When the action is “hybrid”–ethical challenges of the emerging technologies in the operating room

The paper addresses some ethical issues arising from the interaction between surgeons and emerging technologies in the Operating Room (OR). We argue that introducing new technologies capable of performing some functions performed by the surgeon “autonomously” may transform the doctor-patient relationship, which is no longer direct, but “mediated” by autonomous devices. On the one hand, the patient is inserted in a “hybrid” environment, in which decision-making is hybrid as well: many of the actions take place almost independently of the presence (or action) of a human being. On the other, the surgeon is constantly under observation and his/her responsibility may be partially reduced. All of this implies new ethical reflections and challenges to the healthcare environment. To explain these changes and the need for a new ethical outlook, we consider three cases where emerging technologies have a crucial and sometimes controversial role in the OR: (1) the case of audio and panoramic video recording in the OR; (2) the case of the impact of artificial intelligence on surgical decision making; (3) the case of robotic-assisted tele-surgery. The new actions carried out through emerging technologies in the OR imply, thus, a change in our ethical outlook. To do so, we must first rethink the paradigm of technology we are using: following the post-phenomenological reflections, we argue that technologies are not just the “means” we use but the environments we interact with. This entails the idea of a “hybrid” responsibility and, therefore, a different assessment of the possible consequences of the actions.