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Extrinsic Trust as a Contractual Framework for Accountable AI in Health Care: Viewpoint
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Extrinsic Trust as a Contractual Framework for Accountable AI in Health Care: Viewpoint
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Journal Article
Extrinsic Trust as a Contractual Framework for Accountable AI in Health Care: Viewpoint
2026
Overview
Artificial intelligence (AI) promises efficiency and equity in health care. However, adoption remains fragmented due to weak foundations of trust. This Viewpoint highlights the gap between intrinsic trust, based on interpretability, and extrinsic trust, based on functional validation. We propose a contractual framework between AI systems and users defined by 3 promises: reliability, scope and equity, and shift and uncertainty. Illustrated through a vignette, we show how health systems can operationalize these promises through structured evidence and governance, translating trustworthy AI into accountable clinical deployment.
Publisher
Journal of Medical Internet Research,JMIR Publications Inc,JMIR Publications
