Author Archives: Jacqueline Ashby

What does patient consent, autonomy, and trust mean when AI is involved in the delivery of care?

In American Journal of Bioethics (Mar 2025), Y. Tony Yang’s commentary “Beyond Disclosure: Rethinking Patient Consent and AI Accountability in Healthcare” challenges the idea that simply telling patients “AI might be involved” is enough.
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Yang urges us to unpack what “Right to Notice and Explanation” means and to move beyond disclosure. It’s more than informing the patient that AI is used, it also includes:

1. Ensuring true patient understanding through opportunities to ask questions and seek clarification.
2. Identifying accountability by requiring that an AI system’s logic and functionality be documented and subject to audit.
3. Embedding explainability and trust at the core of AI-informed care through implementing ethical frameworks that emphasize fairness, transparency, and trustworthiness.

As the digital transformation of medicine speeds forward, our consent frameworks must be updated to reflect how the technology is being operationalized, while also considering how to minimize the disruption to current workflows and delivery of care.

Question for the network: How have you seen healthcare providers incorporate, or fail to incorporate, meaningful AI explanations into patient conversations?

Yang, Y. T. (2025). Beyond Disclosure: Rethinking Patient Consent and AI Accountability in Healthcare. The American Journal of Bioethics, 25(3), 151–153. https://lnkd.in/gq2kccuU

Last week, I had the opportunity to lead an academic session with incoming family medicine residents on one of the most pressing issues in modern healthcare: bias and confabulation in clinical AI tools.

We explored:
+ Real-world cases of AI bias, such as how LLMs alter triage and diagnostic suggestions based solely on patient demographics.
+ Confabulation traps where AI fabricates confident-sounding (but incorrect) medical guidelines.
+ Interactive bias testing: residents input identical chest pain cases into multiple AI tools, tweaking only the patient’s background to examine how different platforms analyze and articulate the patient’s management.
+ Ethical and legal dilemmas: including what happens when a chatbot contributes to chart notes, and whether disclosure is required.

We closed with this question:
+ What safeguard will you commit to using in your own practice to reduce the risk of AI misinformation entering the patient record?

Teaching AI literacy is about clinical discernment, ethical awareness, and training tomorrow’s physicians to engage AI with both curiosity and caution.
Grateful to this next generation of residents for their sharp thinking and thoughtful engagement.

🌍 Join Us in Shaping Compassionate Healthcare in Nigeria

The Primary Compassionate Care Initiative (PCCI) is seeking visionary leaders to join our Board of Directors.

Our mission is to strengthen community-based health and mentorship programs across Nigeria, ensuring every individual has access to compassionate, equitable care.

As a board member, you will:
• Guide strategy for impactful health initiatives
• Strengthen governance and accountability
• Build partnerships with communities and health leaders
• Advocate for compassionate care at every level

We welcome leaders with expertise in governance, finance, public health, advocacy, youth development, or community engagement.

If you’re passionate about creating lasting health impact, we’d love to connect. Together, we can build a healthier, more compassionate future.

📩 Interested? Please reach out to me on LinkedIn to learn more: https://www.linkedin.com/in/jacquelinepashby/

Check us out on Instagram too!

Five Years of Impact – Primary Compassionate Care Initiative

Almost exactly five years ago, Dr. Aisha Liman, Pankat Gurumding, Tim Fitzpatrick, and I launched the Primary Compassionate Care Initiative with a simple but bold vision: to mentor and equip young leaders to transform healthcare delivery in underserved communities.

What started as a small pilot has grown into one of the most meaningful projects of my career. Together, we’ve trained and mentored incredible students who are passionate about public health, community engagement, and leading with compassion.

This year marks our 5th anniversary and the start of Cohort 6 of our mentorship program with LASU students! 🇳🇬❤️⚕️

For six months, these students will:
1. Participate in workshops and mentorship with experienced public health leaders.
2. Lead community-based projects that address real health needs.
3. Build practical skills while centering empathy and equity in care.

Here’s to five years of learning, mentorship, and impact, and to the next five years of shaping compassionate healthcare leaders.

Photos from our first cohort in 2020. 🇳🇬
Learn more here: https://www.primarycompassionatecare.org/

From Mentees to Changemakers: Where Are They Now?

Our Primary Compassionate Care Initiative (PCCI) mentorship goes far beyond the program and often it sparks a journey. We are thrilled to launch our “Where Are They Now” series, where we reconnect with alumni making a difference in their communities.

In Episode 1, we caught up with Onyi Judith (Owerri Cohort), who reflected on a moment that still inspires her today:

“The moment that stands out was the day we carried out a sanitation sensitization in the village market square Eziobodo, Imo State. How joyful the women were to see young adults looking out for their wellbeing.”

