By Charles Binkley and Tyler Loftus, co-authors of Encoding Bioethics: AI in Clinical Decision-Making

Encoding Bioethics begins where all good healthcare stories begin: in the trenches of patient care. We have many professional roles in healthcare, but above all, we are surgeons. Providing the best patient care possible inside and outside the operating room is our true North and deep passion. We have taken different paths toward this shared goal, Charles by caring for patients suffering from cancer while developing expertise in bioethical theory and application, and Tyler by caring for patients suffering from traumatic injury and other emergency surgical conditions while developing expertise in artificial intelligence (AI)-enabled clinical decision support. Throughout our careers, it has become increasingly apparent that providing the best patient care possible has many facets and takes a village.

Healthcare, like many other industries, is increasingly subspecialized and siloed. Many cathedrals – renowned for their architectural and engineering excellence – were built over the lifetimes of one or two master builders who intimately understood and personally oversaw every critical aspect of the project. The results were breathtakingly beautiful, but the process was slow and highly dependent on a few people overseeing many workers who were granted little agency. Today, great architectural feats are accomplished by large teams comprising subspecialists in every aspect of architecture and engineering, working in concert to deliver excellent results efficiently. Modern healthcare intends similar agility and cooperation among subspecialists, but instead, we observe that healthcare is often fragmented and occasionally fractured.

Herein lies the foundation of our new book Encoding Bioethics. We endeavor to unite perspectives from major stakeholders of ethical AI in clinical decision-making: patients, physicians, developers, payers, and health system administrators. This unification is not a roadmap for training AI ethics master builders, but rather a path for generating a shared understanding of the values and principles of each stakeholder. Through this understanding, we hope that each stakeholder will make decisions and take actions that build stronger, more ethical applications of AI-enabled clinical decision support, ultimately toward the best patient care possible.

In Encoding Bioethics we explore the evolving landscape of healthcare, where AI and ethical considerations intersect. We believe that by understanding and addressing the ethical challenges posed by AI in healthcare, we can foster a more harmonious and effective system. Our goal is to bridge the gaps between various subspecialties and create a cohesive approach to patient care that leverages the strengths of both human and artificial intelligence.

Imagine a future where human-AI teams work together seamlessly to tackle the most complex ethical dilemmas in medicine. Picture a primary care physician receiving a notification from a computable phenotyping algorithm that conditions for implementing a living will are imminent. This prompt ensures that the patient’s wishes are documented and honored, enhancing the quality of care. Envision a multidisciplinary tumor board consulting with AI-enabled decision support to determine the optimal sequence and timing of chemotherapy, radiation, and surgery for a patient with pancreatic cancer. This collaboration could significantly improve treatment outcomes and patient survival rates.

Consider the scenario of a blood bank manager collaborating with a resource allocation algorithm to prioritize blood products for patients who are most likely to benefit from transfusion. By diverting resources away from futile treatments, we can maximize the positive impact on patient health and well-being. These examples illustrate the potential of ethical AI to transform healthcare, making it more patient-centered, efficient, and effective.

However, achieving this vision requires breaking down the silos that currently hinder progress. It demands a concerted effort to foster mutual understanding and collaboration among all stakeholders. In Encoding Bioethics, we delve into the principles and values that guide each stakeholder’s decisions and actions. We explore the ethical frameworks that underpin their roles and responsibilities, and we highlight the importance of empathy, transparency, and accountability in building a more ethical healthcare system.

Our journey through the pages of Encoding Bioethics is not just a theoretical exploration. It is grounded in real-world experiences and case studies that illustrate the challenges and opportunities of integrating AI into clinical practice. We share stories of triumph and tribulation, of moments when ethical dilemmas tested our resolve and shaped our perspectives. Through these narratives, we aim to provide readers with a deeper understanding of the complexities of ethical AI in healthcare and inspire them to become active participants in this transformative journey.

We believe that by uniting diverse perspectives and fostering a shared understanding of ethical principles, we can create a healthcare system that is not only technologically advanced but also deeply humanistic. Encoding Bioethics is a call to action for all stakeholders to embrace their roles in shaping the future of healthcare. It is an invitation to join us in building a system where AI and human intelligence work in harmony to deliver the best possible care for every patient.

As you turn the pages of Encoding Bioethics, we hope you will be inspired by the potential of ethical AI to revolutionize healthcare. We invite you to explore the ethical challenges and opportunities that lie ahead and to join us in our quest to create a brighter future for patient care. Together, we can build a healthcare system that is not only efficient and effective but also deeply compassionate and ethical.