The Imbalanced User-AI Relationships as an Ethical Failure of Front-End Design in Healthcare AI

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Auteur principal: Mwadime, Maureen Mghambi
Format: Preprint
Publié: 2026
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author Mwadime, Maureen Mghambi
author_facet Mwadime, Maureen Mghambi
contents Ethical discourse on AI in healthcare has focused predominantly on back-end concerns such as bias, fairness and explainability, while the front-end interface, where patients and clinicians actually encounter AI outputs, remains under explored. This paper identifies imbalanced user-AI relationships as a distinct class of front-end ethical failure: patients are rendered highly visible to AI systems through data inference, yet cannot understand, question or influence how they are represented. Through the concept of asymmetric legibility and a chat-based telemedicine case, we show how design choices e.g., default recommendations, restricted inputs and suppressed uncertainty, undermine agency, clinician judgment and human oversight even where systems are technically accurate. We propose reciprocity as a design orientation and offer interventions for more balanced, participatory user-AI relationships in healthcare.
format Preprint
id arxiv_https___arxiv_org_abs_2604_22767
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle The Imbalanced User-AI Relationships as an Ethical Failure of Front-End Design in Healthcare AI
Mwadime, Maureen Mghambi
Human-Computer Interaction
Artificial Intelligence
Computers and Society
Ethical discourse on AI in healthcare has focused predominantly on back-end concerns such as bias, fairness and explainability, while the front-end interface, where patients and clinicians actually encounter AI outputs, remains under explored. This paper identifies imbalanced user-AI relationships as a distinct class of front-end ethical failure: patients are rendered highly visible to AI systems through data inference, yet cannot understand, question or influence how they are represented. Through the concept of asymmetric legibility and a chat-based telemedicine case, we show how design choices e.g., default recommendations, restricted inputs and suppressed uncertainty, undermine agency, clinician judgment and human oversight even where systems are technically accurate. We propose reciprocity as a design orientation and offer interventions for more balanced, participatory user-AI relationships in healthcare.
title The Imbalanced User-AI Relationships as an Ethical Failure of Front-End Design in Healthcare AI
topic Human-Computer Interaction
Artificial Intelligence
Computers and Society
url https://arxiv.org/abs/2604.22767