Artificial intelligence (AI) is revolutionizing healthcare, but little is known about consumer receptivity to AI in medicine. Consumers are reluctant to utilize healthcare provided by AI in real and hypothetical choices, separate and joint evaluations. Consumers are less likely to utilize healthcare (study 1), exhibit lower reservation prices for healthcare (study 2), are less sensitive to differences in provider performance (studies 3A–3C), and derive negative utility if a provider is automated rather than human (study 4). Uniqueness neglect, a concern that AI providers are less able than human providers to account for consumers’ unique characteristics and circumstances, drives consumer resistance to medical AI. Indeed, resistance to medical AI is stronger for consumers who perceive themselves to be more unique (study 5). Uniqueness neglect mediates resistance to medical AI (study 6), and is eliminated when AI provides care (a) that is framed as personalized (study 7), (b) to consumers other than the self (study 8), or (c) that only supports, rather than replaces, a decision made by a human healthcare provider (study 9). These findings make contributions to the psychology of automation and medical decision making, and suggest interventions to increase consumer acceptance of AI in medicine.

Rapid development and adoption of AI, machine learning, and natural language processing applications challenge managers and policy makers to harness these transformative technologies. In this context, the authors provide evidence of a novel “word-of-machine” effect, the phenomenon by which utilitarian/hedonic attribute trade-offs determine preference for, or resistance to, AI-based recommendations compared with traditional word of mouth, or human-based recommendations. The word-of-machine effect stems from a lay belief that AI recommenders are more competent than human recommenders in the utilitarian realm and less competent than human recommenders in the hedonic realm. As a consequence, importance or salience of utilitarian attributes determine preference for AI recommenders over human ones, and importance or salience of hedonic attributes determine resistance to AI recommenders over human ones (Studies 1–4). The word-of machine effect is robust to attribute complexity, number of options considered, and transaction costs. The word-of-machine effect reverses for utilitarian goals if a recommendation needs matching to a person’s unique preferences (Study 5) and is eliminated in the case of human–AI hybrid decision making (i.e., augmented rather than artificial intelligence; Study 6). An intervention based on the consider-the-opposite protocol attenuates the word-of-machine effect (Studies 7a–b).

Changing collective behaviour and supporting non-pharmaceutical interventions is an important component in mitigating virus transmission during a pandemic. In a large international collaboration (Study 1, N = 49,968 across 67 countries), we investigated self-reported factors associated with public health behaviours (e.g., spatial distancing and stricter hygiene) and endorsed public policy interventions (e.g., closing bars and restaurants) during the early stage of the COVID-19 pandemic (April-May 2020). Respondents who reported identifying more strongly with their nation consistently reported greater engagement in public health behaviours and support for public health policies. Results were similar for representative and non-representative national samples. Study 2 (N = 42 countries) conceptually replicated the central finding using aggregate indices of national identity (obtained using the World Values Survey) and a measure of actual behaviour change during the pandemic (obtained from Google mobility reports). Higher levels of national identification prior to the pandemic predicted lower mobility during the early stage of the pandemic (r = −0.40). We discuss the potential implications of links between national identity, leadership, and public health for managing COVID-19 and future pandemics.

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