AI, humanity, and the open world of health care: enduring imperatives for the next century.

This address was delivered by Eric Horvitz, MD, PhD, at the 2026 graduation ceremony of Columbia University School of Nursing on May 19, 2026, where he received the Second Century Award for Excellence in Health Care. The address considers the responsibilities of clinicians in shaping the future of artificial intelligence in medicine. It frames health care as an "open world," where information is incomplete, time is limited, and decisions are made under uncertainty. As AI transforms biomedicine and clinical care, the address emphasizes the importance of clinician engagement in guiding how these technologies are developed and used, and calls for systems that strengthen clinical judgment, support care teams, and advance human health, dignity, connection, and trust.