Focusing a Bioethics Lens on the Development and Use of Artificial Intelligence in Medicine and Neurosurgery

The rapid pace of development and application of digital technology and data science, including artificial intelligence (AI), is transforming our world. In this chapter, we address the question: "Is bioethics relevant to how we should develop, govern, and use AI in healthcare, specifically in neurosurgery?" We recognize that medical decision-making involves uncertainty and is complex, and predicting potential outcomes is difficult. We conclude that the use of AI in neurosurgery is not inherently unethical. Hence, the ethical question becomes: Do its benefits and potential benefits in neurosurgery outweigh its risks and harms, and what safeguards are needed to ensure this? Requiring and obtaining patients' valid informed consent is important, but what such consent requires is debatable. Earning and maintaining the trust of everyone involved, especially patients and clinicians, is also essential. We recommend that to ensure the ethical development and use of AI, neurosurgeons approach its use with knowledge of both the science of AI and applied ethics and employ moral humility and moral courage in their decision-making.