(A116) Emerging Ethical Considerations in Otolaryngology: A Scoping Review

Introduction: Recent medical, societal, and technological changes have presented a host of novel ethical considerations for otolaryngologists. This scoping review aims to identify current topics of ethical debate within otolaryngology, and to evaluate the themes and ethical principles raised.

Methods: A structured review of six databases was conducted to identify literature pertaining to ethics in otolaryngology. Articles published from 2019-2024 that addressed at least one ethical domain were included. An inductive qualitative content analysis was performed, and papers were evaluated for major themes, use of primary data, and methodology of ethical argumentation.

Results: 120 studies met inclusion criteria. Of the four cardinal medical ethical principles, recent otolaryngology literature most emphasized justice. Thematic and content analyses identified 7 major themes: diversity and inclusion within the otolaryngology workforce, equitable access to otolaryngology care, physician responsibilities during pandemic conditions, clinical integration of novel technologies including artificial intelligence and telehealth, informed consent, and ethical practices in research and resident education. Authors presented a variety of suggestions to address injustices across the field of ENT, with 40% of studies presented primary data. In the absence of primary data, many authors relied on traditional deontological reasoning.

Conclusions: This review identified justice as the primary ethical consideration in current otolaryngology literature, albeit with variable definitions. While recent events including the Coronavirus pandemic and development of artificial intelligence present ethical challenges, many authors have identified related opportunities to advance fairness within our field.