“SHADOW ARTIFICIAL INTELLIGENCE” (SHADOW AI) IN CLINICAL PRACTICE: LEGAL MECHANISMS FOR MONITORING ITS UNAUTHORIZED USE BY DOCTORS

Authors

Keywords:

artificial intelligence, shadow AI, clinical practice, AI compliance, medical confidentiality, personal data, legal liability, medical law

Abstract

The article examines the phenomenon of “shadow artificial intelligence” (Shadow AI) in clinical practice, which refers to the unauthorized use of unverified generative artificial intelligence (AI) tools by doctors outside of procedures and protocols established by the medical organization. The primary focus is on the legal mechanisms for controlling such use. Based on comparative-legal and formal-legal methods, the risks of violating medical secrets and personal data legislation, threats to patient safety, and problems in defining and distributing legal liability are analyzed. The necessity of developing internal AI compliance policies for medical organizations and establishing relevant requirements in the legislation of the Republic of Uzbekistan is substantiated.

References

Cestonaro, C., Delicati, A., Marcante, B., Caenazzo, L., & Tozzo, P. (2023). Defining medical liability when artificial intelligence is applied on diagnostic algorithms: A systematic review. Frontiers in Medicine, 10, Article 1305756. https://doi.org/10.3389/fmed.2023.1305756

European Parliament & Council of the European Union. (2024). Regulation (EU) 2024/1689 of the European Parliament and of the Council of 13 June 2024 laying down harmonised rules on artificial intelligence (Artificial Intelligence Act). Official Journal of the European Union, L, 2024/1689. https://eur-lex.europa.eu/eli/reg/2024/1689/oj

Gibelli, F., Maio, G., & Ricci, G. (2024). Editorial: Healthcare in the age of sapient machines: Physician decision-making autonomy faced with artificial intelligence. Ethical, deontological and compensatory aspects. Frontiers in Medicine, 11, Article 1477371. https://doi.org/10.3389/fmed.2024.1477371

Iqbal, U., Tanweer, A., Rahmanti, A. R., Greenfield, D., Lee, L. T.-J., & Li, Y.-C. J. (2025). Impact of large language model (ChatGPT) in healthcare: An umbrella review and evidence synthesis. Journal of Biomedical Science, 32, Article 45. https://doi.org/10.1186/s12929-025-01131-z

Lawton, T., Morgan, P., Porter, Z., Hickey, S., Cunningham, A., Hughes, N., Iacovides, I., Jia, Y., Sharma, V., & Habli, I. (2024). Clinicians risk becoming ‘liability sinks’ for artificial intelligence. Future Healthcare Journal, 11(1), Article 100007. https://doi.org/10.1016/j.fhj.2024.100007

President of the Republic of Uzbekistan. (2020, October 5). On approval of the Strategy “Digital Uzbekistan – 2030” and measures for its effective implementation (Decree No. DP-6079). Lex.uz. https://lex.uz/docs/5031048

President of the Republic of Uzbekistan. (2021, February 17). On measures for creating conditions for the accelerated introduction of artificial intelligence technologies (Resolution No. RP-4996). Lex.uz. https://lex.uz/docs/5297051

President of the Republic of Uzbekistan. (2024, October 14). On the approval of the Strategy for the Development of Artificial Intelligence Technologies until 2030 (Resolution No. RP-358). Lex.uz. https://lex.uz/docs/7158606

Price, W. N., II, Gerke, S., & Cohen, I. G. (2024). Liability for use of artificial intelligence in medicine. In B. Solaiman & I. G. Cohen (Eds.), Research handbook on health, AI and the law (pp. 150–166). Edward Elgar Publishing. https://doi.org/10.4337/9781802205657.00016

Republic of Uzbekistan. (2019, July 2). On personal data (Law No. LRU-547). Lex.uz. https://lex.uz/docs/-4396428

Republic of Uzbekistan. (2026, January 21). On amendments and addenda to certain legislative acts of the Republic of Uzbekistan in connection with the regulation of relations arising from the use of artificial intelligence (Law No. LRU-1115). Lex.uz. https://lex.uz/ru/docs/8011930

Tian, S., Jin, Q., Yeganova, L., Lai, P.-T., Zhu, Q., Chen, X., Yang, Y., Chen, Q., Kim, W., Comeau, D. C., Islamaj, R., Kapoor, A., Gao, X., & Lu, Z. (2024). Opportunities and challenges for ChatGPT and large language models in biomedicine and health. Briefings in Bioinformatics, 25(1), bbad493. https://doi.org/10.1093/bib/bbad493

Wang, L., Wan, Z., Ni, C., Song, Q., Li, Y., Clayton, E., Malin, B., & Yin, Z. (2024). Applications and concerns of ChatGPT and other conversational large language models in health care: Systematic review. Journal of Medical Internet Research, 26, e22769. https://doi.org/10.2196/22769

Wolters Kluwer Health. (2026). Shadow AI: A hidden risk to healthcare. Wolters Kluwer. https://www.wolterskluwer.com/en/solutions/uptodate/ai-clinical-decision-support/shadow-ai-report?utm_source

World Health Organization. (2024). Ethics and governance of artificial intelligence for health: Guidance on large multi-modal models. World Health Organization. https://www.who.int/publications/i/item/9789240084759?utm_source

Zack, T., Lehman, E., Suzgun, M., Rodriguez, J. A., Celi, L. A., Gichoya, J., Jurafsky, D., Szolovits, P., Bates, D. W., Abdulnour, R. E., Butte, A. J., & Alsentzer, E. (2024). Assessing the potential of GPT-4 to perpetuate racial and gender biases in health care: A model evaluation study. The Lancet Digital Health, 6(1), e12–e22. https://doi.org/10.1016/S2589-7500(23)00225-X

Downloads

Published

2026-08-28

How to Cite

“SHADOW ARTIFICIAL INTELLIGENCE” (SHADOW AI) IN CLINICAL PRACTICE: LEGAL MECHANISMS FOR MONITORING ITS UNAUTHORIZED USE BY DOCTORS. (2026). JURISPRUDENCE, 6(4), 100-107. https://yurisprudensiya.tsul.uz/index.php/yurisprudensiya/article/view/784