Table 1.

Ethical principles as defined by Beauchamp and Childress [21], with examples.

Principle	Definition [21]	Examples
Autonomy	Respect for an individual’s right to informed medical decision making	Informed consent; full disclosure and discussion regarding the risks and benefits of surgical intervention; full disclosure and discussion regarding the involvement of an LLM in a patient’s care; respecting a patient’s right to privacy and confidentiality; and respecting a researcher’s right to have proper recognition and attribution for their work.
Beneficence	Maximization of benefit to the patient (“do good”), while minimizing harm	Training of highly skilled, patient-focused surgeons; practice of evidence-based medicine; and supervision and verification to ensure LLM-generated content meets quality standards and is beneficial.
Nonmaleficence	Avoidance of patient harm (“do no harm”)	Ongoing efforts by surgeons to minimize surgical complications; the avoidance of unnecessary procedures; the identification and rectification of inaccurate, incomplete, or outdated information that can lead to potentially harmful recommendations; and stringent security measures to maintain patient confidentiality and prevent harmful repercussions from unauthorized disclosures or data breaches.
Justice	Fair distribution of healthcare resources	Conscious efforts to minimize bias that can widen healthcare disparities and inequalities; establishing infrastructure to support equitable resource allocation; and identifying and rectifying training dataset bias to avoid the production of biased content and recommendations.