Relationship-centered care relies on trust and meaningful connection. As AI enters clinical settings, we must ask not just what it can do, but how it should be positioned to support these values. We examine a "middle, not top" approach where AI mediates communication without usurping human judgment. Through studies of CLEAR, an asynchronous messaging system, we show how this configuration addresses real-world constraints like time pressure and uneven health literacy. We find that mediator affordances (e.g., availability, neutrality) redistribute interpretive work and reduce relational friction. Ultimately, we frame AI mediation as relational infrastructure, highlighting critical design tensions around framing power and privacy.

翻译：关系为中心的护理依赖于信任和有意义的连接。随着人工智能进入临床环境，我们不仅要问它能够做什么，还要问它应该如何定位以支持这些价值。我们探讨了一种"在中间，而非顶端"的方法，即人工智能在不取代人类判断的情况下介导沟通。通过对异步消息系统CLEAR的研究，我们展示了这种配置如何应对时间压力和健康素养不均等现实约束。我们发现，介导者可供性（例如，可用性、中立性）重新分配了解释性工作并减少了关系摩擦。最终，我们将人工智能介导构建为关系基础设施，强调了围绕框架权力和隐私的关键设计张力。