From clinical negligence to digital healthcare harm: A medico-legal framework for liability assessment in the era of artificial intelligence, telemedicine and cybersecurity

Healthcare is increasingly mediated by artificial intelligence, telemedicine platforms, electronic health records, cloud-based infrastructures and cybersecurity architectures. These technologies create new opportunities for care delivery, but also new pathways through which patients may be harmed. This article proposes Digital Healthcare Harm as an analytical category for the medico-legal assessment of adverse events arising wholly or partially from interactions between healthcare professionals, healthcare organisations, digital technologies and digital infrastructures. It further introduces a Socio-Technical Liability Framework structured around four layers: the clinical actor, the healthcare organisation, the digital technology and the digital infrastructure. The framework is intended to support the forensic and medico-legal reconstruction of causation, foreseeability, control, preventability and responsibility allocation in digitally mediated healthcare. It does not replace existing doctrines of professional negligence, organisational liability or product liability, but provides a structured method for analysing how these doctrines may interact in complex digital healthcare ecosystems. By integrating artificial intelligence, telemedicine and cybersecurity within a single medico-legal model, the article aims to assist legal medicine practitioners, forensic experts and healthcare institutions in assessing liability where patient harm cannot be adequately explained by clinician conduct alone.