(Toronto, March 23, 2026) JMIR Publications today announced the release of a timely new article in its News and Perspectives section, examining the legal and ethical complexities of the right to explanation for patients in the era of artificial intelligence. The article, " The Right to Understand in Health Care AI ," explores a critical tension: while the European Union's AI Act provides a legal basis for transparency, the technical and clinical reality of meaningful explanations remains largely undefined.
Authored by Anshu Ankolekar, JMIR Correspondent, the report highlights that as high-risk AI systems become standard in medical imaging and diagnostics, patients are increasingly entitled to ask, "Why did the computer conclude this?" However, the opacity of advanced algorithms often leaves even the most experienced clinicians unable to provide an answer that is both technically accurate and practically useful for the patient.
The Paradox of Clinical AI Transparency
The analysis points to several significant hurdles that prevent current legal frameworks, such as the EU AI Act and GDPR, from translating into better patient care:
The Interpretability Trade-off: The most accurate AI models often operate through millions of parameters that are impossible for humans to trace fully. Forcing simpler, more explainable models could potentially sacrifice diagnostic accuracy, creating a direct conflict with patient safety.
Automation Bias: Research indicates that incorrect AI suggestions can pull clinicians toward an incorrect diagnosis regardless of experience level. An explanation delivered by a clinician who has already deferred to an algorithm may not reflect an independent clinical assessment.
The Literacy Barrier: Between 22% and 58% of EU citizens report difficulty understanding health information. Providing technical detail on algorithmic logic often leads to cognitive overload rather than informed consent.
Shifting from Compliance to Effectiveness
The article argues for a paradigm shift: moving away from a check-the-box compliance approach toward one focused on decision-relevant clarity. Experts suggest that a truly useful patient-facing explanation must address what the system recommends, how confident it is, and what the known performance gaps are for specific populations.
To bridge this gap, the report calls for:
Co-design Partnerships: Developers must test explanation systems with actual patients and advocates to ensure they meet real-world needs.
Institutional Support: Health care systems need to allocate specific time for AI discussions and train staff to navigate these complex conversations.
Standards for Comprehension: Policy makers should prioritize digital health literacy and develop standards that measure whether a patient can actually use the information provided to make a choice.
"The EU AI Act provides the legal foundation, but the capacity to deliver an explanation that a patient can genuinely use is shaped by forces the law alone cannot govern," the report concludes. "What patients need now are answers they can use."
Please cite as:
Ankolekar A. The Right to Understand in Health Care AI. J Med Internet Res 2026;28:e95090
URL: https://www.jmir.org/2026/1/e95090
DOI: 10.2196/95090
About JMIR Publications News and Perspectives
JMIR Publications is a leading open access publisher of digital health research. The News and Perspectives section is the newest addition to its portfolio, established to bring the rigor and integrity of academic publishing to scientific journalism. The section features well-researched, expert-driven content from the Scientific News Editor, Kayleigh-Ann Clegg, PhD, and a network of specialist JMIR Publications Correspondents to keep the digital health community informed, inspired, and ahead of the curve.
About JMIR Publications
JMIR Publications is a leading open access publisher of digital health research and a champion of open science. With a focus on author advocacy and research amplification, JMIR Publications apartners with researchers to advance their careers and maximize the impact of their work. As a technology organization with publishing at its core, we provide innovative tools and resources that go beyond traditional publishing, supporting researchers at every step of the dissemination process. Our portfolio features a range of peer-reviewed journals, including the renowned Journal of Medical Internet Research.
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