Arjomandi Rad Arian, Vardanyan Robert, Athanasiou Thanos, Maessen Jos, Sardari Nia Peyman
Department of Translational Health Sciences, University of Bristol, Bristol, UK.
Department of Surgery and Cancer, Imperial College London, London, UK.
Interdiscip Cardiovasc Thorac Surg. 2025 Mar 5;40(3). doi: 10.1093/icvts/ivae192.
The integration of artificial intelligence (AI) into surgery raises significant ethical concerns, including the impact on autonomy, human authority and the patient-doctor relationship. This study underscores the need for a multidisciplinary approach to navigate these ethical dilemmas, involving stakeholders from various fields. A comprehensive literature review up to March 2024 was conducted to assess the ethical implications of AI applications in surgery. This included an examination of data privacy, informed consent, algorithmic bias, the role of advanced robotics, and the impact on surgeons' decision-making. The study also considered the development of autonomous surgical robots and their ethical implications. The review highlights that while AI can enhance surgical precision and improve clinical decision-making, it also poses several ethical challenges. AI's ability to support decision-making risks undermining surgeons' autonomy and judgement, raising concerns about over-reliance on technology. Issues such as data privacy, algorithmic bias and equitable access to AI-driven tools were identified as key ethical concerns. Autonomous surgical robots, while promising, introduce complex questions about accountability and liability, particularly when unexpected outcomes occur. Effective integration of AI into surgical practices demands the development of ethical frameworks that respect both the capabilities of AI and the irreplaceable value of human judgement. Balancing technological advancement with ethical integrity is essential to safeguard patient-centred care and ensure equitable access to AI benefits in healthcare.
将人工智能(AI)整合到外科手术中引发了重大的伦理问题,包括对自主性、人类权威以及医患关系的影响。本研究强调需要采取多学科方法来应对这些伦理困境,涉及各个领域的利益相关者。截至2024年3月进行了全面的文献综述,以评估人工智能在手术中的应用所带来的伦理影响。这包括对数据隐私、知情同意、算法偏差、先进机器人技术的作用以及对外科医生决策的影响的审查。该研究还考虑了自主手术机器人的发展及其伦理影响。综述强调,虽然人工智能可以提高手术精度并改善临床决策,但它也带来了一些伦理挑战。人工智能支持决策的能力有可能损害外科医生的自主性和判断力,引发对过度依赖技术的担忧。数据隐私、算法偏差以及公平获取人工智能驱动工具等问题被确定为关键的伦理问题。自主手术机器人虽然前景广阔,但引发了关于问责制和责任的复杂问题,尤其是当出现意外结果时。将人工智能有效整合到手术实践中需要制定伦理框架,既要尊重人工智能的能力,又要尊重人类判断力不可替代的价值。在技术进步与道德诚信之间取得平衡对于保障以患者为中心的医疗服务以及确保在医疗保健中公平获取人工智能的益处至关重要。