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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\u2013AI 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.<\/jats:p>","DOI":"10.1111\/den.70198","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T03:40:54Z","timestamp":1780890054000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ethical and Legal Implications of Implementing\n                    <scp>AI<\/scp>\n                    in Gastrointestinal Endoscopy"],"prefix":"10.1111","volume":"38","author":[{"given":"Ahmed","family":"El\u2010Sayed","sequence":"first","affiliation":[{"name":"Division of Surgery &amp; Interventional Sciences University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Geelani","sequence":"additional","affiliation":[{"name":"University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherif","family":"El\u2010Sayed","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan Ali","family":"Choudry","sequence":"additional","affiliation":[{"name":"George Eliot Hospital NHS Trust  Nuneaton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence B.","family":"Lovat","sequence":"additional","affiliation":[{"name":"Division of Surgery &amp; Interventional Sciences University College London  London UK"},{"name":"University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer F.","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Division of Surgery &amp; Interventional Sciences University College London  London UK"},{"name":"University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,7]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746\u2010024\u201001399\u20109"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12910\u2010021\u201000687\u20103"},{"key":"e_1_2_13_4_1","unstructured":"American Medical Association \u201cPatients Want Privacy Accountability for How Their Health Data Is Used \u201d(2022) https:\/\/www.ama\u2010assn.org\/practice\u2010management\/hipaa\/patients\u2010want\u2010privacy\u2010accountability\u2010how\u2010their\u2010health\u2010data\u2010used."},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/make5030053"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tgie.2019.150636"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS\u201025\u201003415"},{"key":"e_1_2_13_8_1","unstructured":"Recital 26 \u201cNot Applicable to Anonymous Data. 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