Response to FDA's Request for Comment on AI-Enabled Medical Devices

Stanford scholars respond to a federal RFC on evaluating AI-enabled medical devices, recommending policy interventions to help mitigate the harms of AI-powered chatbots used as therapists.
Executive Summary
In this response to a request for public comment issued by the Food and Drug Administration on measuring and evaluating AI-enabled medical device performance in the real world, scholars from Stanford HAI, the Behavioral Science & Policy Institute at the University of Texas at Austin, and Carnegie Mellon University provide recommendations that focus on policy interventions to help mitigate the harms of AI-powered chatbots used as therapists or for other psychological purposes. The recommendations focus on closing the gap in systematic evaluations of chatbot efficacy and grounding design choices in behavioral sciences. They include calls to:
Develop comprehensive benchmarks that incorporate human clinical expertise.
Require chatbot developers to provide API end points for user-facing models.
Institute reporting requirements for performance evaluations and safety protocols.
Designate a trusted third-party evaluator for AI mental health chatbots.
Mandate companies to designate products designed for therapeutic uses.
Ensure chatbot design that prevents AI sycophancy and parasocial relationships.









