Beyond Disclosure: Rethinking Patient Consent and AI Accountability in Healthcare

Beyond Disclosure: Rethinking Patient Consent and AI Accountability in Healthcare
Open Peer Commentaries
Tony Yang
The American Journal of Bioethics, 24 February 2025
Excerpt
    The growing integration of artificial intelligence (AI) into healthcare raises fundamental questions about patient consent, autonomy, and trust. The concept of a “Right to Notice and Explanation” (RN&E) articulated in Hurley et al.’s work highlights an essential ethical obligation: ensuring that patients are aware of AI’s role in their care and understand its implications (Hurley et al. 2025). While this framework is compelling, it can be further strengthened by situating it within broader regulatory, ethical, and operational contexts. Insights from recent regulatory developments, systematic reviews, and calls for responsible AI highlight the need to reconceptualize RN&E as a dynamic, participatory, and institutionally embedded process (Kleinberg et al. Citation2018).
One of the key gaps in current discussions on RN&E is the lack of clarity regarding what constitutes sufficient “notice” and “explanation” in practice (Hurley et al. 2025). While it is clear that patients should be informed when AI influences their care, it remains less clear how that information should be conveyed and at what level of technical detail. Explanations must balance transparency with simplicity, ensuring that patients understand the role of AI without being overwhelmed by technical complexity (Siala and Wang 2022). This can be achieved by designing explanations with a human-centered approach, focusing on health literacy and contextual relevance. For instance, AI explanations should be aligned with existing health literacy practices, leveraging the principles of plain language and clear communication to ensure patient comprehension (Sørensen et al. 2012). By embedding these elements into health system workflows, RN&E can move beyond a static “disclosure” model to become a participatory process in which patients are not only informed but also empowered to ask questions, seek clarification, and participate in decisions regarding their care…