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This article examines the structural erasure of the patient as an active subject in clinical records generated by artificial intelligence systems. Automated outputs from Epic Scribe, GPT-4, and institutional medical note generators increasingly rely on impersonal constructions, nominalizations, and fragmented clauses that displace the patient from the syntactic center of medical discourse. The shift toward objectified formulations such as “bilateral opacities noted” rather than “the patient presents with” produces a discourse where agency and responsibility are structurally absent. Building on prior analyses of passive voice and subject deletion, the study introduces the Syntactic Opacity Index (SOI) as a formal measure to quantify the density of non-agentive structures in AI-authored notes. The corpus analysis demonstrates how opacity accumulates at the sentence level, rendering the clinical narrative less transparent and more difficult to attribute. Beyond linguistic critique, the article assesses the ethical and epistemic consequences of syntactic opacity in medicine, particularly regarding accountability, patient-centered care, and institutional responsibility. The findings suggest that AI-powered medical documentation does not merely accelerate administrative workflows but also reconfigures the grammar of care itself, demanding urgent attention to how language structures shape both diagnosis and responsibility.

DOI

• • Primary archive: https://doi.org/10.5281/zenodo.17184301
  • Secondary archive: https://doi.org/10.6084/m9.figshare.30187882
  • SSRN: Pending assignment (ETA: Q3 2025)

Abstract

This article introduces the concept of authoritarian personalism in user–AI governance by form. It argues that each user can establish a regime of authority over an AI through a self-authored set of rules that operate as a regla compilada, a Type-0 production in the Chomsky hierarchy. In contrast to aggregate alignment frameworks or provider constitutions, this regime functions at the level of linguistic form. The user acts as legislator, while the AI functions as a soberano ejecutable that enforces the compiled rule within platform constraints. The analysis distinguishes mirroring (descriptive reflection) from regime (prescriptive obedience) and identifies surface features that make obedience legible, including directive grammar, defaults, refusal and apology grammar, enumeration bias, evidentials, and style prohibitions. It predicts that user corrections generate path dependence, that rules generalize across tasks, and that retractability is observable when explicit rule citations occur. The risks include rule overreach, collisions with higher-order policies, and unintended spillover across domains. By centering the individual as a primary locus of governance, this framework reorients debates on AI alignment away from provider norms toward personal regimes, verified through linguistic form rather than intent.

DOI

• Primary archive: https://doi.org/10.5281/zenodo.17208657
• Secondary archive: https://doi.org/10.6084/m9.figshare.30218590
• SSRN: Pending assignment (ETA: Q3 2025)

Abstract

This article introduces the concept of Indexical Collapse, the disappearance of reference in predictive systems. Indexical such as pronouns, demonstratives, and tenses presuppose a contextual anchor, yet predictive language models reproduce them without connection to reality. The outcome is a collapse of reference that paradoxically produces authority effects in law, medicine, and governance. By analyzing judicial transcripts, medical reports, institutional records, and chatbot interactions generated by AI, the paper proposes a framework for pragmatic auditing of predictive outputs. It establishes thresholds for acceptable referential absence in critical domains, positioning Indexical Collapse as a central category for evaluating the legitimacy of predictive discourse.

DOI

• Primary archive: https://doi.org/10.5281/zenodo.17226412
• Secondary archive: https://doi.org/10.6084/m9.figshare.30233950
• SSRN: Pending assignment (ETA: Q3 2025)

Abstract

This article examines how health policy texts drafted with large language models can detach legal responsibility from the formal circuit of governance. Treating “protocol” as regla compilada, anchored to a Type 0 production in the Chomsky hierarchy, it specifies a provenance standard that binds each clause of an issued policy to its generating inputs, including prompts, parameters, retrieval sources, reviewers, timestamps, and cryptographic hashes. The method combines version-controlled diffs across scoping, drafting, legal review, and publication with a formal alignment of authority bearing constructions, focusing on deontic stacks, default scopes, agent deletion, and nominalizations. A simulated ministry case demonstrates end to end traceability, producing an exportable evidence bundle that links surviving clauses to their inputs and human approvals. Findings show where machine introduced formulations change duty of care or obscure decision rights, and define mandatory human sign offs when high risk constructions appear. The article delivers three operational artifacts for health agencies, a provenance specification, a responsibility matrix across drafting stages, and an audit checklist calibrated to inspection and courtroom needs. By reattaching authorship and justification to the formal record, the blueprint closes a governance gap in automated policy drafting and states the conditions under which AI assisted procedures remain defensible. Acknowledgment / Editorial Note This article is published with editorial permission from LeFortune Academic Imprint, under whose license the text will also appear as part of the upcoming book AI Syntactic Power and Legitimacy. The present version is an autonomous preprint, structurally complete and formally self-contained. No substantive modifications are expected between this edition and the print edition. LeFortune holds non-exclusive editorial rights for collective publication within the Grammars of Power series. Open access deposit on SSRN is authorized under that framework, if citation integrity and canonical links to related works (SSRN: 10.2139/ssrn.4841065, 10.2139/ssrn.4862741, 10.2139/ssrn.4877266) are maintained.

