AI is already in the theatre of war just not on the side of the patient: clinical chatbots, telemedicine, and an agenda for "AI for medical humanity".

Abstract

Artificial intelligence (AI) is already embedded in modern warfare, mainly through surveillance, targeting, and military decision-making. However, its potential to support clinicians and patients in conflict settings remains underdeveloped. Frontline medical teams must make time-critical, high-stakes decisions with scarce diagnostics, disrupted referrals, insecure communications, changing injury patterns, and irregular access to specialist expertise. Humanitarian medicine needs a proactive clinician-facing AI agenda that strengthens clinical judgment, not replaces it. We propose a two-stage model: a bounded, protocol-anchored chatbot as the "first mile" of point-of-care support, and telemedicine as the "second mile" for specialist oversight and accountability. The chatbot would structure assessments, guide protocol-based actions, identify missing information and areas of uncertainty, generate standard handovers, and trigger escalations. Remote specialists would provide context and retain responsibility for clinical decisions. Safe deployment requires transparent protocols, constrained scope, hard refusals, awareness of uncertainty, data minimisation, offline-first functionality, adversarial threat modelling, and safeguards against coercive or dual-use applications. Evaluation should use locally informed simulation, silent deployment, prospective monitoring of deviations and harms, predefined safety thresholds, and independent humanitarian oversight before wider clinical use. AI will increasingly shape conflict medicine, with or without humanitarian engagement. The priority is to ensure design, governance, and evaluation are guided by patient safety, medical neutrality, local involvement, and clinical accountability, placing AI on the side of the patient, not the machinery of war.