatments, its implementation requires ethical safeguards to prevent the reduction of the doctor-patient relationship to a technical process. The conclusions highlight the need for regulatory frameworks that balance technological innovation with bioethical principles, prioritizing human dignity and the active participation of patients and families in end-of-life decisions.