AI03 Common law with divergent futures: a comparative analysis of medicolegal liability for artificial intelligence-discordant triage in Great Britain, Northern Ireland and the Republic of Ireland

Abstract

The introduction of artificial intelligence (AI) in dermatology creates a liability conflict between the ‘product’ (the algorithm) and the ‘user’ (the dermatologist). This tension is most pronounced in Northern Ireland (NI) following the Windsor Framework. They practise under UK common law while many diagnostic AI tools remain regulated under EU law. This review compares liability exposure when a clinician overrides a correct AI malignancy alert across Great Britain (GB), NI and the Republic of Ireland (ROI). The aim was to determine whether the standard of care for AI-discordant triage is uniform across the British Isles, or whether the ‘Brussels Effect’ imposes a higher liability burden on dermatologists in NI and the ROI compared with their counterparts in GB. We conducted a comparative legal analysis of negligence and regulatory frameworks (2020–2026). The GB analysis applied the Bolam test and Medicines and Healthcare products Regulatory Agency proinnovation guidance. The ROI analysis applied the Dunne principles alongside the EU Artificial Intelligence Act (2024). The NI analysis examined the hybrid interaction between Bolam and EU Medical Device Regulation requirements. A simulated scenario modelled liability where a clinician dismisses a lesion as benign despite a high-confidence AI malignancy alert. In GB, liability is governed by Bolam; clinician protection exists where a responsible body supports overriding AI. In the ROI, the Dunne defence is complicated by Article 14 of the EU AI Act, mandating human oversight of high-risk AI. Ignoring an AI alert without justification may constitute statutory breach. NI clinicians face a ‘hybrid trap’. Although judged under Bolam, reliance on EU-regulated high-risk devices weakens claims that a responsible body would disregard mandated safety warnings, effectively raising the NI standard of care above GB. Regulatory divergence has created a liability hierarchy, exposing NI and ROI dermatologists to greater legal risk than GB colleagues when disagreeing with AI outputs.