Thomas Quinn

Prehospital ambulance based research has unique ethical considerations due to urgency, time limitations and the locations involved. We sought to explore these issues through interviews with experts in this research field. We undertook semi-structured interviews with expert informants, primarily based in the UK, seeking their views and experiences of ethics in ambulance based clinical research. Participants were questioned regarding their experiences of ambulance based research, their opinions on current regulations and guidelines, and views about their general ethical considerations. Participants were chosen because they were actively involved in, or in their expert capacity expressed an interest in, ambulance based research. Fourteen participants were interviewed including principal investigators, researchers, ethicists and medical lawyers. Five major themes were identified: Capacity, Consent, Clinical Considerations, Consultation and Regulation. Questions regarding consent and capacity were foremost in the discussions as all participants highlighted these as areas for concern. The challenges and use of multiple consent models reflected the complexity of research in this environment. The clinical theme referred to the role of paramedics in research and how research involving ambulance services is increasingly informing improvements to patient care and outcomes and reducing the burden on hospital services. Most felt that, although current regulations were fit for purpose, more specific guidance on implementing these in the ambulance setting would be beneficial. This related closely to the theme of consultation, which examined the key role of ethics committees and other regulatory bodies, as well as public engagement. By interviewing experts in research or ethics in this setting we were able to identify key concerns and highlight areas for future development such as improved guidance.

This paper provides the first comprehensive analysis of ethical issues raised by artificial intelligence (AI) in veterinary medicine for companion animals. Veterinary medicine is a socially valued service, which, like human medicine, will likely be significantly affected by AI. Veterinary AI raises some unique ethical issues because of the nature of the client–patient–practitioner relationship, society’s relatively minimal valuation and protection of nonhuman animals and differences in opinion about responsibilities to animal patients and human clients. The paper examines how these distinctive features influence the ethics of AI systems that might benefit clients, veterinarians and animal patients—but also harm them. It offers practical ethical guidance that should interest ethicists, veterinarians, clinic owners, veterinary bodies and regulators, clients, technology developers and AI researchers.