The Governance Diagonal

A deployer's one-page map for AI oversight in medical imaging: clinical risk against five positions of autonomy, and the human contact that thins, but never disappears, as the dial turns. If you scanned the QR from the slide, this is the right place.

As presented at AOCR / SGCR-WiRES 2026 · Sun 23 Aug · Singapore Expo

One-page chart titled The Governance Diagonal. Clinical risk is plotted against five positions of AI autonomy, from in the loop to out of the loop, with a dashed diagonal separating what is governable today from higher-risk autonomy where the human stays close. Example deployments sit along the diagonal, from incidental-finding flagging to agentic follow-up scheduling. Below the chart: the five positions of the dial (deciding, reading, signing, sampling, watching every case), three Monday-morning questions (what is running, was it tested on our patients, who is watching it) and three predictions, ending with: license the practice, not the product. Tagline: the higher the stakes, the closer the human. — One page · best read zoomed Download the PDF

The longer versions

The diagonal is the one-page answer to a larger question: what happens after a tool clears the regulator. The essay makes that argument in full, and the register shows the start lines it applies to.

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