AI scribes are rapidly becoming a staple in sectors where documentation is an essential part of practice, including healthcare, legal services, education, and business. These tools use natural language processing (NLP) and machine learning to transcribe conversations and generate documentation, offering users increased efficiency, improved productivity, and better organization of information.

But with these benefits comes a serious need for ethical reflection. As a social worker, educator, and advocate for responsible AI, I often remind practitioners that just because something is faster doesn’t mean it’s automatically better. Ethical considerations must be at the forefront. This blog outlines the key ethical challenges of AI scribes and offers best practices for implementing AI scribes responsibly and intentionally while using risk management strategies.

What Are AI Scribes and How Do They Work?

AI scribes are software applications that use NLP and machine learning to listen, interpret, and document spoken communication in real-time or post-interaction. They’re currently being used to transcribe medical consultations, client interviews, legal depositions, academic lectures, and business meetings.

Unlike human scribes, AI scribes operate without fatigue and can integrate seamlessly with electronic systems. However, they lack human judgment, empathy, and the nuanced understanding that often comes from professional experience. That’s where we need to pause and assess how these tools are used.

Ethical Considerations for AI Scribe Implementation

Privacy and Data Security

Confidentiality remains a cornerstone across professions. Whether governed by HIPAA in healthcare or confidentiality clauses in legal and education settings, AI scribes must be designed and deployed with rigorous attention to privacy.

• Use encryption and secure servers for data transmission and storage

• Ensure third-party vendors are contractually bound to data protection standards

• Avoid overcollection of information, and data minimization is key

• Consider localized data storage to reduce exposure

Informed Consent Practices

Clients and staff should know when an AI scribe is being used. Transparency builds trust and ensures ethical integrity.

• Obtain clear, written consent 

• Provide opt-out options

• Document all consent processes

When using Berries’ AI scribe, a consent form template is provided on the website, which can be found here. Establishing a consistent, transparent consent process not only protects client rights but also reinforces organizational accountability and professionalism.

Bias and Fairness

AI systems learn from human data, which means they can inherit human biases. This can show up in how speech is interpreted or how different dialects are transcribed.

• Audit systems for performance across race, gender, and language differences

• Select vendors with a proven commitment to bias mitigation

• Engage diverse stakeholders in testing and monitoring

If you choose to use AI scribes, you, the human expert, must review all of their content and edit as you see fit to ensure there are no biases and errors. 

Accuracy and Accountability

Documentation errors can lead to real harm, particularly in clinical or legal contexts. Clarity about who reviews, verifies, and corrects AI-generated notes is essential.

• Implement human-in-the-loop verification

• Train staff to review and correct AI output

• Clarify legal and ethical accountability in organizational policies

• Monitor for patterns in AI errors to retrain or adjust models

Establishing a clear review and accountability process ensures that AI-assisted documentation enhances, rather than compromises, service quality and ethical standards.

Best Practices for Using an AI Scribe At Your Practice

To ensure responsible and ethical integration of AI scribes, organizations must establish clear structures for oversight, training, and quality control. Accountability systems safeguard against misuse and promote consistent, ethical practice.

• Develop clear written policies outlining acceptable AI use

• Create a multidisciplinary oversight committee

• Set up regular audits of AI performance and documentation quality

• Provide staff training on ethical, legal, and functional use

• Use a hybrid model that includes an AI plus human to verify critical records

• Ensure systems and processes are set up to provide and collect client consent to use AI AI scribes. 

Embedding accountability mechanisms into AI implementation builds trust, reduces risk, and reinforces a culture of ethical responsibility. These systems also help organizations adapt to emerging challenges as AI tools evolve.

Developing an Ethical Framework for AI Scribe Use

Integrating AI scribes into professional settings requires more than just technical readiness. It also demands a strong ethical foundation. Proactively creating an ethical framework ensures that AI tools are used responsibly and in alignment with core values.

1. Conduct Risk Assessments – Evaluate risks to privacy, equity, and accuracy

2. Engage Stakeholders – Include clients, staff, IT, and legal in decision-making

3. Develop Policies – Align with laws, ethics codes, and organizational values

4. Establish Feedback Loops – Encourage continuous reporting and adaptation

5. Revisit Regularly – Ethics is not a one-and-done task; review annually or as needed

By embedding ethics into every stage of AI scribe implementation, organizations can foster a culture of trust, accountability, and continuous improvement. A well-maintained ethical framework not only protects clients and staff but also strengthens the integrity of the organization’s AI use.

Conclusion

AI scribes are powerful tools, but with power comes responsibility. The efficiency they provide must never outweigh our duty to protect the dignity, privacy, and autonomy of those we serve. Ethical AI use starts with awareness and grows through accountability.

If you’re considering using AI scribes in your organization, begin with a critical eye. Ask who benefits, who could be harmed, and how you’ll ensure integrity at every stage. Build systems that align with your mission and values. Let’s lead the way in using AI not just responsibly, but ethically.

Frequently Asked Questions

Is using an AI scribe HIPAA-compliant? Yes, but only if the tool and its vendor meet all HIPAA requirements, including data encryption, secure storage, and business associate agreements. Berries AI is a HIPAA-compliant tool. 

How do I properly obtain consent for AI scribe use? Explain the tool clearly, provide written opt-in or opt-out options, and ensure consent is documented and revisited if circumstances change.

Who is responsible if an AI scribe makes an error? Ultimately, the organization and human professionals remain accountable. That’s why review systems and correction workflows are essential.

What bias concerns should I be aware of with AI scribes? Bias in speech recognition may affect those with accents, disabilities, or who speak in dialects. Testing for fairness and mitigating bias should be a core requirement.

How often should AI scribe outputs be reviewed by humans? Ideally, all outputs should be reviewed, especially in sensitive contexts like healthcare and legal documentation. Set organizational standards for review frequency.

Do clients/patients need to be informed that an AI is being used? Yes. Transparency builds trust and ensures ethical use. Inform individuals upfront and document your communication.