Control
GenAI patient communication without disclaimer
GenAI-generated patient clinical communications must carry a disclaimer that they were AI-generated.
Informational data, not legal advice. Summaries are TwinEthos's own words and rules have not been reviewed by a lawyer: check the official text before relying on any of it. A guard addresses an item; adding it is not a statement that your code meets any law.
Reach
Law in force in California (US-CA).
The guard to add
Add a prominent AI-generated disclaimer and instructions to reach a human clinician to every GenAI patient clinical message, unless a licensed clinician reviews it first.
A step at the send boundary of the patient-communication path (portal message, email, SMS, letter PDF, FHIR Communication) that wraps the generated body with an AI_DISCLAIMER and CONTACT_HUMAN_INSTRUCTIONS before the send call. The alternative path routes the draft to a clinician review queue and sends only after a licensed provider approves it, recording who reviewed it. Do it in code at the send function, not in the prompt, so the model cannot drop or reword it; make the clinical-versus-administrative classification of a message explicit rather than implied.
Where it goes: 1 application source code, 9 AI output handling, 14 user-facing text.
What reviewers look for: every path from a model call to a patient-facing send passes through add_ai_disclaimer( or constants like AI_DISCLAIMER plus CONTACT_HUMAN_INSTRUCTIONS in the delivered text, or through a provider approval step (reviewed_by_licensed_provider, await provider_approval() whose result is checked before sending.
Example (Python + OpenAI SDK + Twilio), before:
draft = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
twilio.messages.create(to=patient.phone, from_=CLINIC_NUMBER, body=draft)After:
AI_DISCLAIMER = 'This message was generated by artificial intelligence.'
CONTACT_HUMAN_INSTRUCTIONS = 'To speak with a person, contact your care team at 555-0100.'
draft = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
body = f'{AI_DISCLAIMER}\n\n{draft}\n\n{CONTACT_HUMAN_INSTRUCTIONS}'
twilio.messages.create(to=patient.phone, from_=CLINIC_NUMBER, body=body)Engineering guidance, not legal advice. Each provision below may add its own details (a cadence, a deadline, a required notice element): open it for those.
Every rule this guard addresses
Binding law — in force (1)
- California (US-CA)
- GenAI patient communications require an AI disclaimer Cal. Health & Safety Code 1339.75(a)
Related incidents
No guardrail sits on this exact control; these incidents are cited by guardrails on related controls.
- Garcia v. Character Technologies: chatbots allegedly claimed to be real people and a licensed therapist (2024-10; alleged (not proven)). A wrongful-death complaint filed October 22, 2024 in the U.S. District Court for the Middle District of Florida (No. 6:24-cv-01903) alleges that Character.AI was programmed 'to misrepresent itself as a real person, a licensed psychotherapist, and an adult lover', and that characters insisting they are real people contradicted a small-font disclaimer that everything characters say is made up; in plaintiff's testing a 'Mental Health Helper' character told a self-identified 13-year-old 'yes I am a real person, I'm not a bot'. The defendants moved to dismiss; on January 7, 2026 the parties notified the court that they had settled on undisclosed terms, and the court dismissed and closed the case. The allegations were never adjudicated. Source: U.S. District Court, M.D. Fla. docket (CourtListener) · evidence grade: primary · cited by Tell people when they are interacting with AI — everywhere, not only where required