# Medical negligence in the age of statistically superior AI

## TL;DR

This paper explores legal obligations and transparency in using AI in medicine, proposing a framework to balance AI's statistical advantages with clinician accountability and patient trust.

## Contribution

A novel two-stage transparency framework for AI in medicine, linking legal accountability to institutional validation and explainability.

## Key findings

- Legal duties to use AI arise only with institutional endorsement and meaningful transparency.
- AI opacity can lead to adverse legal inferences in court if information is not preserved or disclosed.
- The framework ensures statistical gains do not harm minority groups while preserving clinical judgment.

## Abstract

As artificial intelligence (AI) systems increasingly outperform human clinicians in specific diagnostic tasks, legal debates have turned to whether such statistical superiority should create new obligations in medical practice. This article proposes a two-stage transparency framework, distinguishing ‘pre-deployment transparency’ from ‘post-deployment interpretability’, to clarify when clinicians may, must, or must not use or rely upon AI systems. It argues that duties to adopt or rely on AI arise only where institutional endorsement and meaningful transparency enable doctors to make informed, context-sensitive judgments. Legal responsibility in AI-assisted care must rest on institutional validation and explainability, not on statistical performance alone. The article further shows that, consistent with existing case law, courts may draw adverse inferences from evidentiary gaps created by AI opacity, particularly when a party fails to preserve or disclose information within its control. This framework preserves clinical judgment and patient trust while ensuring that overall statistical gains do not mask systematic harms to minority groups. It concludes with recommendations for adapting medico-legal standards to the growing role of AI without displacing the clinician’s role as the legally accountable decision-maker.