Lume‑Med: Deterministic AI Governance for Medical Systems Using Lume and Lume‑V

Lume‑Med introduces a deterministic governance substrate for nondeterministic AI systems in high‑stakes environments. It unifies invariant‑based validation, deterministic explainability, cryptographically verifiable audit trails, safety‑dominant arbitration, and deterministic natural‑language interfaces into a single reproducible pipeline. I define a 10‑layer medical governance architecture, introduce LTC‑Med v1.0 — a cryptographically signed trust certificate standard for medical AI — formalize medical domain adapters, and establish nine integration patterns for medical AI and robotics. Lume‑Med aligns deterministic governance with major regulatory frameworks (FDA SaMD, HIPAA, IEC 62304, ISO 14971, NIST AI RMF) and contributes to the creation of a new universal category: Deterministic Autonomous Infrastructure Governance Systems (DAIGS). This work positions Lume‑Med as the medical instantiation of a general, cross‑industry deterministic governance architecture built on the Lume programming language and the Lume‑V governance engine.