Privacy, ethics, transparency, and accountability in AI systems for wearable devices

The integration of artificial intelligence (AI) and machine learning (ML) into wearable sensor technologies has substantially advanced health data science, enabling continuous monitoring, personalised interventions, and predictive analytics. However, the fast advancement of these technologies has raised critical ethical and regulatory concerns, particularly around data privacy, algorithmic bias, informed consent, and the opacity of automated decision-making. This study undertakes a systematic examination of these challenges, highlighting the risks posed by unregulated data aggregation, biased model training, and inadequate transparency in AI-powered health applications. Through an analysis of current privacy frameworks and empirical assessment of publicly available datasets, the study identifies significant disparities in model performance across demographic groups and exposes vulnerabilities in both technical design and ethical governance. To address these issues, this article introduces a data-driven methodological framework that embeds transparency, accountability, and regulatory alignment across all stages of AI development. The framework operationalises ethical principles through concrete mechanisms, including explainable AI, bias mitigation techniques, and consent-aware data processing pipelines, while aligning with legal standards such as the GDPR, the UK Data Protection Act, and the EU AI Act. By incorporating transparency as a structural and procedural requirement, the framework presented in this article offers a replicable model for the responsible development of AI systems in wearable healthcare. In doing so, the study advocates for a regulatory paradigm that balances technological innovation with the protection of individual rights, fostering fair, secure, and trustworthy AI-driven health monitoring.