Ethical and Policy Gaps for Responsible AI in Indian Healthcare: Review Toward Viksit Bharat

Abstract

The accelerated adoption of Artificial Intelligence (AI) within the Indian healthcare sector – particularly in medical imaging, clinical decision support, and predictive diagnostics – has emerged as a critical enabler of the national vision of Viksit Bharat (Developed India). AI-driven technologies offer substantial potential to improve diagnostic accuracy, optimize healthcare delivery, and address systemic challenges such as workforce shortages and regional disparities. This review critically examines existing academic literature, government reports, and publicly available policy documents to assess the ethical, regulatory, and governance frameworks shaping Health AI implementation in India. While the country leverages robust Digital Public Infrastructure (DPI) to support large-scale digital health initiatives, the analysis reveals notable policy and regulatory deficiencies. Foremost among these is the absence of a comprehensive, standalone national Health AI policy that clearly defines accountability, liability, and governance mechanisms. Significant gaps persist in mandating independent audits to identify and mitigate algorithmic bias, particularly in high-stakes diagnostic applications. Furthermore, existing policies inadequately address data protection, transparency, and informed consent within DPI-enabled AI systems, raising concerns regarding patient privacy and trust. The study underscores the urgent need for a coherent policy framework that integrates ethical safeguards, legal clarity, and technical oversight. Addressing these shortcomings is essential to ensure that AI adoption in Indian healthcare remains reliable, equitable, and socially responsible, while effectively contributing to national development objectives and public health outcomes.