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Artificial Intelligence and Surgery: Ethical Dilemmas and Open Issues.

Lorenzo Cobianchi1,2, Juan Manuel Verde3, Tyler J Loftus4

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Artificial intelligence (AI) in surgery poses ethical challenges, including agency, accountability, and fairness. Addressing these requires focusing on implementation science and digital health education for surgeons.

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Area of Science:

  • Medical Ethics
  • Surgical Technology
  • Artificial Intelligence in Medicine

Background:

  • AI applications in surgical decision-making introduce new ethical threats to patient care.
  • Understanding and mitigating these threats is crucial for maintaining ethical surgical standards.
  • The European Commission's Ethics Guidelines for Trustworthy Artificial Intelligence provide a framework for analysis.

Purpose of the Study:

  • To identify and summarize the primary ethical issues associated with AI in surgery.
  • To explore potential solutions for addressing these emerging ethical challenges.
  • To inform the development of ethical guidelines for AI in surgical practice.

Main Methods:

  • A modified Delphi process was utilized to achieve expert consensus on the identified ethical issues.
  • The study systematically reviewed ethical considerations based on established AI ethics frameworks.
  • Expert opinions were gathered and synthesized to ensure comprehensive coverage of the topic.

Main Results:

  • Key ethical issues identified include human agency, accountability for errors, technical robustness, data privacy, transparency, diversity, non-discrimination, and fairness.
  • Expanding surgical AI research to focus on implementation science can help address many ethical concerns.
  • Formal digital health education is increasingly vital for surgeons and trainees due to AI's disruptive potential.

Conclusions:

  • A multidisciplinary approach integrating implementation science and digital health education is essential.
  • Balancing the opportunities of AI in surgery with ethical principles is paramount for patient-centric care.
  • Proactive education and research are needed to navigate the ethical landscape of AI-assisted surgery.