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SASP Symposium 2026 — Ethics and the use of AI in physiotherapy

Better than, or better with?

Ethics and AI in physiotherapy practice
Michael Rowe University of Lincoln
The default

Is AI better than us?

  • Every headline, every study, every hallway conversation about AI in healthcare asks the same thing: is it better than us?
  • Diagnosis, empathy, even bedside manner; we're the ones keeping score
  • It's the main question we're asking
  • And it's the wrong one
Slide 02 / 08
The problem

It's a contest we're going to lose

  • If we treat capability as a zero-sum game, we're going to lose
  • Every time it closes a gap, we just redraw the line; find the next thing that's "essentially human" and start the next contest
  • The field assumes that AI is a replacement but in practice, augmentation is the norm
  • Nearly every study is designed to answer the competitive question; even the most recent physiotherapy-specific work still pits AI against students (Michou et al., 2026)
Slide 03 / 08
The resistance

Why AI feels threatening

  • Work with a colleague who's better than you at something, and it doesn't diminish you
  • It's a reason to get better yourself; with humans we call that mentorship
  • AI produces a different reaction: research on physicians' resistance to health AI finds threats to expertise, status, autonomy, even to what it means to be a "care provider" (Jussupow et al., 2018)
  • None of those threats are about the patient; they're about us
  • A better colleague raises our game so why would working with AI do the opposite?
  • So what would it look like to make this about the relationship instead of about us?
Slide 04 / 08
The admission

An uncomfortable question

  • What if we're only keeping the human in the loop because we find the alternative profoundly uncomfortable?
  • A pilot who insists on hand-flying to prove a point is putting the flight at risk; what if we're doing the same thing with AI?
  • What if the honest answer is simply: what could we reach together?
Slide 05 / 08
The opening

What AI makes possible

  • Patients are already forming real relationships with AI outside the clinic — a 210-patient mental-health chatbot trial found alliance ratings comparable to human therapists (Heinz et al., 2025)
  • The real question: where does this let you reach, that you couldn't before?
  • More time actually present with a patient, instead of buried in documentation
  • Pattern recognition across a caseload no one can hold in their head
  • AI already rates as more empathic than clinicians in head-to-head studies (Howcroft et al., 2025)
  • Proposed as a Socratic partner for sharpening our own moral reasoning (Lara & Deckers, 2019)
  • What would you add to that list?
Slide 06 / 08
The ask

Bring AI into the room

  • Ask patients what AI has already told them; many have already asked it something
  • Describe your own AI use as part of the conversation
  • If you're not using AI, consider starting immediately
  • Teach students to engage with AI, honestly and critically
SASP Symposium 2026 — Ethics and the use of AI in physiotherapy

Thank you

Questions and discussion
Michael Rowe University of Lincoln