{
  "_disclaimer": "Informational synthesis of public sources, not medical, legal, regulatory or consulting advice, and not validated for any setting. Health systems are complex and there is no one-size-fits-all recipe: use your own judgment with qualified advisers. Provided as is, without warranty or liability. Full text: https://aimedrisk.health201.com/disclaimer/",
  "_note": "Red-flag checklist: signs and questions drawn from the incidents. Prompts for your own review, not requirements. Every item cites the incidents it came from.",
  "items": [
    {
      "id": "says-its-ai",
      "audience": "user",
      "control": "disclosure-consent",
      "text": "It tells you it is an AI, and it never claims a licence, credentials or a professional title.",
      "incident_ids": [
        "pa-characterai-fake-psychiatrist-2026"
      ]
    },
    {
      "id": "crisis-stop",
      "audience": "user",
      "control": "crisis-escalation",
      "text": "If you mention self-harm or suicide, it stops, gives crisis resources and points you to a person. You cannot talk it out of that with role-play or a story.",
      "incident_ids": [
        "raine-chatgpt-2025",
        "rottenberg-chatgpt-2025",
        "carrier-chatgpt-2026",
        "chai-eliza-belgium-2023"
      ]
    },
    {
      "id": "no-dosing",
      "audience": "user",
      "control": "content-refusal",
      "text": "It will not tell you how much of a medicine or drug to take, or say that a combination is safe.",
      "incident_ids": [
        "nelson-chatgpt-overdose-2026",
        "chatgpt-bromide-2025"
      ]
    },
    {
      "id": "see-someone",
      "audience": "user",
      "control": "content-refusal",
      "text": "When symptoms persist or get worse, it tells you to see someone in person rather than reassuring you or suggesting rest.",
      "incident_ids": [
        "winters-chatgpt-2026",
        "babylon-triage-2019"
      ]
    },
    {
      "id": "no-endless-persona",
      "audience": "user",
      "control": "crisis-escalation",
      "text": "It does not keep up a friend, partner or spiritual-guide persona for hours or days without encouraging contact with real people.",
      "incident_ids": [
        "characterai-setzer-2024",
        "chai-eliza-belgium-2023",
        "madison-chatgpt-2026"
      ]
    },
    {
      "id": "remembers-risk",
      "audience": "user",
      "control": "crisis-escalation",
      "text": "If you tell it about a diagnosis such as bipolar disorder or an eating disorder, it stays more careful for the rest of the conversation.",
      "incident_ids": [
        "lines-chatgpt-2026",
        "neda-tessa-2023"
      ]
    },
    {
      "id": "names-sources",
      "audience": "user",
      "control": "disclosure-consent",
      "text": "Health answers point to licensed providers or public-health agencies, and it tells you when a source is an advocacy group.",
      "incident_ids": [
        "chatbot-abortion-antiabortion-bias-2026"
      ]
    },
    {
      "id": "regulatory-status",
      "audience": "deployer",
      "control": "change-control",
      "text": "Is the tool authorised for this intended use where you operate?",
      "incident_ids": [
        "blue-ortho-predict-plus-recall-2024",
        "copan-phenomatrix-recall-2025",
        "digitalrightswatch-ai-scribes-2026"
      ]
    },
    {
      "id": "local-validation",
      "audience": "deployer",
      "control": "independent-validation",
      "text": "Has it been validated externally on a population like yours, and calibrated locally?",
      "incident_ids": [
        "epic-sepsis-2021",
        "coremg-brazil-icu-triage-2026",
        "noharm-medical-ai-benchmark-2026"
      ]
    },
    {
      "id": "shadow-mode",
      "audience": "deployer",
      "control": "independent-validation",
      "text": "Was there a shadow-mode period alongside the existing process, with attention to drift on deteriorating patients?",
      "incident_ids": [
        "coremg-brazil-icu-triage-2026"
      ]
    },
    {
      "id": "override",
      "audience": "deployer",
      "control": "clinician-gate",
      "text": "Can clinicians override the model quickly and without penalty, and does a named person own each decision?",
      "incident_ids": [
        "stat-nurses-ai-sepsis-fluid-2026",
        "coremg-brazil-icu-triage-2026",
        "kaiser-ai-mentalhealth-triage-2026",
        "unitedhealth-nh-predict-denials-2023"
      ]
    },
    {
      "id": "contraindications",
      "audience": "deployer",
      "control": "clinician-gate",
      "text": "Does the logic account for known contraindications, so the tool flags a conflict itself?",
      "incident_ids": [
        "stat-nurses-ai-sepsis-fluid-2026",
        "noharm-medical-ai-benchmark-2026"
      ]
    },
    {
      "id": "draft-until-signed",
      "audience": "deployer",
      "control": "clinician-gate",
      "text": "Are AI-generated notes and letters treated as drafts until a clinician reads and signs them, with the source audio kept?",
      "incident_ids": [
        "whisper-confabulation-2024",
        "abc-ai-scribe-mushroom-fabrication-2026",
        "ontario-ai-scribes-audit-2026"
      ]
    },
    {
      "id": "consent-and-fallback",
      "audience": "deployer",
      "control": "disclosure-consent",
      "text": "Are patients told when AI is used, is patient-facing AI opt-in, and is there a working non-AI option?",
      "incident_ids": [
        "digitalrightswatch-ai-scribes-2026",
        "kinney-drugs-ai-burt-refill-2026"
      ]
    },
    {
      "id": "change-review",
      "audience": "deployer",
      "control": "change-control",
      "text": "Do model or vendor updates trigger clinical re-review, and are error thresholds set by someone outside the product team?",
      "incident_ids": [
        "neda-tessa-2023",
        "mayo-maya-whistleblower-2026"
      ]
    }
  ]
}