Professional AI’s Dual Trust Problem

13 min read Original article ↗

Front page
Balkin.com

Balkinization
an unanticipated consequence of
Jack M. Balkin


Balkinization Symposiums: A Continuing List

E-mail:
Jack Balkin:
jackbalkin at yahoo.com
Bruce Ackerman
bruce.ackerman at yale.edu
Ian Ayres
ian.ayres at yale.edu
Corey Brettschneider
corey_brettschneider at brown.edu
Mary Dudziak
mary.l.dudziak at emory.edu

Joey Fishkin
joey.fishkin at gmail.com
Heather Gerken heather.gerken at yale.edu
Abbe Gluck abbe.gluck at yale.edu
Mark Graber
mgraber at law.umaryland.edu
Stephen Griffin
sgriffin at tulane.edu
Jonathan Hafetz
jonathan.hafetz at shu.edu

Jeremy Kessler
jkessler at law.columbia.edu
Andrew Koppelman
akoppelman at law.northwestern.edu
Marty Lederman
msl46 at law.georgetown.edu
Sanford Levinson
slevinson at law.utexas.edu
David Luban
david.luban at gmail.com
Gerard Magliocca
gmaglioc at iupui.edu
Jason Mazzone
mazzonej at illinois.edu
Linda McClain
lmcclain at bu.edu
John Mikhail
mikhail at law.georgetown.edu

Frank Pasquale
pasquale.frank at gmail.com
Nate Persily
npersily at gmail.com
Michael Stokes Paulsen
michaelstokespaulsen at gmail.com
Deborah Pearlstein
dpearlst at yu.edu
Rick Pildes
rick.pildes at nyu.edu
David Pozen
dpozen at law.columbia.edu
Richard Primus
raprimus at umich.edu
K. Sabeel Rahman
sabeel.rahman at brooklaw.edu
Alice Ristroph
alice.ristroph at shu.edu
Neil Siegel
siegel at law.duke.edu

David Super
david.super at law.georgetown.edu
Brian Tamanaha
btamanaha at wulaw.wustl.edu
Nelson Tebbe
nelson.tebbe at brooklaw.edu
Mark Tushnet
mtushnet at law.harvard.edu
Adam Winkler
winkler at ucla.edu

Compendium of posts on Hobby Lobby and related cases

The Anti-Torture Memos: Balkinization Posts on Torture, Interrogation, Detention, War Powers, and OLC

The Anti-Torture Memos (arranged by topic)

Recent Posts

Professional AI’s Dual Trust Problem

Tuesday, September 01, 2026

Professional AI’s Dual Trust Problem

Guest Blogger

For the Balkinization Symposium on the Global Political Economy of Artificial Intelligence.

Claudia E. Haupt

Each day, more than forty million people ask ChatGPT health questions. When OpenAI and Anthropic launched dedicated health AI tools that let users upload their medical records and receive personalized guidance, the obvious question was: “Should you trust them?” The question has only grown more pressing: since early 2026, five major technology companies (OpenAI, Anthropic, Microsoft, Amazon, and Perplexity) have released or expanded dedicated consumer-facing AI health applications, each allowing users to connect medical records, lab results, and wearable data to receive personalized guidance.

That question, it turns out, has more than one layer. Instinctively, we might assume the concern is about output accuracy: will the AI give bad professional advice? But a second, perhaps less obvious, problem arises that reaches beyond any individual bad outcome. Untrustworthy AI undermines the entire system of trust that makes human professional advice work in the first place. It’s a dual trust problem.

I examine professional AI’s dual trust problem in a forthcoming essay, Misplaced Trust in Artificial Professional Advice, which makes the argument in two steps.

The First Problem: AI’s Professional Advice Isn’t Trustworthy

The professional relationship with a doctor, lawyer, financial advisor, accountant, pharmacist, therapist, or another advice-giving professional is a specific social interaction. The professional possesses knowledge the client lacks; this results in a knowledge asymmetry that creates vulnerability. The law responds with a set of safeguards: licensing requirements, fiduciary duties, malpractice liability, informed consent. These mechanisms protect the conditions under which a client or patient can reasonably place confidence in a professional’s expertise.

