From the Departments of Clinical, Diagnostic, and Pediatric Sciences (Cobianchi, Ansaloni), University of Pavia, Pavia, Italy.
IRCCS Policlinico San Matteo Foundation, General Surgery, Pavia, Italy (Cobianchi, Ansaloni).
J Am Coll Surg. 2022 Aug 1;235(2):268-275. doi: 10.1097/XCS.0000000000000242. Epub 2022 Apr 21.
Artificial intelligence (AI) applications aiming to support surgical decision-making processes are generating novel threats to ethical surgical care. To understand and address these threats, we summarize the main ethical issues that may arise from applying AI to surgery, starting from the Ethics Guidelines for Trustworthy Artificial Intelligence framework recently promoted by the European Commission.
A modified Delphi process has been employed to achieve expert consensus.
The main ethical issues that arise from applying AI to surgery, described in detail here, relate to human agency, accountability for errors, technical robustness, privacy and data governance, transparency, diversity, non-discrimination, and fairness. It may be possible to address many of these ethical issues by expanding the breadth of surgical AI research to focus on implementation science. The potential for AI to disrupt surgical practice suggests that formal digital health education is becoming increasingly important for surgeons and surgical trainees.
A multidisciplinary focus on implementation science and digital health education is desirable to balance opportunities offered by emerging AI technologies and respect for the ethical principles of a patient-centric philosophy.
旨在支持手术决策过程的人工智能 (AI) 应用程序给合乎伦理的手术护理带来了新的威胁。为了理解和应对这些威胁，我们从欧盟委员会最近提出的值得信赖的人工智能伦理准则框架出发，总结了将 AI 应用于手术可能产生的主要伦理问题。
采用改良 Delphi 法达成专家共识。
这里详细描述了将 AI 应用于手术所引发的主要伦理问题，涉及到人类的能动性、对错误的问责、技术稳健性、隐私和数据治理、透明度、多样性、非歧视和公平性。通过扩大手术 AI 研究的广度，关注实施科学，可能解决其中的许多伦理问题。AI 具有颠覆手术实践的潜力，这表明对外科医生和外科受训者进行正式的数字健康教育正变得日益重要。
有必要多学科地关注实施科学和数字健康教育，以平衡新兴 AI 技术带来的机遇和对以患者为中心的哲学的伦理原则的尊重。
