Two‑Eyed Seeing and artificial intelligence - Enhancing healthcare delivery in Indigenous communities requires an ethical and culturally relevant public health framework

Sep 28, 2026

Artificial intelligence (AI) is poised to transform healthcare delivery, with particular relevance for underserved rural, remote, and Indigenous communities. The commentary examines how AI could improve access and outcomes while stressing culturally safe and ethical implementation. It proposes a public-health framework that pairs AI with Indigenous knowledge systems through the Two-Eyed Seeing approach, aiming for equitable, culturally sensitive, and effective AI-driven care.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Abstract

Introduction

AI in healthcare: A tool for transformation

Integrating Indigenous knowledge: The Two‑Eyed Seeing approach

Canadian Journal of Public Health (2025) 116:883–886 [https://doi.org/10.17269/s41997-025-01037-1](https://doi.org/10.17269/s41997-025-01037-1) Two‑Eyed Seeing and artificial intelligence: Enhancing healthcare delivery in Indigenous communities requires an ethical and culturally relevant public health framework Amal Khan1,2 · Veronica McKinney2,3 · Ivar Mendez2,4 Received: 14 December 2024 / Accepted: 25 March 2025 / Published online: 23 April 2025 © The Author(s) 2025 Abstract Artificial intelligence (AI) is poised to transform healthcare delivery; this may be particularly important to underserved rural, remote, and Indigenous communities. This commentary explores the potential of AI to enhance healthcare access and outcomes of these populations while emphasizing the need for culturally safe and ethical implementation. By integrating AI with Indigenous knowledge systems through the Two-Eyed Seeing approach, we propose a framework that ensures that AI-driven healthcare is equitable, culturally sensitive, and effective. This public health perspective highlights the importance of approaching AI advancements with a culturally appropriate and relevant lens. Résumé L’intelligence artificielle (IA) est sur le point de transformer la prestation des soins de santé, ce qui pourrait être particulièrement important pour les communautés autochtones, rurales et éloignées mal desservies. Dans ce commentaire, nous explorons la possibilité que l’IA améliore l’accès aux soins de santé et les résultats cliniques de ces populations, mais nous soulignons la nécessité de l’appliquer de façon éthique et culturellement sûre. En intégrant l’IA aux systèmes de savoir autochtones selon l’approche de la «vision à deux yeux», nous proposons un cadre pour que les soins de santé guidés par l’IA soient équitables, culturellement appropriés et efficaces. Cette perspective de santé publique fait ressortir l’importance d’aborder les avancées en IA selon un prisme pertinent et culturellement approprié . Keywords Two-Eyed Seeing · Indigenous data sovereignty · Culturally safe AI · Ethical AI implementation · Public health framework · Co-governance in AI design Mots‑clés Vision à deux yeux · Souveraineté des données autochtones · IA culturellement sûre · Application éthique del’IA · Cadre de santé publique · Gouvernance conjointe de la conception de l’IA * Amal Khan[amal.khan@usask.ca](amal.khan@usask.ca) 1 Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada 2 Virtual Health Hub, Saskatoon, SK, Canada 3 Northern Medical Services, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada 4 Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada Introduction The integration of artificial intelligence (AI) into healthcare systems presents an unprecedented opportunity to enhance service delivery, particularly for underserved populations. AI offers the potential to improve clinical decision-making, optimize workflows, reduce costs, and improve outcomes, making healthcare more efficient and accessible (Maleki Varnosfaderani & Forouzanfar, 2024 ; Yelne et al. , 2023) . Efficiency does not necessarily equate with equitability, and access is more than having healthcare options present. Therefore, the deployment of AI in healthcare must be approached with consideration and incorporation of Indigenous approaches to health and wellness, along with the recognition that operationalization will require attention to the complex systems involved when applied to Indigenous and other marginalized communities. Historical and intergenerational impacts of colonialism and systemic racism in healthcare have profoundly shaped Indigenous perspectiveson technology, including AI, often fostering skepticism and mistrust toward healthcare innovations. The long history of data extraction and misuse has reinforced these concerns, as data mining practices have perpetuated colonial struc

FAQs

How does the commentary describe the role of AI in healthcare delivery for underserved communities?

It argues that AI could improve access and outcomes for rural, remote, and Indigenous populations, but only when implemented with strong ethical and cultural safeguards.

What is the Two‑Eyed Seeing approach used for in the proposed framework?

It is used to integrate Indigenous knowledge systems with AI, combining Indigenous and Western perspectives to support equitable and effective healthcare delivery.

Why does the commentary emphasize Indigenous data sovereignty and culturally safe AI?

It highlights harms from historical data extraction, misuse, and systemic racism, explaining that trust and equity require AI that is culturally safe and ethically governed.

Sep 28, 2026

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