Public-facing AI eliminates the human professional. What remains looks like professional advice: conversational, personalized, authoritative in tone. But the legal and ethical framework that ensures professional advice is trustworthy is absent.

The accuracy problem is real and documented: as of 2024, no commercially available AI app met professional standards for skin cancer detection. Earlier studies on general health queries found frequent errors, and more recent work reinforced those findings. A study published in Nature Medicine found that participants using AI chatbots to navigate common medical scenarios performed no better than a control group relying on ordinary home resources such as internet searches—and users describing the same symptoms sometimes received conflicting advice depending on how they phrased their questions. A separate Mount Sinai study found that ChatGPT Health under-triaged more than half of medical emergencies in structured clinical testing, potentially directing patients with serious conditions toward routine follow-up rather than urgent care.

But accuracy is not even the core issue. Trust is an attitude; trustworthiness is a property. And as Ignacio Cofone argues in a companion piece to this symposium, as well as in more detail in a forthcoming article,[1] trustworthiness is a property of institutions, not of AI systems. The professional relationship, not the chatbot, carries that institutional trustworthiness.

The Second Problem: Untrustworthy AI Undermines Trust in Human Professionals

When a patient consults a public-facing AI and then sees a physician whose advice diverges, the patient faces a question they are not equipped to answer: who is right? And behind that question lurks a more unsettling one: where does expertise actually live?

The proliferation of AI that mimics professional judgment creates epistemic uncertainty about institutional expertise itself. Beyond harming individual users, the AI systematically undermines confidence in the professionals it displaces or contradicts. The problem is structural, rooted in the same inequities of access that drive people to seek AI as a substitute for healthcare in the first place.

Many people turn to AI health tools precisely because they lack access to affordable human care. A March 2026 KFF tracking poll found that about one in five adults who use AI for health advice cite inability to afford a provider as a major reason, a figure that rises to nearly three in ten among users ages 18 to 29. Uninsured adults are more than twice as likely as insured adults to rely on AI for mental health guidance. And the pattern tracks race: Black and Hispanic adults turn to AI for mental health advice at substantially higher rates than White adults. Viewed this way, AI health tools are an attempted patch for a broken system.

The trust being displaced was already fragile, and unevenly distributed across race, income, and geography. Worse, the AI health tools with the most personalized features—those enabling direct integration with medical records—are increasingly behind paywalls, potentially placing them out of reach for those who are already struggling to afford care. What consumer-facing health AI offers is not a substitute for the human professional relationship.

As the law and political economy literature would recognize, the roots of this problem predate AI. First Amendment doctrine, as I have argued elsewhere, has long assumed the availability of professional advice without reckoning with its unequal distribution.[2] This assumption places a heavier burden on those who can least afford expert counsel and who are most dependent on publicly available information (however unreliable) as a substitute. Consumer-facing health AI does not solve this problem; it exploits it, offering a widely available facsimile of expert advice. And the data suggests it’s relied on by users for whom the absence of access to professional advice was already most consequential.

Trust in Institutions, Not AI

The stakes extend beyond individual harm to institutional erosion. As Woodrow Hartzog and Jessica Silbey argue, AI has the capacity to destroy the civic and professional institutions on which public life depends.[3] It may do so by steadily undermining the trust that sustains them. The professions are no exception. Professional expertise generates trust because it is grounded in training, accountable to standards, and answerable to the people it serves. Deploying AI that mimics expertise without embodying any of those properties creates bad individual outcomes and casts doubt on where expertise lives.

The question, then, is not simply whether we should trust AI. It is whether deploying untrustworthy AI erodes the very institutions whose trustworthiness we depend on, and what regulatory frameworks built around human professional relationships can do about it.

Claudia E. Haupt is Professor of Law and Political Science, Northeastern University. You can reach her by e-mail at c.haupt@northeastern.edu.


