[When AI is involved in making decisions. Ethical considerations on shared decision-making in psychotherapeutic-psychiatric treatment].

BACKGROUND: Artificial intelligence (AI) is on the rise in the treatment of persons with psychiatric disorders. It can integrate diverse data points, analyze patterns and thereby generate clinically relevant insights that can influence the shared decision-making (SDM) process between patient and practitioner. OBJECTIVE: This article aims to examine how AI can influence the SDM process in psychiatric and psychotherapeutic care. Furthermore, ethical and clinical considerations relevant to an appropriate and justified implementation are addressed. METHODS: The potential effects on SDM are analyzed with an adapted process model which is expanded by the dimensions of relational autonomy and epistemic justice, using three exemplary clinical applications. RESULTS: The use of AI has the potential to support patients in reflecting on and validating their own experiences by providing additional information; however, the use of such tools can influence the patient-practitioner relationship. This is particularly important if algorithmic assessments undermine the patients' self-reports or shift responsibilities in the decision-making process. DISCUSSION: Whether AI supports or hinders SDM seems to depend on its embedment in the treatment context. When results are transparently communicated, interpreted within the participant-practitioner alliance and considered as a part of the participatory decision-making process, AI can be implemented in a clinically and ethically responsible and beneficial manner.