From the what to the how: why the stewardship of ethics implementation in AI healthcare matters

Abstract The release of Generative AI and its availability to the general population was a game changer. Making Generative AI accessible to members of the public opened up knowledge that was previously guarded by experts. As a result, Generative AI is changing the relationship between AI, patient and clinicians. Ethics guidelines issued by governments lay out what should be considered when implementing AI-enabled healthcare. However, how these guidelines are implemented matters. This perspective reflects on the complexity of the task, and how to go about it. Systems Thinking is a well-suited discipline to the task of implementing AI-enabled healthcare and involves participatory processes. However, given the financial and epistemic power imbalance between the AI technology owners and its users, there is a need for strong stewardship of the process. First Nations of Australia cultural processes offer possible guidance about how to enact this stewardship.