Ethical Considerations for Generative Artificial Intelligence in Plastic Surgery

Why this matters

The integration of artificial intelligence (AI) into surgical care is rapidly transforming healthcare by enhancing efficiency, clinical decision-making, and patient outcomes. This work contributes to evidence-based plastic and reconstructive surgery — helping clinicians interpret outcomes, refine technique, and counsel patients with clearer data.

Author

Dr. Orr Shauly

Plastic and reconstructive surgery resident at Emory University (UCLA BS, USC MD) with an h-index of 15 and peer-reviewed work spanning aesthetic surgery, reconstruction, medical devices, and AI in medicine.

Abstract

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.