Op-Ed: Why AI Can’t Replace Community-Led Care

As artificial intelligence becomes more embedded in our healthcare systems, one thing is clear: the same institutions that have failed Black, Indigenous, disabled, queer, trans and poor communities for generations are now automating that failure at unbelievable scale. 

Experts, including practitioners and organizers from Healing Justice and Disability Justice, have raised concerns about algorithmic bias, highlighting how data-driven tools perpetuate the same disparities that our communities have long resisted. 

Many people ask what could possibly go wrong with introducing artificial intelligence into healthcare. These are the kinds of things that could go wrong, and some already are:

• A Black woman walks into a hospital with signs of heart disease, but the risk prediction tool says she is fine. 
• A Latinx patient shows up with textbook symptoms of depression, but the screening algorithm does not flag them for follow-up care. 
• A Black man with kidney failure is told he is not sick enough for a transplant because the model calculating his eligibility was built on the false assumption that Black kidneys function differently from everyone else’s.
• Algorithms are being used to flag who is likely to miss appointments, leading to lower prioritization for follow-up care.
• Insurers use AI to deny coverage altogether, labeling patients too high-risk to treat, disproportionately impacting Black, poor, disabled, trans, and undocumented people who are already more likely to be misdiagnosed, underinsured, or excluded from care. 

These examples are not just hypothetical; they are grounded in real patterns and fears already identified by our communities. They do not reflect potential glitches in an otherwise neutral machine; rather, they are reflections of a system designed to delay, deny, and disappear care for the most marginalized. These tools were not designed to serve our communities, and they have no place in systems of care. Their origins are rooted in surveillance, profit, and control, not in healing. Instead of closing gaps in access, AI is deepening them, embedding racist and ableist logics into the very tools being sold as solutions. 

What we’re seeing is not innovation. It is the automation of violence, surveillance and neglect. AI isn’t correcting injustice in medicine. It’s scaling it, and taking decades of racist, sexist, and ableist decision-making and hardcoding it into tools that now claim to be objective.

At the same time, these systems consistently prioritize people with power and access, allowing them to hoard care and critical resources while others are left to suffer. We saw this clearly during COVID-19, when wealthier countries and communities secured far more vaccines than they needed, while others had little to none. This is not just about access. It is about the underlying eugenic logic that shapes these systems, where some lives are protected and others are treated as disposable. Healing Justice interrupts this logic, and it invites us to build systems of care rooted in dignity, accountability, and shared survival.

This is the reality of the medical industrial complex. It rewards data over dignity, surveillance over consent, and compliance over care. It turns care into a commodity and often strips it of its political and cultural roots. It punishes those who do not fit its mold and labels people as non-compliant when they resist racist, gendered, ableist systems of control. 

That is why we need Healing Justice.

Healing justice is a political and spiritual strategy born from the leadership of Black Feminist, queer and trans, southern abolitionist healers and health practitioners. It is not a wellness trend or a branding tool. It is a movement-based response to generational trauma, systemic abandonment, and state violence of the medical industrial complex. It cannot be commodified, depoliticized, or extracted from the movements and communities that created it. And it was developed for moments like this.

The anthology Healing Justice Lineages brings this framework to life. It uplifts the stories of birth workers, incarcerated survivors, movement organizers, abolitionist healing and health practitioners, cultural workers and so on who have built entire ecosystems of care without institutional backing. The Healing Justice Lineages digital archive features oral testimonies from movement leaders, organizers, and health, healing, and spiritual practitioners that illuminate the depth and breadth of healing justice, collective care, and community safety work. These interviews carry the wisdom, practices, contradictions, and complexities of both past and present healing justice strategies while planting seeds for radical futures. This archive is offered as a resource for learning and political reflection. These stories call for deep listening, respect, and accountability. To engage with them is to step into a living legacy of healing and liberation.

Healing Justice seeks to build collective care strategies that move us away from Western medical models rooted in capitalist, racist, and ableist assumptions about whose bodies are expendable and whose are considered worth saving. These dominant models often center care around the individual without accounting for the structural conditions that communities are navigating. Healing Justice instead asks what societal forces, such as incarceration, poverty, environmental racism, and transphobia, are shaping our health and well-being in the first place.

While AI technologies often promise quick fixes or predictive accuracy, they rarely address these root conditions. Instead, they generate new forms of data capitalism that widen the divide between those with resources and those without, once again leaving Black and Brown communities behind. Data for Black Lives speaks directly to this in their 2021 report Data Capitalism and Algorithmic Racism, naming how data technologies continue to reproduce systems of harm rather than dismantle them. In light of the decimation of the healthcare system and the Supreme Court permitting Department of Government Efficiency (DOGE) access to massive data from the Social Security Administration under the rise of authoritarianism, we are watching the take down of any protection from the misuse and abuse of data while ramping up AI to replace it.  It also comes with a massive environmental cost. Data centers drive up emissions and fossil fuel use, accelerating climate change and worsening public health, especially in Black and Brown communities already facing environmental harm. With little regulation and a national push to dominate the AI race, corporate power is being prioritized over collective safety, and our communities are being left behind again.

