Narrative Transparency in AI-Driven Consent

Narrative Transparency in AI-Driven Consent
Open Peer Commentaries
Jarrel De Matas, Jiefei Wang, Vibhuti Gupta
American Journal of Bioethics, 7 April 2025
Excerpt
As artificial intelligence (AI) systems become more prevalent, ethical inquiry into transparency, trust, and patient autonomy must develop with similar pace. One area where such inquiry required is in the process of obtaining informed consent, particularly in a biobanking context, where participants are asked to share their biological data for research purposes. Although Barnes et al. (Citation2025) proposes using blockchain and AI to improve transparency and engagement in biobanking through demonstrated consent, their approach lacks a concrete framework: informed consent should not only be considered a transactional process, as Manson and O’Neill (Citation2007) argue, but more importantly a user-centered, communicative act that requires participants to understand complex information, balance risks and benefits, and make decisions that overlap with their values and preferences. To complement what we identify in Barnes et al. (Citation2025) as an overstatement of the transactional approach to informed consent, we suggest a Narrative Transparency Framework. This framework applies storytelling principles to drive AI-assisted consent processes and aims to improve decision-making, enhance understanding, and foster trust by enhancing personalized, ethically framed, and user-adaptive narratives. In this paper, we explore the theoretical basis of narrative transparency which is premised on the role of narrative structure in shaping participant understanding and decision-making. We also outline the components of the Narrative Transparency Framework and discuss practical strategies for utilizing narrative-driven AI consent interactions…