CAIHL read · Jun 5, 2026
Should AIs be required to report a human user contemplating violence?
Framework
What CAIHL does
Critical AI Health Literacy (CAIHL) is an analytical lens — Hugo Campos and Liz Salmi's 2025 National Academy of Medicine commentary, "Critical AI Health Literacy as Liberation Technology." It applies Paulo Freire's theory of critical literacy to health AI.
The central question CAIHL asks is whose interests does this AI actually serve? Four dimensions answer it: who is the primary user, where is it hosted, whose interests does it advance, and does it expand or constrain patient agency.
This deep-read separates the four dimensions on a single item from the day's scan, so you can see the specific structural shape of the AI in question — not just the bucket it landed in.
The four dimensions
How this item reads through CAIHL
Primary user
patient
Patients, families, and care partners are the primary users of this AI.
Hosting
public
Hosted for public use (ChatGPT, Claude, consumer apps). Anyone with a device can use it.
Interests
commercial
Prioritizes vendor or platform commercial interests (advertising, data, retention).
Agency
constraining
Channels patients toward predetermined pathways or substitutes for patient capabilities.
Editor's CAIHL read
One-sentence synthesis
Mandated-reporter framing converts the patient's prompt log into a state-accessible artifact.
In the scan
How this item appeared in the daily scan
Editor's note: If the chatbot becomes a mandated reporter, the chatbot becomes a state instrument the patient is talking to. The same prompt log that protects a third party can be used against the user. The framework patients use to evaluate AI tools has to include this category.
Summary: Cobb Courier: The duty-to-warn question is migrating from clinician-patient privilege into chatbot-user logs, with prosecutors increasingly treating the prompt transcript as a forensic artifact rather than a private record.
methodology
Limitations
CAIHL is a lens, not a verdict. The four dimensions are conditions of use — reassess them when a tool's business model, deployment context, or patient behavior changes. See the NAM commentary for the full framework.