Ethics of Artificial Intelligence in Surgery

You cannot learn to play the piano by going to concerts. A compass [will] point you True North from where you're standing, but it's got no advice about the swamps and deserts and chasms that you'll encounter along the way. If in pursuit of your destination, you plunge ahead, heedless of obstacles, and achieve nothing more than to sink in a swamp... What's the use of knowing True North? The practice of surgery often forces unique ad hoc decisions based on contextual intricacies in the moment, which are not typically captured in broad, top-down, or committee-approved guidelines. Surgical ethics are principled, of course, but also pragmatic. They are also replete with moral contradictions and uncertainties; the introduction of novel technology into this environment can potentially increase those challenges. The essential element that distinguishes an ethical problem from a tragic situation is the element of choice." Moreover, choosing between options often involves identifying factors by which those options are not exactly equal, and the method one uses to weigh these factors can draw upon a set of ethical frameworks that, themselves, can be somewhat incongruous. At their core, artificial intelligence (AI) systems - and machine learning (ML) more specifically - are also designed to make choices, often by categorizing some input among a set of nominal categories. In the past, the choices these systems made could only be evaluated by their correctness - their accuracy in applying the same categorical labels that a human would to previously unseen inputs, like whether an image contains a tumour, or not.