Dhawan Ravi, Brooks Kendall Douglas, Shauly Orr, Shay Denys, Losken Albert
From the Department of Plastic Surgery, Emory University School of Medicine, Atlanta, GA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Plast Reconstr Surg Glob Open. 2025 Jun 2;13(6):e6825. doi: 10.1097/GOX.0000000000006825. eCollection 2025 Jun.
The integration of artificial intelligence (AI) into surgical care is rapidly transforming healthcare by enhancing efficiency, clinical decision-making, and patient outcomes. Generative AI (genAI), a subfield using large language models such as ChatGPT, Bard, and Midjourney, holds significant promise in automating tasks such as surgical planning and discharge summaries. However, it raises concerns about misinformation, data breaches, biases, and misuse. No genAI technology has yet received Food and Drug Administration approval for surgical use, emphasizing the need for thorough regulatory evaluation. This article proposed 5 ethical principles, adapted from World Health Organization recommendations, to guide the adoption and governance of genAI in plastic surgery. These principles include ensuring data transparency, maintaining patient autonomy, prioritizing safety and accountability, promoting equity, and investing in sustainability. Each principle is illustrated with a hypothetical case to highlight potential ethical breaches and the importance of rigorous testing, clear communication, and continuous monitoring. By adhering to these guidelines, stakeholders can ensure that genAI serves to enhance patient care and uphold the highest standards of ethical practice in surgical settings.
将人工智能(AI)整合到外科护理中正在迅速改变医疗保健,提高效率、改善临床决策并提升患者治疗效果。生成式人工智能(genAI)是利用ChatGPT、Bard和Midjourney等大语言模型的一个子领域,在手术规划和出院小结等任务自动化方面具有巨大潜力。然而,它引发了人们对错误信息、数据泄露、偏见和滥用的担忧。目前尚无生成式人工智能技术获得美国食品药品监督管理局的外科手术使用批准,这凸显了进行全面监管评估的必要性。本文借鉴世界卫生组织的建议,提出了5条伦理原则,以指导整形外科中生成式人工智能的采用和管理。这些原则包括确保数据透明度、维护患者自主权、优先考虑安全性和问责制、促进公平以及投资可持续性。每个原则都通过一个假设案例进行说明,以突出潜在的伦理违规行为以及严格测试、清晰沟通和持续监测的重要性。通过遵循这些指导方针,利益相关者可以确保生成式人工智能有助于提升患者护理水平,并在手术环境中坚持最高的道德实践标准。