As AI continues to transform healthcare in South Africa, one principle remains constant: ethical use of technology must begin with trust. Trust is built through transparency, robust consent processes, and strict protection of personal health information, particularly in a system that handles highly sensitive patient data daily.
Healthcare AI depends on data. Algorithms learn from patterns in medical histories, diagnostic images, and clinical outcomes. This means hospitals and technology partners must take exceptional care in how information is collected, stored, and processed. Under POPIA, health data is classified as “special personal information,” requiring explicit consent, strict safeguards, and the minimum use of data necessary for clinical purposes.
AI-powered decision-support systems, including electronic health records with predictive alerts and automated coding, are increasingly being adopted in South African hospitals. These innovations raise important questions about data security, user oversight, and the need for robust consent processes to ensure patients understand how their information is used.
Informed consent becomes even more important in this context. Patients have the right to know not only what treatment they are receiving but also when AI or robotic systems will be used in their care. Updated consent forms must clearly outline how AI works, its limitations, and the potential risks associated with machine-generated recommendations. Importantly, consent must be more than a signature; it must be a meaningful, understandable conversation.
Ethical challenges also arise around fairness and bias. AI tools are only as unbiased as the data used to train them. If datasets underrepresent certain regions, races, or socioeconomic groups, the resulting technology can unintentionally reinforce inequality. This makes active bias mitigation essential for any healthcare organisation deploying AI.
The African philosophy of Ubuntu—”I am because we are”—offers a powerful ethical anchor. It reminds healthcare providers that technology must serve humanity, promote dignity, and reinforce equity. Ethical AI is not only about compliance with legal standards; it is about honouring the relational and compassionate nature of healthcare.
Ultimately, the future of AI in healthcare depends on patients feeling protected, respected, and informed. With strong consent practices, responsible data handling, and values-driven leadership, South Africa can build an AI-enabled healthcare system that is both innovative and deeply ethical.
This article draws on insights from Adv Maud Letzler’s webinar on the “Evolving Landscape of Liability and Ethics in South African Healthcare – Navigating the Age of AI and Robotics.”