JMIR Publications

ABSTRACT

The personalization–privacy paradox highlights a core dilemma of the digital age: personalization depends on extensive data use, yet data practices provoke privacy concerns. This essay examines how the paradox evolves in healthcare, where artificial intelligence (AI) magnifies both opportunities and risks. While AI-driven personalization promises earlier diagnoses, tailored treatments, and preventive care, it also intensifies concerns about surveillance, opacity, third-party exploitation, and re-identification of sensitive health data. The analysis foregrounds the patient–practitioner relationship, where trust and confidentiality remain ethical cornerstones, and shows how AI-driven personalization challenges these principles. Against this backdrop, the European Health Data Space (EHDS) is assessed as a governance framework that seeks to harmonize cross-border data exchange, enable medical AI innovation, and protect privacy under the General Data Protection Regulation (GDPR). Drawing on theoretical perspectives from privacy calculus, social exchange, and well-being research, the essay identifies both opportunities, such as interoperability, privacy-preserving technologies, and patient empowerment and risks, including pseudonymization limits, algorithmic opacity, and sectoral tensions between clinical and public health uses. The central research question guiding this analysis asks how the EHDS can foster trustworthy AI-enabled personalization in healthcare while safeguarding patient privacy. The paper argues that success will depend on embedding transparency, explainability, and robust ethical governance into the architecture of European digital health.