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Ethical Implications of Artificial Intelligence in Gastroenterology: The Co-pilot or the Captain?

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Abstract

Though artificial intelligence (AI) is being widely implemented in gastroenterology (GI) and hepatology and has the potential to be paradigm shifting for clinical practice, its pitfalls must be considered along with its advantages. Currently, although the use of AI is limited in practice to supporting clinical judgment, medicine is rapidly heading toward a global environment where AI will be increasingly autonomous. Broader implementation of AI will require careful ethical considerations, specifically related to bias, privacy, and consent. Widespread use of AI raises concerns related to increasing rates of systematic errors, potentially due to bias introduced in training datasets. We propose that a central repository for collection and analysis for training and validation datasets is essential to overcoming potential biases. Since AI does not have built-in concepts of bias and equality, humans involved in AI development and implementation must ensure its ethical use and development. Moreover, ethical concerns regarding data ownership and health information privacy are likely to emerge, obviating traditional methods of obtaining patient consent that cover all possible uses of patient data. The question of liability in case of adverse events related to use of AI in GI must be addressed among the physician, the healthcare institution, and the AI developer. Though the future of AI in GI is very promising, herein we review the ethical considerations in need of additional guidance informed by community experience and collective expertise.

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Fig. 1
Fig. 2

Abbreviations

ACG:

American College of Gastroenterology

AGA:

American Gastroenterological Association

AI:

Artificial Intelligence

CMS:

Center for Medicare and Medicaid Services

CPT:

Current procedural terminology

FDA:

Food and Drug Administration

GI:

Gastroenterology

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, William Beaumont University Hospital, Royal Oak, MI, USA

    Nishant Aggarwal

  2. Clinical & Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    David A. Drew

  3. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    David A. Drew

  4. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Ravi B. Parikh

  5. Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA

    Ravi B. Parikh

  6. Gastroenterology and Hepatology, Houston Regional Gastroenterology Institute (HRGI), Houston, TX, USA

    Sushovan Guha

  7. Department of Clinical Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA

    Sushovan Guha

Authors
  1. Nishant Aggarwal
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  2. David A. Drew
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  3. Ravi B. Parikh
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  4. Sushovan Guha
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Contributions

NA prepared the initial draft of the manuscript. The manuscript was revised by NA, DD, RP, and SG. Figures 1 and 2 are created by NA using BioRender.com. The final version of the manuscript was reviewed and approved by all authors.

Corresponding author

Correspondence to Sushovan Guha.

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Competing interests

The authors declare no competing interests.

Ethical approval

Dr. Drew served as a member of the American Gastroenterological Association Ethics Committee from 2021 to 2024.

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Aggarwal, N., Drew, D.A., Parikh, R.B. et al. Ethical Implications of Artificial Intelligence in Gastroenterology: The Co-pilot or the Captain?. Dig Dis Sci (2024). https://doi.org/10.1007/s10620-024-08557-9

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