Re: Ethical considerations around the use of artificial intelligence in health care

Issue: BCMJ, vol. 68, No. 2, March 2026, Pages 55,60 Letters
By: Chris Whittington, MB BS, MBA, FCFP, FM & FACRRM, FACTM

Studies have shown that critical reasoning atrophies when using artificial intelligence (AI), even if the intent is to be diligent.[1] Microsoft has confirmed this finding.[2] Deep knowledge of statistics and computers is not needed to understand the negative impact of AI on cognitive abilities.[3]

It doesn’t matter how well you prompt a chat bot; it will still get a staggering number of answers wrong. The example prompt offered in the article [“I am a family physician in Vancouver. What is the best antihypertensive medication for my 55-year-old Indigenous patient with comorbidities including heart failure and chronic kidney disease? Search PubMed for relevant publications and provide references for your answer. Select medications covered by non-insured health benefits.”], like any similar prompt, is subject to which medication has the most aggressive marketing in the data set. This assumes the data set is not limited to peer-reviewed articles, with all conflicts of interest accounted for.

A “good prompt” should consider the risk of violating patient privacy and confidentiality, promote transparency, and meet professional standards of practice.[4]
—Chris Whittington, MB BS, MBA, FCFP, FM & FACRRM, FACTM
Abbotsford

This letter was submitted in response to “Ethical considerations around the use of artificial intelligence in health care.”

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References

1.    Kosmyna N, Hauptmann E, Yuan YT, et al. Your brain on ChatGPT: Accumulation of cognitive debt when using an AI assistant for essay writing task. arXiv. 10 June 2025. Accessed 18 December 2025. https://arxiv.org/abs/2506.08872.

2.    Lee H-P (H), Sarkar A, Tankelevitch L, et al. The impact of generative AI on critical thinking: Self-reported reductions in cognitive effort and confidence effects from a survey of knowledge workers. CHI ’25: Proceedings of the 2025 CHI Conference on Human Factors in Computing Systems. 25 April 2025. https://doi.org/10.1145/3706598.3713778.

3.    Roxin I. Generative AI: The risk of cognitive atrophy. 3 July 2025. Accessed 18 December 2025. www.polytechnique-insights.com/en/columns/neuroscience/generative-ai-the-risk-of-cognitive-atrophy/.

4.    College of Physicians and Surgeons of British Columbia. Ethical principles for artificial intelligence in medicine. Revised 3 October 2024. Accessed 18 December 2025. www.cpsbc.ca/files/pdf/IG-Artificial-Intelligence-in-Medicine.pdf.

Chris Whittington, MB BS, MBA, FCFP, FM & FACRRM, FACTM. Re: Ethical considerations around the use of artificial intelligence in health care. BCMJ, Vol. 68, No. 2, March, 2026, Page(s) 55,60 - Letters.


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