Ethical and Legal Implications of Implementing AI in Gastrointestinal Endoscopy

Artificial intelligence (AI) is advancing rapidly in gastrointestinal endoscopy, offering new opportunities to enhance diagnostic accuracy, procedure quality, and clinical efficiency. However, its integration into practice raises a range of complex challenges. This review identifies the central ethical, legal, and practical concerns in AI adoption, including data governance, patient safety, and the growing complexity of accountability as systems become more autonomous. Bias and limited transparency in model development risk worsening health inequalities, while human-AI interaction introduces concerns such as overreliance and deskilling. Generative AI adds further uncertainty, producing outputs that are difficult to predict or explain. Ensuring responsible implementation will require strong governance, inclusive design, and meaningful human oversight. As these technologies become more embedded in clinical care, ongoing examination of their risks and impacts will be essential to ensure the appropriate balance between innovation and safety.