Editorial: Healthcare in the age of sapient machines: physician decision-making autonomy faced with artificial intelligence. Ethical, deontological and compensatory aspects

Abstract

The decision to explore this topic was inspired by the growing recognition that artificial 12 intelligence (AI) is assuming an increasingly significant role in medical practice. In recent years, in 13 fact, AI has entered the healthcare sector in a significant way, thanks to the extraordinary technological 14 developments that have enabled the transition from traditional AI systems, such as artificial neural 15 networks, rule-based algorithms, expert systems and knowledge-based artificial intelligence, to 16 advanced AI systems, such as machine learning and deep learning. The use of these systems in 17 healthcare, which are capable of operating with a high degree of autonomy, represents an invaluable 18 resource in terms of the quality of care provided, but poses obvious ethical and deontological problems. 19In particular, the introduction of highly automated AI raises crucial questions concerning the decision-20 making autonomy of physicians, a crucial element in guaranteeing the quality of care and trust in the 21 doctor-patient relationship.The aim of this collection was to investigate the state of the art regarding the relationship 23 between physicians' decision-making autonomy and the use of highly automated AI systems in 24 healthcare. We wanted to analyse the critical issues emerging in routine medical practice, examine the 25 attempts implemented to solve the problem and assess the importance of this issue for healthcare 26 professionals and patients. Through the six articles presented, we attempted to provide a 27 comprehensive overview of the topic as well as to stimulate a constructive discussion on these key 28 issues for the future of healthcare. 29The Research Topic features six articles, comprising 1 mini-review, 3 reviews, 1 "hypothesis 30 and theory" article and 1 perspective article. practitioners, the incomplete legislation on AI-assisted TCM, and the need for preserving the human 74 element in patient care while leveraging AI technology for improved outcomes. 75In conclusion, the special issue allowed for a comprehensive exploration of the most relevant 76 medico-legal and bioethical implications of the use of highly automated artificial intelligence systems 77 in medicine, including the issue of the preservation of the physician's decision-making autonomy. The 78 articles collectively highlight the dual potential of AI: enhancing diagnostic accuracy, patient safety, 79 and healthcare outcomes, while simultaneously posing significant ethical, legal, and deontological 80 challenges. Key themes include the necessity for new legislative frameworks to address AI-related 81 liabilities, the importance of maintaining physician autonomy and informed consent, and the 82 imperative to balance AI's technological advancements with the human elements of care. The 83 collection underscores the critical need for cautious integration of AI in healthcare, advocating for a 84 symbiotic relationship where AI supports but does not replace human judgment. This approach aims 85 to preserve the trust and quality inherent in the doctor-patient relationship, ensuring that AI 86 advancements contribute positively to the future of healthcare. 87

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