arXiv:2608.03114econ.THcs.AI2026-08

为医疗AI设计统一责任规则,能有效激励医生合理使用AI。

Optimal Liability Design for Medical AI

论文配图:Optimal Liability Design for Medical AI
图 1 · 摘自论文原文
  • 用委托代理模型分析医生与AI协作下的责任设计。
  • 高精度AI下责任可统一,仍达最优社会效果。
  • 责任规则需根据标准治疗可靠性动态调整。

人工智能正越来越多地融入医疗决策,但其责任归属问题仍复杂,尤其当医生诊断能力差异且质量不可观测时。本文构建一个委托-代理模型,由社会规划者设计医疗责任机制,以调节拥有私有质量信息的医生:在标准治疗、个性化判断或采纳不完美AI建议之间选择。分析揭示若干新见解:第一,在信息不对称下,最优机制出人意料地简单——对所有医生类型,偏离标准诊疗均适用统一责任水平。尽管医生能力异质,此简单政策在标准治疗可靠或AI准确度高时,常实现全信息下的最优结果。第二,AI准确度与最优责任关系非单调。越好的AI未必对应更宽松的责任;随AI准确度提升,最优责任可能单调下降或呈倒U型变化,取决于标准治疗的不确定性。第三,信息不对称并非总是降低社会福利;仅当标准治疗不可靠且AI准确度过低时才导致福利损失,且损失幅度呈倒U型:初期因AI增加监管难度而上升,后期因更高准确度缓解问题而下降。最后,信息不对称在有AI存在时是双刃剑,透明度提升并非对所有利益相关方都有利。

原文摘要 · Abstract (English)

Artificial intelligence (AI) is increasingly integrated into medical decision-making, yet its liability implications remain complex, particularly when physicians differ in diagnostic skills and their quality is unobservable. This paper develops a principal-agent model in which a social planner designs medical liability to regulate a physician with private quality information who chooses between a standard treatment, a personalized judgment-based treatment, or following an imperfect AI recommendation. Our analysis yields several novel insights. First, we show that the optimal mechanism under asymmetric information is surprisingly simple: a uniform, one-size-fits-all liability level for all physician types who deviate from the standard of care. Despite physician heterogeneity, this simple policy often achieves the full-information first-best outcome, particularly when standard care is reliable or AI is highly accurate. Second, the relationship between AI accuracy and optimal liability is non-monotonic. Contrary to common intuition, better AI does not always imply more relaxed liability. As AI accuracy increases, the optimal liability either decreases monotonically or follows an inverted-U pattern, depending on the uncertainty of the standard treatment. Third, asymmetric information does not universally reduce social welfare. Welfare loss arises only when standard care is unreliable and AI accuracy is too low; even then, its magnitude follows an inverted U-shape, initially increasing as AI complicates the regulatory problem, but declining as more accurate AI helps mitigate it. Finally, we find that information asymmetry is a double-edged sword in the presence of AI, and greater transparency does not benefit all stakeholders equally.

医疗AI责任设计机制设计

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