Algorithmic Medicine and the Duty to Disclose: Informed Consent Through the Lens of Radiology

Authors

• Lee Rodriguez, University of Michigan Law School

Abstract

Informed consent is the law’s mechanism for protecting patient autonomy by requiring disclosure of facts that bear on the decision to accept or refuse care. Artificial intelligence now helps decide what is medically true for patients, yet informed consent law still assumes that diagnostic judgment is rendered by a human mind whose reasoning is at least in principle communicable. Radiology has become the leading setting for this tension. AI systems triage worklists, flag suspected abnormalities, and anchor first-pass impressions in ways that guide radiologists’ attention and, in practice, can coauthor diagnostic conclusions while remaining invisible to patients. When patients are kept unaware that nonhuman systems materially shaped the judgment they receive, consent risks preserving its form while losing its animating premise of human agency at the point of judgment. This Note argues that such nonhuman judgment is itself a material fact under Canterbury v. Spence’s reasonable-patient standard. Courts already treat the identity and role of the decisionmaker as autonomy-relevant when surgeons are substituted, trainees participate, or a diagnostic reading is outsourced. Algorithmic medicine triggers the same principle. This Note proposes an Algorithmic Disclosure Rule (ADR) that requires acknowledgment when AI crosses from background tool to meaningful participant in diagnostic or treatment judgment. ADR does not demand technical explainability, a veto over AI, or a human-only pathway. It instead recenters informed consent on evaluative legitimacy: the patient’s right to know who—or what— exercised authority over their care. Using radiology as the core case study, this Note shows how black-box systems already shape clinical judgments upstream of patient awareness. It then maps implementation pathways through professional guidance, hospital governance, regulatory labeling, and patient decision aids. Finally, it explains how ADR can scale as AI moves beyond imaging into pathology, oncology, and general clinical decision support.

Recommended Citation

Lee Rodriguez, Algorithmic Medicine and the Duty to Disclose: Informed Consent Through the Lens of Radiology, 125 Mich. L. Rev. 119 (2026).
Available at: https://repository.law.umich.edu/mlr/vol125/iss1/4