Emerging Ethical Considerations in Otolaryngology-Head and Neck Surgery

To perform a scoping review of ethics-based literature published in the last 5 years in otolaryngology-head and neck surgery (OHNS), and to identify and reflect on emerging topics of ethical consideration for otolaryngologists.

A comprehensive literature search was performed using the PubMed, SCOPUS, and Cochrane databases.

A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews protocol. Inclusion criteria included peer-review articles published from 2019 to 2024 that explored at least one foundational bioethical principle in a primary context of OHNS. Original research, literature reviews, editorials, and letters to the editor were included to capture the full extent of the academic ethics conversation. An inductive qualitative content analysis was performed in multi-step process to identify recurrent ethics issues and themes.

The systematic review identified 1191 unique abstracts, of which 31 met inclusion criteria. This literature emphasized topics including conflicting physician obligations during the coronavirus-19 pandemic, integration of artificial intelligence into clinic practice, diversity and inclusion within OHNS, health equity, ethics education, pediatric autonomy, and considerations for global health programs. These conversations explored conflicting definitions of justice and divergence between personal and institutional ethical obligations.

This scoping review identified salient topics within the current ethics OHNS literature and explores implications for practicing otolaryngologists.