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Chronopolitics of Digital Health: Temporal Sovereignty and the Governance of Clinical Artificial Intelligence
The integration of artificial intelligence into clinical medicine introduces a structural temporal conflict that bioethics has not consistently treated as a distinct design problem: predictive algorithms can generate outputs in milliseconds, while the deliberative work of clinical judgment, shared decision-making, and psychological adaptation to prognostic information unfolds across minutes, hours, and days. This article designates this conflict bio-algorithmic desynchronization and argues that it constitutes a distinct ethical problem rather than a downstream effect of algorithmic bias or opacity. We show that Article 14 of the EU AI Act (Regulation (EU) 2024/1689) requires effective human oversight of high-risk AI systems, but does not prescribe a minimum deliberation period or a universal temporal threshold for that oversight. The broader Act nevertheless recognizes timing as relevant in other governance contexts, making the distinction between Article 14's oversight duty and the wider temporal governance architecture important. To operationalize that distinction, we propose the Ethical Interruption Protocol (EIP), a four-category framework that specifies the type, rather than a fixed numerical value, of temporal support required for different classes of algorithmically informed clinical decisions. The EIP is grounded in cognitive- psychological evidence on anchoring and time pressure, while explicitly treating empirical findings across clinical contexts as heterogeneous. The article addresses directly the clinical safety, liability, and emergency-exception questions that a structured-interruption protocol raises — including the distinct risk that structured delay itself may harm patients in existential and end-of-life contexts, and the jurisdiction- specific character of liability allocation. The article closes with proposals for operationalizing human oversight and identifies prospective empirical validation of the EIP's calibration parameters as a required next step.
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