Background Artificial Intelligence (AI) is an area of computer science which involves the development of intelligent machines that work and react like humans. AI has potential to improve healthcare delivery through purposeful analysis of clinical record data. Examples of AI use in palliative care includes the analysis of electronic patient record data to predict survival, classify pain severity and to identify important clinical discussions. Despite the opportunities of AI, there are a number of ethical challenges of using this technology in palliative care. Consequently, this study aimed to identify the ethical challenges of AI in palliative care.

Methods A narrative scoping review of literature was undertaken to identify the evidence of AI use in palliative care. Three real-world case studies using AI in palliative care were critiqued in depth, using the four ethical principle framework (Autonomy, Justice, Beneficence, Non-maleficence). Ethical challenges were identified and summarised into themes.

Results Very few studies have examined the use of AI in palliative care; no studies discuss the ethical challenges as the primary focus. Ethical challenges for AI in palliative care were summarised into four themes: (1) Data privacy and security; (2) Artificial stupidity; (3) Prognostication; (4) Unexpected results and bias.

Conclusions AI has potential to support delivery in palliative care; however, a number of important ethical challenges need to be considered. AI healthcare data analysis should be built around an ethical framework. This is important in palliative care as individuals may be more vulnerable compared to other specialities. Research to determine the views and opinions of a patients, caregivers and healthcare professionals is urgently needed. Our work has led to the development of recommendations for ethical AI research in palliative care, which will hopefully guide meaningful use of this technology.