Relational Ethics in the Administration of Healthcare Technology: AI, Automation and Proper Distance

Abstract

Automation and AI-driven decision support systems are increasingly reshaping healthcare, particularly in diagnostic and clinical management contexts. Although their potential to enhance access, efficiency and personalisation is widely recognised, there remain ethical concerns especially around the shifting dynamics of healthcare relationships. This article proposes a conceptual framework for understanding the relational ethics of healthcare automation, drawing on the work of Levinas and Silverstone to interrogate the ethical implications embedded in regulatory processes. Focusing on the Australian Therapeutic Goods Administration (TGA) database, we analyse clinical decision support system (CDSS) approvals to examine how healthcare relationships are discursively constructed within regulatory documentation. Through close reading of these technical and administrative texts, we investigate how ethical concerns such as patient autonomy, informed consent and trust are acknowledged or elided. Our findings reveal a limited framing of relational dimensions in regulatory discourse, raising important questions about how ethics are operationalised in the oversight of automated systems. By making visible the administrative practices shaping healthcare automation, this study contributes to emerging debates on AI governance and the ethical integration of automation into clinical practice.