Ethical Issues Arise with Error Disclosures, AI in Pathology
Diagnosis, treatment, and clinical recommendations often hinge on what happens in a lab, and when mistakes are made -- or when emerging tools like artificial intelligence introduce new risks -- patients face serious consequences. A recent ethics session at the College of American Pathologists brought these concerns into sharp focus.
In the session, presenter Suzanne M. Dintzis, MD, PhD shared a case where two kidney biopsies were taken on the same day -- one showing normal function, the other revealing severe rejection. Somewhere in the process, the slides were accidentally switched. Both patients were harmed by the resulting misdiagnoses. The presentation by Dr. Dintzis focused on internal discussion of identifying what went wrong and why, and the next steps by clinicians, including disclosure to the patient.
The conversation didn’t stop with human error. Artificial intelligence, increasingly used in pathology workflows, raises its own set of ethical concerns -- particularly around data privacy. Many organizations assume that de-identified data is safe because patient names and identifiers have been removed. But AI has the ability to take data from multiple sources, including hospitals, labs, insurers, and data brokers, and can re-combine it in ways that inadvertently identify individual patients.
Brian R. Jackson, MD, MS, of the University of Maryland Medical Center urged pathologists and labs to build contractual protections that restrict how data can be used downstream. He also stressed the importance of rigorous oversight when AI tools play a meaningful role in diagnosis, noting that medical AI is still in a very immature phase. Software that influences clinical decisions must be monitored carefully to ensure that accuracy, bias, and model drift do not compromise patient care.
Whether the problem stems from a mislabeled slide, a software malfunction, or an AI-driven privacy risk, the result can be life-altering. Patients rely on accurate pathology results to guide critical medical decisions. When those results are wrong, the ripple effects extend far beyond the lab: delayed treatment, unnecessary procedures, emotional distress, permanent injury, or worse. These are not technical oversights -- they are breaches of trust and safety.
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