AI诊断需与医生协同，共同承担医疗责任
Algorithmic Authority and the Clinical Standard of Care
- 将医生与AI视为一个整体责任主体
- 把AI幻觉类比为人类认知偏差
- 强调数据治理与隐私保护机制
人工智能融入临床医学引发算法概率推理与医生经验直觉之间的根本矛盾。借鉴劳伦斯·莱斯格的‘代码即法律’框架，本文认为临床AI系统的架构已实际发挥医疗监管作用，重塑了责任归属与诊疗标准。将AI‘幻觉’视为与确认偏倚、过早诊断闭合等已知人类认知缺陷具有结构性相似性，二者均需统一治理。因此提出一种辩证的诊疗标准：将整合AI与医生的诊疗组合视为单一责任实体，要求在健全的数据治理与患者隐私保护框架下，实现算法精准性与人类解读权威性的融合。
原文摘要 · Abstract (English)
The integration of artificial intelligence into clinical medicine creates a fundamental tension between algorithmic probabilistic reasoning and the experiential intuition of expert physicians; applying Lawrence Lessig's \enquote{Code is Law} framework, I argue that the architecture of clinical AI systems already functions as de facto medical regulation, reshaping liability and the standard of care. Reframing AI \enquote{hallucination} as structurally analogous to well-documented human cognitive failures such as confirmation bias and premature diagnostic closure, I show that both failure modes demand a unified governance response. I therefore propose a dialectical standard of care that treats the integrated AI-physician dyad as the singular responsible diagnostic entity, mandating the synthesis of algorithmic precision with human interpretive authority within robust data governance and patient privacy frameworks.
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