Examine the ethical principles that should govern the deployment of artificial intelligence in public healthcare systems, referencing WHO's 2021 guidance.

WHO's Ethics and Governance of Artificial Intelligence for Health (2021) laid down six guiding principles for AI in health [1]. In public healthcare systems — where the patient is often poor, uninformed and without alternatives — these principles are not optional add-ons but the precondition for safe adoption.

Protecting human autonomy

• Humans must remain in control of medical decisions; AI is decision-support, not the decision-maker [1].
• Requires informed consent and privacy safeguards over patient data used for training and inference.

Well-being, safety and efficacy

• Developers must meet regulatory requirements for safety and accuracy [1]. In India, AI-enabled medical devices follow the CDSCO pathway under the Medical Devices Rules, 2017 [2].
• BODH, a privacy-preserving benchmarking platform built on ABDM data, allows validation without sharing datasets [3].

Transparency and explainability

• Sufficient information must be published before deployment to permit meaningful public debate [1] — critical where a state health system procures AI for millions.

Responsibility and accountability

• Liability must remain traceable to a trained human professional, with effective redress mechanisms for those harmed [1].
• WHO's 2024 guidance on large multi-modal models additionally warns of automation bias and urges independent audits [4].

Inclusiveness and equity

• AI must be designed for equitable access irrespective of income, gender or ability [1]; otherwise urban-trained models misfire on rural populations.

Responsive and sustainable AI

• Continuous post-deployment assessment, attention to environmental cost and workforce retraining [1].

India has begun institutionalising this ethic: SAHI (Strategy for AI in Healthcare in India), launched with BODH at the India AI Impact Summit (February 2026), provides a common Centre–State framework for ethical, evidence-based AI adoption [3], while membership of the HealthAI Global Regulatory Network links India to shared global safety standards [5].

The way forward lies in pairing device-level regulation with this ethical framework, so that AI widens access to care while accountability stays firmly with the doctor — realising the Article 21 promise of health with dignity.