This is the heart of compassionate care: young leaders stepping forward to create healthier, stronger communities.

➡️ Follow this series to see where purpose-driven mentorship can lead: https://www.instagram.com/primarycompassionatecare/

Investing in Communities Through Compassionate Care

Our Primary Compassionate Care Initiative (PCCI) believes that mentorship comes to life when our teams work hand-in-hand with local communities. This week, our PCCI cohort completed their final project at Ekorinim Health Center in Calabar, Nigeria.

Together with community healthcare workers, they:
1. Donated a new blood pressure monitor and thermometers to support patient care.
2. Delivered 50 immunization cards to children, helping families stay on track with vaccinations.
3. Engaged directly with residents, deepening their understanding of care in rural and remote settings.

These experiences shape future leaders while leaving an immediate impact on community health. We are so proud of our team for their dedication and willingness to learn from those they serve. 💙

Learn more here: https://www.instagram.com/primarycompassionatecare/

🎉 Excited to be facilitating two sessions at the 2025 CHES Celebration of Scholarship hosted by the UBC Centre for Health Education Scholarship.

🗓 October 22, 2025
📍 Robert H. Lee Alumni Centre, UBC

🔹 Round Table Discussion (8:30–9:15am)
“DocBot 101: Making Sense of AI Before It Makes Sense of You”
Co-facilitated with Dr. Meera Anand, this interactive session invites educators and researchers to explore how we can prepare learners to critically engage with AI before it defines the terms for them.

🔹 Oral Presentation (2:15–3:15pm)
“Swipe Right on Clinical Reasoning: Med Students Date the Future (It’s AI)”
I’ll be sharing insights on how generative AI is reshaping clinical reasoning and what this evolving relationship means for medical students and educators.

Grateful to CHES and UBC CPD for supporting meaningful dialogue in health professions education. Looking forward to connecting with colleagues who are navigating and shaping this rapidly changing space and technology.

AI is entering the exam room—who’s liable if it gives the wrong prescription?

In this must-read piece, Solaiman & Malik (2024) dissect the evolving EU legal landscape for algorithmic care, where the Artificial Intelligence Act meets real-world clinical complexity. Doctors are no longer the only ones with decision-making power—AI systems are being trained, deployed, and (occasionally) hallucinate diagnoses with remarkable confidence. 🙂

But when the AI makes a mistake… who takes the fall? The doctor? The developer? The data itself?

This paper explores how regulatory frameworks are shifting the traditional doctor–patient model, nudging us into a new triangle: doctor–patient–algorithm. Spoiler alert: Only one of them has a CE marking.

🌍 The EU’s AI Act is more than just red tape—it’s an attempt to ensure transparency, accountability, and safety in algorithmic care. And if you’re in healthcare or med ed, this isn’t just legalese—it’s your future.

✨ Favourite quote?
“AI’s growing sophistication presents unique challenges that threaten to erode the autonomy gained by disempowering patients and doctors alike and shifting controls to external market forces. Although AI’s potential to enhance diagnostic accuracy and support informed decision-making seems promising, it risks over-reliance by doctors, diminished personal interaction with patients, and raises concerns about data privacy, opacity, and accountability.”

🩺 Doctors may need to add “algorithm whisperer” to their CVs.

Read the full article here: https://academic.oup.com/medlaw/article/33/1/fwae033/7754853?login=false

“It is interesting to note that there is so much evidence regarding the intervention of these digital systems in medical education that it is practically impossible for the human mind to summarize. It is stated that to ensure the success of AI in medical education, it is crucial to foster interdisciplinary collaboration and increase investment in education and training.”

Just published: A scoping review mapping the integration of AI in undergraduate medical education (April 2025)

A new review (34 studies analyzed) highlights the global patchiness in how AI is brought into med school curricula. While AI tools like intelligent tutoring systems, chatbots, and VR simulations are gaining ground, there’s no unified framework yet. Key takeaways:

1. AI is best introduced as a supportive tool—enhancing ethics, digital competency, and collaboration—not merely a standalone subject.
2. Teaching must go beyond technical know-how: it needs to embrace ethical reasoning, patient‑centered care, and systems thinking. (See Deborah Lupton’s book on Digital Health for more in this area)
3. Institutional hurdles persist: from lack of faculty training to resource gaps.
4. There’s a critical need for adaptable, globally informed curricula.

We need standardized yet flexible frameworks to train tomorrow’s physicians to use AI responsibly and effectively. Let’s foster interdisciplinary collaboration (ethics + data science + clinical practice) and expand institutional support for curricular reform.

Read more on “Mapping the use of artificial intelligence in medical education: a scoping review”: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-025-07089-8