[Examine the ethical principles that should govern the deployment of artificial intelligence in public healthcare systems, referencing WHO's 2021 guidance. (GS-II/IV, 10 marks)](/upsc-mains-answer/examine-ethical-principles-should-govern-deployment-7c9062f)

WHO's 2021 guidance Ethics and Governance of Artificial Intelligence for Health — its first global report on the subject — lays down six guiding principles for AI design and use [1]. In public healthcare, where patients are often poor, unaware and unable to seek redress, these principles are not optional add-ons but preconditions for safe adoption.

Protecting human autonomy

• Humans must remain in control of medical decisions; AI should support, not supplant, clinical judgement [1].
• Requires privacy protection and informed consent for use of patient data — a duty reinforced in India by data protection law.

Promoting well-being, safety and public interest

• Developers must meet regulatory standards of safety, accuracy and efficacy, with quality control [1]. India routes this through the Medical Devices Rules, 2017, under which CDSCO regulates Software as a Medical Device and AI-based updates [2].

Transparency and explainability

• Sufficient information must be published before deployment to permit meaningful public consultation [1]. "Black-box" diagnostic tools in government hospitals defeat this test.

Responsibility and accountability

• Liability must remain traceable to a human actor, with mechanisms of redress for those harmed by algorithmic decisions [1]. WHO's 2024 guidance on large multi-modal models extends this, urging independent audits and impact assessments at scale [3].

Inclusiveness and equity

• AI must serve users irrespective of age, sex, income, race or ability [1]. In India, urban-skewed data risks under-serving rural patients — the concern India's SAHI strategy addresses by treating safety, equity and public trust as central design principles, backed by the BODH benchmarking platform for validating models on real-world data [4][5].

Responsiveness and sustainability

• Continuous post-deployment assessment, plus planning for environmental impact and workforce disruption [1].

These principles converge on a single idea: technology must extend, never dilute, the doctor–patient relationship. India's dual-track approach — statutory device regulation plus an ethical strategy — offers a workable template, provided independent audit and grievance redress are institutionalised. Governed thus, AI can advance the constitutional promise of Article 21 and SDG-3's goal of universal health coverage.