Beyond Autonomy: A Plastic Surgeon's Responsibility in the Face of AI-Driven Misinformation

Abstract

A promising development in medical practice is a shift from a “doctor knows best” model toward patient autonomy rooted in shared decisions, transparent risk, and respect for values.1,2 Increasing Internet access, social media communities, and more recently generative large language models (LLMs) such as ChatGPT may have helped push patient autonomy forward by providing near-instant access to clinical information from trusted sources, but can also relay harmful medical misinformation. LLMs' fluent style can mask factual hallucinations and transmit the same gaps that already trouble online medical content. As a result, medical visits increasingly begin with fact-checking claims, shifting time away from substantive decision making toward correction. We argue that without deliberate safeguards for autonomy, increasing patient reliance on LLMs can pull clinical encounters back toward paternalism.

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