Editorial
Medicine has never been more capable of speed, and never less practiced in stillness. The artificial intelligence now arriving at the bedside is being marketed as augmentation, deployed as efficiency, and absorbed, often, as inevitability. CURACO exists because none of those framings is sufficient.
We started this magazine because the technical literature on clinical AI, however brilliant, is not the same conversation as the one happening in clinic rooms, on ward rounds, and in the quiet moments when a clinician stops to ask whether the tool in their hand belongs there. The first conversation is well funded and well published. The second is largely unwritten. CURACO sets out to write it.
Issue 01 begins where it should, with consciousness. Article one asks what happens to the mind when an anaesthetic agent extinguishes it, and what that might mean for any artificial system claiming to replicate clinical understanding. Article two asks why cardiac AI was built on a seventeenth-century pump metaphor when the heart, we now know, is a sensory and emotionally entangled organ. From there the issue widens, into the labour conditions of data labelling, the carbon cost of training a model, the algorithmic bias reproducing structural racism, the regulatory vacuum around the consumer language model in the resident doctor’s pocket, the diagnostic gap a well-built algorithm could finally close.
We have grouped these nineteen pieces under five headings: Mind & Machine, The Hidden Costs, Governance, Justice, and The Clinician. They argue with each other. We meant them to.
Every article is assessed against the CURACO framework, which stands for Clinical Safety, Understanding through Awareness, Research-Informed, Authentic First Principles, Conscientious Ethics, and Optimised Technology.
Dr Ismail Sooltan and Dr Sudantha Bulugahapitiya, Editors-in-Chief, CURACO
Contents
The Vanishing Act
Consciousness, anaesthesia
The Heart Has a Mind of Its Own. Cardiac AI Does Not Know This.
Cardiology, embodiment
The Wound Behind the Screen
Labour, supply chains
Breathing Data
Environment, ethics
The Intelligibility Deficit
Trust, auditability
The Procurement Is the Policy
Procurement, power
The Algorithm That Learned to Discriminate
Bias, justice
The Clinician Who Forgot How to Think
Cognition, training
The Clinician Who Reads the Room
Bedside, phenomenology
The Governance Gap
Governance, safety
The Algorithm That Could Close the Diagnostic Gap
Diagnostic equity
The Governance Gap That Will Kill Someone
The Algorithm That Cannot See You
Disability, inclusion
The Clinician at the Bedside Is Not a Medical Device. But the Risk Is Real.
Regulation, practice
The Algorithm Decided. Who Is Responsible?
Liability, accountability
The Examination That AI Has Already Passed
Education, examinations
The Identity Wound That AI Is Quietly Inflicting on NHS Clinicians
Identity, profession
The Regulator and the Vendor Are the Same Person
Regulatory capture
The Unschooled Hand on the Algorithm
Education, lancet
Download the full issue of CURACO AI — Issue 01