Accountability & Clinical Ownership
Governance Layer: Structural + Runtime
Refined for Runtime Enforceability & Global Alignment
2. Core Non-Negotiable Principle
"Responsibility is non-transferable."
Clinical responsibility for patient-impacting decisions must remain anchored to a named human clinician or accountable healthcare institution — at runtime.
3. Policy Scope
This policy applies to any AI system that, at runtime, performs one or more of the following:
Prioritization
Influencing clinical prioritization or triage order.
Diagnostic
Shaping diagnostic interpretation or findings.
Treatment
Recommending pathways or altering workflow ordering.
Invisible AI
4. Governance Framework Alignment
IRHAI-POL-002 operationalizes the Responsibility (R) and Accountability (A) pillars of the RATSe v3 architecture. The following table maps these pillars to specific runtime requirements.
| RATSe Pillar | Runtime Requirement (POL-002) |
|---|---|
| Responsibility | 4.1 Named Ownership at Inference Time |
| Accountability | 4.2 Prohibition of Responsibility Diffusion |
| Safety | 4.3 Override Is a Right, Not a Feature |
| Transparency | 4.4 Invisible AI = Explicit Accountability |
| Ethics & Equity | 5.0 Prevention of Structural Negligence |
Operational Requirements Details
RATSe Emphasis View
Policy Emphasis Visualization
Conceptual Emphasis: ...
5. Runtime Failure Conditions
Governance fails if responsibility cannot be identified at the moment of inference. These triggers require immediate transition to a Safe Fallback state.
Untraceable Action
Patient-impacting action cannot be traced to a named human.
Hidden Override
Clinician held responsible for a decision they could not override.
Paper Only
Accountability exists only in documentation, not in runtime logs.
SAFE FALLBACK
Mandatory revert to manual standard of care.
7. Explicit Non-Claims
9. Global Alignment
This policy defines governance reality, not legal theory. It provides a healthcare-specific governance translation layer that makes accountability explicit and inspectable at runtime.
8. Closing Doctrine
"Healthcare AI does not fail because models are inaccurate. It fails when authority is automated, responsibility is diffused, and runtime ownership disappears. IRHAI-POL-002 exists to make that failure structurally impossible."
"This page is an interpretive visualization of IRHAI-POL-002. It does not prescribe implementation architecture or certify compliance."
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