ARTIFICIAL INTELLIGENCE IN BRAZILIAN PRIMARY HEALTH CARE: CARE INNOVATION, ETHICAL GOVERNANCE AND EQUITY IN THE SUS

Abstract

This chapter analyzes the potential benefits, ethical risks and governance requirements associated with the incorporation of artificial intelligence (AI) into Brazilian Primary Health Care (PHC). It is a theoretical-reflective narrative study based on scientific literature and normative documents addressing machine learning, clinical decision support, digital health, data protection, algorithmic bias and equity. The findings indicate that AI may support risk stratification, population health management, surveillance, natural language processing, telehealth and reduction of administrative workload. Nevertheless, these applications may reproduce historical inequalities, generate opaque decisions, expose sensitive data, increase technological dependence and exclude populations with limited digital access. High average performance does not guarantee distributive justice; therefore, results must be assessed across race/skin color, sex, age, disability, territory and socioeconomic status. Responsible incorporation into the Brazilian Unified Health System should be driven by concrete public health needs and include local validation, meaningful human oversight, transparency, continuous monitoring, social participation and accountability mechanisms. Technology should strengthen person-centered care and the principles of universality, comprehensiveness and equity without replacing professional judgment, therapeutic relationships or in-person alternatives.