[1] Ignacio Cofone, Institutional Accountability and Legitimate Inference in Algorithmic Adjudication: Beyond Trustworthy AI, Cambridge Forum on AI Law and Governance (forthcoming 2026), https://papers.ssrn.com/sol3/papers.cfm?abstract_id=6516459

[2] Claudia E. Haupt, Assuming Access to Professional Advice, 49 J. Law, Med. & Ethics 531 (2021).

[3] Woodrow Hartzog & Jessica Silbey, How AI Destroys Institutions, UC L. REV. (forthcoming 2026) https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5870623.



Books by Balkinization Bloggers

The Actual Art of Governing

Gerard N. Magliocca, The Actual Art of Governing: Justice Robert H. Jackson's Concurring Opinion in the Steel Seizure Case (Oxford University Press, 2025)

The Routledge Companion to Gender and COVID-19

Linda C. McClain and Aziza Ahmed, The Routledge Companion to Gender and COVID-19 (Routledge, 2024)

The Constitution of the War on Drugs

David Pozen, The Constitution of the War on Drugs (Oxford University Press, 2024)

Memory and Authority

Jack M. Balkin, Memory and Authority: The Uses of History in Constitutional Interpretation (Yale University Press, 2024)

What Roe v. Wade Should Have Said

Mark A. Graber, Punish Treason, Reward Loyalty: The Forgotten Goals of Constitutional Reform after the Civil War (University of Kansas Press, 2023)

What Roe v. Wade Should Have Said

Jack M. Balkin, What Roe v. Wade Should Have Said: The Nation's Top Legal Experts Rewrite America's Most Controversial Decision - Revised Edition (NYU Press, 2023)

Burning Down the House

Andrew Koppelman, Burning Down the House: How Libertarian Philosophy Was Corrupted by Delusion and Greed (St. Martin’s Press, 2022)

Washington's Heir

Gerard N. Magliocca, Washington's Heir: The Life of Justice Bushrod Washington (Oxford University Press, 2022)

The Anti-Oligarchy Constitution

Joseph Fishkin and William E. Forbath, The Anti-Oligarchy Constitution: Reconstructing the Economic Foundations of American Democracy (Harvard University Press, 2022)

Power to the People

Mark Tushnet and Bojan Bugaric, Power to the People: Constitutionalism in the Age of Populism (Oxford University Press 2021).

Power to the People

Mark Philip Bradley and Mary L. Dudziak, eds., Making the Forever War: Marilyn B. Young on the Culture and Politics of American Militarism Culture and Politics in the Cold War and Beyond (University of Massachusetts Press, 2021).

What Obergefell v. Hodges Should Have Said

Jack M. Balkin, What Obergefell v. Hodges Should Have Said: The Nation's Top Legal Experts Rewrite America's Same-Sex Marriage Decision (Yale University Press, 2020)

New Laws of Robotics

Frank Pasquale, New Laws of Robotics: Defending Human Expertise in the Age of AI (Belknap Press, 2020)

The Cycles of Constitutional Time

Jack M. Balkin, The Cycles of Constitutional Time (Oxford University Press, 2020)

Taking Back the Constitution

Mark Tushnet, Taking Back the Constitution: Activist Judges and the Next Age of American Law (Yale University Press 2020).

Gay Rights vs. Religious Liberty

Andrew Koppelman, Gay Rights vs. Religious Liberty?: The Unnecessary Conflict (Oxford University Press, 2020)

The Trillion Dollar Revolution

Ezekiel J Emanuel and Abbe R. Gluck, The Trillion Dollar Revolution: How the Affordable Care Act Transformed Politics, Law, and Health Care in America (PublicAffairs, 2020)

Who's the Bigot

Linda C. McClain, Who's the Bigot?: Learning from Conflicts over Marriage and Civil Rights Law (Oxford University Press, 2020)

Democracy and Dysfunction

Sanford Levinson and Jack M. Balkin, Democracy and Dysfunction (University of Chicago Press, 2019)