Healing Justice offers a different path, one rooted not in optimization or speed, but in relationship, context, and collective liberation.

Healing Justice is not just a notion; it is a practice that lives in our communities. It lives in Black birth worker collectives in the South, creating sacred, culturally rooted spaces for birth within a system that continues to endanger Black lives. It looks like incarcerated people leading grief circles from the onset of the COVID-19 crisis to now, as the state refuses to acknowledge the scale of harm and loss disproportionately impacting Black and Brown and disabled communities. It lives in harm reduction workers providing life-saving care on the frontlines of the overdose crisis, responding with dignity where the system offers only punishment. It shows up in the work of land stewards, ritualists, and spiritual caretakers who are preserving ancestral healing traditions while navigating gentrification, displacement, and generational loss.

Healing Justice also confronts private and public health institutions and ideologies of Western-based models of care rooted in racism and ableism; in the work of abolitionist health practitioners who are disrupting harmful practices from within. These are doctors, nurses, birth workers, midwives, and therapists who are refusing carceral logics, challenging bias in the use of algorithms in clinical settings, and practicing consent, transparency, and cultural accountability every day. Healing Justice challenges the false divide between health practitioners on one side and community-based healers on the other. Rather, it calls us to recognize how both can work together when grounded in values of liberation, dignity, and justice. These practices are not alternatives to care—they are the care—they are the infrastructure our communities and movements have built and sustained when no other options were given.

Where the medical industrial complex separates mind from body, spirit from science, and patient from power, Healing Justice reweaves what was never meant to be divided. It affirms that we actually cannot algorithm our way to liberation. We cannot automate care, and we cannot rely on institutions built on harm to suddenly become sources of healing.

We affirm six truths that the rise of AI in medicine makes more urgent than ever:

Care is not neutral.
Technologies reflect the values of their makers. For years, we have collectively discussed the fact that biased inputs create biased outcomes. Healing Justice refuses neutrality. It is rooted in abolitionist, anti-capitalist, and anti-eugenic traditions.

Medical technologies without accountability are dangerous
New medical technologies have often reinforced racist, ableist, and classist beliefs. Assisted reproductive technologies are being misused to surveil, punish, and erase BIPOC, LGBTQ, intersex and disabled communities that have been targeted for elimination, echoing eugenic ideals. Disability justice frameworks have long made clear that technologies built without disabled people in mind have often become tools of control rather than care for our communities. They remind us that progress that does not center interdependence, access, and dignity is not progress at all. 

Healing Justice insists that care must honor the full dignity of every body and every life.

Communities must have self-determination and not be objectified through research
Too often, our communities are treated like research subjects for profit: observed, surveyed, written about, but rarely supported. Our communities must lead and have the autonomy to build our own collective care strategies.

Engagement without resources is extraction. Healing Justice calls for more than participation in someone else’s agenda. It demands real investment in the grassroots and lineage-based systems of care our communities have sustained for generations. We have led our own research, created our own practices, and built care systems when none existed or when existing ones excluded us. That work deserves not only recognition but resourcing.

Data without context is violence.
No algorithm can fully account for histories of colonialism, displacement, or incarceration, as mentioned by Dr. Ruha Benjamin. Healing Justice offers a political and cultural analysis that connects current harm to its root causes.

True healing is not scalable, but power is.
You cannot mass-produce ancestral wisdom. You cannot code trust. But you can organize. You can build relationships, fight for collective safety, and sustain communities who have already been doing the work such as Anti Police Terror Project, Healing Histories Project and National Queer & Trans Therapist of Color Network.

The book Fatal Invention by Dorothy Roberts reveals how science and technology are being used to reinforce old hierarchies, even under the guise of innovation. Healing justice insists that our bodies are not problems to be fixed, cured or categorized to be sorted, but sacred, interconnected, and worthy of care beyond measure.

We are the strategy.
Healing Justice is not something to implement from the outside. It lives in everyday people. In trans doulas resisting medical neglect; in people fighting for the bodily sovereignty of intersex children; in disabled organizers leading mutual aid networks; in cultural workers tending to grief through ritual and resistance. 

This work is not just about critique, it is about creation. Healing Justice practitioners are not just reacting to broken systems; they are actively building the world we need, one that values care, dignity, and collective survival. 

As AI advances, we must be clear: the future of care cannot be defined by predictive analytics or machine learning. It must be shaped by the people who have already imagined, practiced, and protected care beyond the limits of the state. 

Technology will not save us, but our people can.

Cara Page and Erica Woodland are the co-editors of Healing Justice Lineages: Dreaming at the Crossroads of Liberation, Collective Care, and Safety.

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