Ethical considerations for clinical adoption of ambient digital scribe technology

BACKGROUND AND SIGNIFICANCE: Ambient digital scribe (ADS) platforms, which combine ambient speech recognition and large language models to generate clinical documentation, are currently undergoing rapid clinical adoption. Early data suggest that ADS utilization may reduce documentation burden and improve provider efficiency; however, the ethical implications of this largely unregulated technology remain relatively unexamined. FINDINGS: In this article, we identify and explore 4 key ethical issues surrounding ADS technology-safety, bias, data ownership, and justice-from a range of stakeholder perspectives. We provide an overview of current international regulatory policies, highlighting the need for standardized evaluation and reporting guidelines. RECOMMENDATIONS: Drawing on established ethical frameworks, we propose actionable recommendations for safe and equitable ADS implementation, including standardized evaluation metrics, regulatory oversight, and safeguards at institutional and end-user levels. CONCLUSION: Ensuring the ethical implementation of ADS technology is essential for actualizing its potential benefits while upholding foundational principles of safety, equity, and transparency in clinical practice.