Algorithmic Authority and the Clinical Standard of Care
For clinicians and regulators, it addresses the governance gap created by AI integration in medicine, but the argument is conceptual and lacks empirical evidence.
This paper argues that AI systems in clinical medicine already function as de facto regulation, reshaping liability and the standard of care, and proposes a dialectical standard treating the AI-physician dyad as a single responsible entity.
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.