The ethics of listening walls: patient autonomy and consent in the age of ambient clinical AI.

Kumah, Emmanuel; Antwi, Juvina; Boakye, Dorothy Serwaa; Botchwey, Charles Owusu-Aduomi; Anyimadu, Eric · NPJ Digit Med · 2026

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Abstract

Ambient clinical AI scribes are rapidly adopted to reduce documentation burden and clinician burnout. While evidence shows efficiency gains, these always-listening systems raise significant ethical concerns around informed consent, autonomy, privacy, data governance, and trust. This paper examines patient perspectives, identifies regulatory and equity gaps, and argues for patient-centered consent, transparency, data minimization, and robust governance to ensure ethical deployment of ambient AI in clinical care settings.