Pediatric Cardiology in the Age of Artificial Intelligence: An Updated Review of Bioethical Considerations and Impact on Care Quality

Innovations in technology continue to create new possibilities in all areas of medicine, including pediatric cardiology. Some of these possibilities include earlier diagnosis, clinical decision support, risk assessment, and image interpretation. As artificial intelligence (AI)-integrated systems transition from research to routine practice, they influence employee decision-making and raise concerns about patient safety, data privacy, clinician control, and accountability, especially in decisions impacting minors and their families. This article is presented as a narrative, ethics- and quality-focused review rather than a formal systematic review or meta-analysis. We utilize the review framework provided by the World Health Organization (WHO) and the Institute of Medicine (IOM), focusing on the six domains of quality: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. We address current applications of AI in pediatric cardiology, including echocardiography, electrocardiography, AI-based detection in congenital heart disease, and prognostic modeling in the ICU. We address pediatric algorithmic bias, explainability, and consent, which are among the most challenging bioethical issues when framing an AI tool as appropriate for bedside use. Consistency across use cases is essential; AI should strengthen, not replace, clinical reasoning and responsibility.