Human-AI governance through innovation systems: Digital sovereignty in the Basque Country’s healthcare system

Calzada, Igor ORCID: https://orcid.org/0000-0002-4269-830X 2026. Human-AI governance through innovation systems: Digital sovereignty in the Basque Country’s healthcare system. Presented at: 2nd International Conference on Digital Sovereignty (ICDS) 2025, Oslo, Norway, 27 - 31 October 2025. Published in: Misra, Sanjay, Kvalvik, Petter, Kjølerbakken, Kai and Jørgensen, Per-Arne eds. 2nd International Conference on Digital Sovereignty: ICDS 2025 Proceedings. Springer Proceedings in Complexity Cham, Switzerland: Springer, pp. 65-76. 10.1007/978-3-032-21524-6_6

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Abstract

In the context of the ICDS 2025 (2nd International Conference on Digital Sovereignty; Track 1 Human-Centric Digital Sovereignty), this paper investigates how Human–AI Governance (HAIG) frameworks, understood through the lens of innovation systems, can reinforce digital sovereignty in healthcare. Generative Artificial Intelligence (GenAI) is rapidly reshaping public services, raising questions of trust, accountability, and equity. By examining the Basque Country as a reference case, the study highlights how territorially grounded innovation systems and cooperative traditions create fertile conditions for embedding trustworthy AI without undermining democratic legitimacy. Drawing on qualitative action research and Living Lab experimentation, the paper identifies five interdependent factors shaping GenAI adoption: (i) epistemic uncertainty and clinical judgment, (ii) trust and explainability, (iii) accountability and error, (iv) data ownership and consent, and (v) digital divides and access. Findings indicate that GenAI must be designed as an augmentative tool that strengthens, rather than substitutes, human expertise. Living Labs function as governance infrastructures that enable participatory design, institutional reflexivity, and anticipatory regulation, demonstrating how digital sovereignty can be operationalized through inclusive socio-technical arrangements. The Basque case illustrates how regional innovation systems can align AI deployment with cooperative values, ethical standards, and democratic oversight, mitigating risks of algorithmic exclusion while fostering public trust. Policy recommendations emphasize embedding augmentative design principles in innovation governance, advancing participatory models of data sovereignty, and institutionalizing deliberative spaces for experimentation. More broadly, the paper argues that innovation systems are central to ensuring GenAI contributes to human-centric, territorially grounded, and digitally sovereign healthcare futures.

Item Type:	Conference or Workshop Item - published (Paper)
Date Type:	Publication
Status:	Published
Schools:	Schools > Social Sciences (Includes Criminology and Education)
Publisher:	Springer
ISBN:	9783032215239
ISSN:	2213-8684
Last Modified:	28 Jul 2026 14:32
URI:	https://orca.cardiff.ac.uk/id/eprint/188589

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