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. 2022 Sep 16:9:1015367.
doi: 10.3389/fsurg.2022.1015367. eCollection 2022.

Autonomous surgical robotic systems and the liability dilemma

Aimun A B Jamjoom  1 , Ammer M A Jamjoom  2 , Jeffrey P Thomas  3 , Paolo Palmisciano  4 , Karen Kerr  5 , Justin W Collins  6 , Effy Vayena  7 , Danail Stoyanov  5   8 , Hani J Marcus  8   9 ; iRobotSurgeon Collaboration
Affiliations

Autonomous surgical robotic systems and the liability dilemma

Aimun A B Jamjoom et al. Front Surg. .

Abstract

Background: Advances in machine learning and robotics have allowed the development of increasingly autonomous robotic systems which are able to make decisions and learn from experience. This distribution of decision-making away from human supervision poses a legal challenge for determining liability.

Methods: The iRobotSurgeon survey aimed to explore public opinion towards the issue of liability with robotic surgical systems. The survey included five hypothetical scenarios where a patient comes to harm and the respondent needs to determine who they believe is most responsible: the surgeon, the robot manufacturer, the hospital, or another party.

Results: A total of 2,191 completed surveys were gathered evaluating 10,955 individual scenario responses from 78 countries spanning 6 continents. The survey demonstrated a pattern in which participants were sensitive to shifts from fully surgeon-controlled scenarios to scenarios in which robotic systems played a larger role in decision-making such that surgeons were blamed less. However, there was a limit to this shift with human surgeons still being ascribed blame in scenarios of autonomous robotic systems where humans had no role in decision-making. Importantly, there was no clear consensus among respondents where to allocate blame in the case of harm occurring from a fully autonomous system.

Conclusions: The iRobotSurgeon Survey demonstrated a dilemma among respondents on who to blame when harm is caused by a fully autonomous surgical robotic system. Importantly, it also showed that the surgeon is ascribed blame even when they have had no role in decision-making which adds weight to concerns that human operators could act as "moral crumple zones" and bear the brunt of legal responsibility when a complex autonomous system causes harm.

Keywords: autonomous; liability; public opinion; robotics; surgery.

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Conflict of interest statement

KK is employed by Digital Surgery Medtronic Ltd. JC is employed part-time by CMR Surgical Ltd. DS is employed part-time by Digital Surgery Medtronic Ltd and is a shareholder in Odin Vision Ltd. None of these companies provided any funding for the study.

Figures

Figure 1
Figure 1
The irobotsurgeon survey poses five scenarios to respondents and asks them to decide who they believe is most liable: the surgeon, robot manufacturer, hospital or another party (A) a total of 2191 responses were collected from 78 countries spanning 6 continents (B).
Figure 2
Figure 2
A total of 10,955 individual scenario responses were captured from 2,191 respondents. Bar charts demonstrating the overall responses across the five scenarios (A) the levels of autonomy (B) and the individual scenarios (C). The comments from another party option were collated and qualitatively then quantitively analysed (D).
See this image and copyright information in PMC

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