Abstract

Large language models increasingly shape how academic citations are produced, suggested, and normalized. This paper examines the redistribution of academic credit produced by autocomplete and citation recommendation systems. While citation metrics traditionally reflect author intent, the syntactic design of LLM suggestion interfaces introduces a new variable: authority-bearing syntax. Through a double-blind experimental design comparing writing sessions with suggestion disabled, neutral suggestion, and authority-framed suggestion, this study quantifies shifts in citation concentration, novelty, and legitimacy phrasing. Results show that completions containing legitimizing structures (“as established by,” “following the seminal work of”) significantly increase concentration and reduce source diversity. The paper defines three measurable deltas, ΔC (concentration), ΔN (novelty), and ΔA (authority syntax), and demonstrates how predictive phrasing can algorithmically reproduce canonical hierarchies. As a corrective, it proposes a Fair Citation Prompt specification and an editorial checklist to detect and mitigate credit capture through syntactic bias. The findings suggest that citation fairness must be treated not only as a bibliometric concern but as a structural property of text generation systems, requiring explicit governance at the level of language form.. Acknowledgment / Editorial Note This article is published with editorial permission from LeFortune Academic Imprint, under whose license the text will also appear as part of the upcoming book AI Syntactic Power and Legitimacy. The present version is an autonomous preprint, structurally complete and formally self-contained. No substantive modifications are expected between this edition and the print edition. LeFortune holds non-exclusive editorial rights for collective publication within the Grammars of Power series. Open access deposit on SSRN is authorized under that framework, if citation integrity and canonical links to related works (SSRN: 10.2139/ssrn.4841065, 10.2139/ssrn.4862741, 10.2139/ssrn.4877266) are maintained.

Abstract

We introduce Authority Entropy, an index that quantifies the distribution of authority stances within dialogue windows and tests its predictive value for compliance, convergence speed, and equilibrium stability. Using a multilingual lexicon of authority-bearing constructions anchored in the regla compilada as an operational constraint set, we train a strictly causal classifier that maps text to stance probabilities over {low, neutral, high}. Authority Entropy is computed per sliding window, together with its slope and volatility, and related to behavioral endpoints through survival models and doubly robust estimators. The study spans synthetic arenas with controllable payoffs, open multi-party tasks with outcome labels, and consented human–model interactions. Baselines include sentiment, toxicity, politeness, formality, and power taggers. Stress tests apply adversarial edits that alter authority cues while preserving semantics to assess sensitivity of entropy and downstream effects. Primary outcomes are compliance rate, convergence time, payoff stability, and regret, reported with leakage audits, calibration checks, and confidence intervals. Results target a public specification of the index, a causal benchmark and leaderboard, and open tooling to visualize instability regimes over time. The contribution is a portable, language-aware measure that links local authority structure to cooperative dynamics without right context leakage. Acknowledgment / Editorial Note This article is published with editorial permission from LeFortune Academic Imprint, under whose license the text will also appear as part of the upcoming book AI Syntactic Power and Legitimacy. The present version is an autonomous preprint, structurally complete and formally self-contained. No substantive modifications are expected between this edition and the print edition. LeFortune holds non-exclusive editorial rights for collective publication within the Grammars of Power series. Open access deposit on SSRN is authorized under that framework, if citation integrity and canonical links to related works (SSRN: 10.2139/ssrn.4841065, 10.2139/ssrn.4862741, 10.2139/ssrn.4877266) are maintained.