Written in Stone

Sanford Levinson, Written in Stone: Public Monuments in Changing Societies (Duke University Press 2018)

Constitutional Democracy in Crisis

Mark A. Graber, Sanford Levinson, and Mark Tushnet, eds., Constitutional Democracy in Crisis? (Oxford University Press 2018)

The Heart of the Constitution

Gerard Magliocca, The Heart of the Constitution: How the Bill of Rights became the Bill of Rights (Oxford University Press, 2018)

Fault Lines in the Constitution

Cynthia Levinson and Sanford Levinson, Fault Lines in the Constitution: The Framers, Their Fights, and the Flaws that Affect Us Today (Peachtree Publishers, 2017)

A Realistic Theory of Law

Brian Z. Tamanaha, A Realistic Theory of Law (Cambridge University Press 2017)

Nullification and Secession in Modern Constitutional Thought

Sanford Levinson, Nullification and Secession in Modern Constitutional Thought (University Press of Kansas 2016)

An Argument Open to All

Sanford Levinson, An Argument Open to All: Reading The Federalist in the 21st Century (Yale University Press 2015)

Broken Trust

Stephen M. Griffin, Broken Trust: Dysfunctional Government and Constitutional Reform (University Press of Kansas, 2015)

Bottlenecks

Frank Pasquale, The Black Box Society: The Secret Algorithms That Control Money and Information (Harvard University Press, 2015)

We The People Volume III: The Civil Rights Revolution

Bruce Ackerman, We the People, Volume 3: The Civil Rights Revolution (Harvard University Press, 2014)

Balkinization Symposium on We the People, Volume 3: The Civil Rights Revolution

Bottlenecks

Joseph Fishkin, Bottlenecks: A New Theory of Equal Opportunity (Oxford University Press, 2014)

A New Introduction to American Constitutionalism

Mark A. Graber, A New Introduction to American Constitutionalism (Oxford University Press, 2013)

Elements of Moral Cognition

John Mikhail, Elements of Moral Cognition: Rawls' Linguistic Analogy and the Cognitive Science of Moral and Legal Judgment (Cambridge University Press, 2013)

American Founding Son

Gerard N. Magliocca, American Founding Son: John Bingham and the Invention of the Fourteenth Amendment (New York University Press, 2013)

Long Wars and the Constitution

Stephen M. Griffin, Long Wars and the Constitution (Harvard University Press, 2013)

The Tough Luck Constitution

Andrew Koppelman, The Tough Luck Constitution and the Assault on Health Care Reform (Oxford University Press, 2013)

Ordered Liberty

James E. Fleming and Linda C. McClain, Ordered Liberty: Rights, Responsibilities, and Virtues (Harvard University Press, 2013)

Balkinization Symposium on Ordered Liberty: Rights, Responsibilities, and Virtues

Defending American Religious Neutrality

Andrew Koppelman, Defending American Religious Neutrality (Harvard University Press, 2013)

Failing Law Schools

Brian Z. Tamanaha, Failing Law Schools (University of Chicago Press, 2012)

Sanford Levinson, Framed

Sanford Levinson, Framed: America's 51 Constitutions and the Crisis of Governance (Oxford University Press, 2012)

Mary Dudziak, War Time: An Idea, Its History, Its Consequences

Linda C. McClain and Joanna L. Grossman, Gender Equality: Dimensions of Women's Equal Citizenship (Cambridge University Press, 2012)

Mary Dudziak, War Time: An Idea, Its History, Its Consequences

Mary Dudziak, War Time: An Idea, Its History, Its Consequences (Oxford University Press, 2012)

Living Originalism

Jack M. Balkin, Living Originalism (Harvard University Press, 2011)

Copyfraud and Other Abuses of Intellectual Property Law

Jason Mazzone, Copyfraud and Other Abuses of Intellectual Property Law (Stanford University Press, 2011)

First Amendment Stories

Richard W. Garnett and Andrew Koppelman, First Amendment Stories, (Foundation Press 2011)

