Blockchain-Enabled Governance for Health IoT Data Access via Interpretable Multi-Objective Optimization and Bargaining Under Privacy–Latency–Robustness Trade-Offs

Health Internet of Things (Health IoT) systems continuously stream sensitive physiological data, making data access governance safety-critical under conflicting objectives such as privacy risk, latency, energy/resource cost, and robustness, especially when conditions change during emergencies. This paper proposes FiB-MOBA-EAFG, a hybrid blockchain–AI framework that separates on-chain accountability from off-chain decision intelligence. Off-chain, fuzzy context inference parameterizes scenario priorities, Pareto-based multi-objective search generates candidate governance policies, an emergency-aware feasibility guard filters unsafe trade-offs, and a bargaining-based selector chooses a single deployable policy. On chain, the blockchain layer records consent commitments, access events, and hashes of the selected policy and decision trace, serving as an immutable audit and accountability substrate rather than an online decision or optimization engine, while raw health data remain off-chain. Using simulation studies of home remote monitoring, clinic telehealth, and emergency triage under stochastic network variation and adversarial device behavior, FiB-MOBA-EAFG improves robustness and yields more repeatable policy selection than rule-based control and scalarized baselines within the evaluated simulation scenarios, while maintaining latency within ranges compatible with modeled edge deployment constraints through explicit emergency-aware feasibility constraints. A budget-matched random-search ablation further indicates that structured Pareto exploration is needed to reliably obtain robust, low-risk governance policies.