Clinical trial recruitment is often treated as a logistical hurdle. In reality, it determines who is included in research, who bears risk, and whose experiences shape medical knowledge. In this lecture from the 2025 BEI Winter School Online, Dr. Kalina Kamenova, Founder and Research Director of the Canadian Institute for Genomics and Society, examines how generative AI is reshaping that process through a bioethics and policy lens. What appears as efficiency is also a shift in power, moving decisions from clinicians to algorithms that are not always transparent or accountable. As recruitment becomes increasingly automated, the challenge is no longer just improving access, but understanding how these systems may reproduce bias and redefine responsibility in clinical research. Watch the full lecture here.