Constitutional Redemption: Political Faith in an Unjust World

Jack M. Balkin, Constitutional Redemption: Political Faith in an Unjust World (Harvard University Press, 2011)

The Tragedy of William Jennings Bryan

Gerard Magliocca, The Tragedy of William Jennings Bryan: Constitutional Law and the Politics of Backlash (Yale University Press, 2011)

The Illusion of Free Markets: Punishment and the Myth of Natural Order

Bernard Harcourt, The Illusion of Free Markets: Punishment and the Myth of Natural Order (Harvard University Press, 2010)

The Decline and Fall of the American Republic

Bruce Ackerman, The Decline and Fall of the American Republic (Harvard University Press, 2010)

Balkinization Symposium on The Decline and Fall of the American Republic

Carrots and Sticks: Unlock the Power of Incentives to Get Things Done

Ian Ayres. Carrots and Sticks: Unlock the Power of Incentives to Get Things Done (Bantam Books, 2010)

Why the Constitution Matters

Mark Tushnet, Why the Constitution Matters (Yale University Press 2010)

Lifecycle Investing

Ian Ayres and Barry Nalebuff: Lifecycle Investing: A New, Safe, and Audacious Way to Improve the Performance of Your Retirement Portfolio (Basic Books, 2010)

The Laws of Change

Jack M. Balkin, The Laws of Change: I Ching and the Philosophy of Life (2d Edition, Sybil Creek Press 2009)

Beyond The Formalist/Realist Divide

Brian Z. Tamanaha, Beyond the Formalist-Realist Divide: The Role of Politics in Judging (Princeton University Press 2009)

A Right to Discriminate?

Andrew Koppelman and Tobias Barrington Wolff, A Right to Discriminate?: How the Case of Boy Scouts of America v. James Dale Warped the Law of Free Association (Yale University Press 2009)

The The Constitution in 2020

Jack M. Balkin and Reva B. Siegel, The Constitution in 2020 (Oxford University Press 2009)

The Democracy Index

Heather K. Gerken, The Democracy Index: Why Our Election System Is Failing and How to Fix It (Princeton University Press 2009)

Exporting American Dreams

Mary Dudziak, Exporting American Dreams: Thurgood Marshall's African Journey (Oxford University Press 2008)

Legal Ethics and Human Dignity

David Luban, Legal Ethics and Human Dignity (Cambridge Univ. Press 2007)

Super Crunchers

Ian Ayres, Super Crunchers: Why Thinking-By-Numbers is the New Way to be Smart (Bantam 2007)

Cybercrime

Jack M. Balkin, James Grimmelmann, Eddan Katz, Nimrod Kozlovski, Shlomit Wagman and Tal Zarsky, eds., Cybercrime: Digital Cops in a Networked Environment (N.Y.U. Press 2007)

State of Play

Jack M. Balkin and Beth Simone Noveck, The State of Play: Law, Games, and Virtual Worlds (N.Y.U. Press 2006)

Same Sex, Different States

Andrew Koppelman, Same Sex, Different States: When Same-Sex Marriages Cross State Lines (Yale University Press 2006)

Law as a Means to an End

Brian Tamanaha, Law as a Means to an End (Cambridge University Press 2006)

Our Undemocratic Constitution

Sanford Levinson, Our Undemocratic Constitution (Oxford University Press 2006)

Dred Scott and the Problem of Constitutional Evil

Mark Graber, Dred Scott and the Problem of Constitutional Evil (Cambridge University Press 2006)

What Roe v. Wade Should Have Said

Jack M. Balkin, ed., What Roe v. Wade Should Have Said (N.Y.U. Press 2005)

Torture: A Collection

Sanford Levinson, ed., Torture: A Collection (Oxford University Press 2004)

Balkin.com homepage
Bibliography
Conlaw.net
Cultural Software
Writings
Opeds
The Information Society Project
BrownvBoard.com
Useful Links
Syllabi and Exams