CAIHL read · Jun 10, 2026
Narrative medicine is what AI in medicine cannot replace
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
clinician
Clinicians or care teams are the primary users. Patients are affected downstream.
Hosting
public
Hosted for public use (ChatGPT, Claude, consumer apps). Anyone with a device can use it.
Interests
patient-aligned
Interest structure prioritizes patients. Operates on a philanthropic, public-service, or advocacy footing.
Agency
expanding
Expands patient capabilities, supports their questions, increases their ability to act on their own values across and beyond health systems.
Editor's CAIHL read
One-sentence synthesis
Clinician-voice defense of the irreducible narrative layer; expanding patient agency by naming what the AI cannot substitute.
In the scan
How this item appeared in the daily scan
Editor's note: The argument is the inverse of the 'AI saves clinician time' narrative. If the saved time was the listening time, the saving is the loss. The narrative-medicine layer is the patient agency the AI cannot deliver because the AI is not the patient's interlocutor in that register.
Summary: KevinMD: Clinician essay arguing that narrative medicine — the structured interpretation of a patient's story as clinical evidence — is the irreducible layer of clinical work that AI in medicine cannot replace.
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.