Critical AI Health Literacy as Liberation Technology: A New Skill for Patient Empowerment

Artificial Intelligence (AI) is reshaping health care in ways that affect patients, clinicians, and institutions alike. Health AI, as defined in this commentary, encompasses digital tools deployed by health care organizations (e.g., generative AI, ambient scribes, machine learning) as well as tools used independently by patients and their care partners (typically generative AI). In institutional settings, AI is typically deployed to standardize clinical workflows, enforce compliance, manage operational risk, meet financial objectives, and extract value from big data (Allen et al., 2024; Goh et al., 2025; Gonzalez-Smith et al., 2022). For clinicians, AI is framed as a way of reducing administrative burden and improving diagnostic accuracy. Within health care organizations, all staff operate under the constraint of using institutionally approved digital solutions, which may narrow clinicians’ discretion, while aligning practice with organizational priorities.

In contrast, patient-directed AI offers new opportunities for personal autonomy and agency that are not constrained by institutional policy. While patients may face barriers such as access, limited digital literacy, and incomplete access to health data, these tools leave room for curiosity and experimentation, allowing them to ask unconventional questions and pursue lines of inquiry institutions may discourage or overlook, a shift some describe as the rise of “AI Patients” (Blumenthal and Goldberg, 2025; Woods et al., 2025). This commentary explores how AI can evolve from a tool of compliance to one of patient agency, reflection, and liberation, showing how strategic use can sharpen patient reasoning, deepen critical engagement with institutional priorities, and support patients in influencing the systems that shape care, reclaiming ownership of their health narrative.