Towards an Ontological Shift in Patient and Citizen Participation

Amid the growing prominence of healthcare artificial intelligence (AI), current research still pays only nominal attention to patient and citizen participation. However, this engagement rarely extends beyond tokenism, as healthcare AI ethics continues to reinforce rigid distinctions between doctors and patients and also between subjects and objects. These distinctions, which impedes genuine participation, are rooted in a specific ontology. By embracing a new ontology, participation becomes self-evident, shifting the focus from questioning its feasibility to justifying any limitations on its scope. Importantly, this shift is not limited to healthcare AI ethics; adopting a new ontology could enable meaningful progress across the entire field of bioethics.