Surgery and Innovation in the 21st Century: How Artificial Intelligence is Changing the Ethical Landscape
Thursday, October 12, 2023
2:30 PM – 3:45 PM ET
Location: Iron (Fourth Floor)
Surgery differs from other specialties in several ways. Unlike other providers, surgeons often intentionally inflict harm initially to achieve a desired therapeutic outcome. The process of informed consent is similarly unique. After providing consent, patients effectively relinquish their ability to make further medical decisions upon entering the operative suite and receiving anesthesia. Moreover, in contrast to comprehensive evaluation required for new drug therapies before clinical administration, conventional surgical innovation rarely necessitates that novel surgical procedures undergo similarly careful study before implementation. Recently, artificial intelligence-based (AI) technologies (e.g., machine learning, computer vision, robotics) have become increasingly recognized due to their potential clinical benefits, particularly in surgery. Unquestionably, the role of these technologies in surgery warrants exploration. However, these tools are not without risk, many of which relate to violating ethical norms and principles. Examples of the myriad ethical concerns associated with AI in surgery include questions regarding data privacy and security, feasibility of informed consent, data and algorithmic bias, and technical robustness and safety. Indeed, each of the four moral principles espoused by Beauchamp and Childress – autonomy, beneficence, nonmaleficence, justice – is at high risk for violation with the hasty use of AI in surgery. This presentation highlights ethically-relevant dangers of AI in surgery and describes potential mitigation strategies. In contrast to conventional surgical innovation – where advancements may be employed clinically without controlled examination – this presentation argues that a methodical approach to developing, testing, and implementing AI-based technology is necessary to minimize attendant ethical risks in surgery.