Exploring AI Impact on the Physician–Patient Relationship: From Confucian and Daoist Views

The integration of artificial intelligence (AI) into the medical domain has brought about significant transformations in healthcare practices, particularly in diagnostics and therapeutics, while simultaneously giving rise to substantial ethical dilemmas concerning its potential impact on the physician–patient relationship. This study delves into these complex issues by examining them through the dual lenses of Confucian and Daoist philosophies, offering Eastern insights to complement prevailing Western ethical frameworks. Beginning with an exploration of the distinction between the gradual and harmonious integration of AI and the rapid and transformative intelligence explosion, this research investigates the concept of diverse AI ethical agents and introduces two novel physician–patient relationship models—the AI–Patient model and AI–Physician–Patient model—put forth in recent Western philosophical discourse on machine ethics. Subsequently, this study presents a Daoist perspective on the utilization of machines, shedding light on why proponents of Daoism may object to the adoption of medical AI. The Daoist viewpoint posits that medical AI could potentially disrupt the physician's connection to the Dao, characterized by a deep, intuitive, and harmonious approach to medical practice. Furthermore, this research provides insights from a Confucian virtue ethics standpoint, leveraging its emphasis on the five basic human relationships to argue why Confucianism may favour the AI–Physician–Patient model over the AI–Patient model for the integration of AI in healthcare. Additionally, supplementary Confucian principles are introduced to emphasize the importance of pursuing this Confucian objective with careful consideration. The study contends that while the integration of AI into patient-end services is an inevitable progression, caution should be exercised against developing medical AI systems to replace human physicians, as healthcare extends beyond clinical interventions to encompass holistic approaches to addressing illnesses and take care of patients.
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2025