The UK National Health Service (NHS) has committed £250 million toward the deployment of artificial intelligence (AI). One compelling use case involves patient-recorded cardiac waveforms, interpreted in real-time by AI to predict the presence of common, clinically actionable cardiovascular diseases. Waveforms are recorded by a handheld device applied by the patient at home in a self-administered “smart” stethoscope examination. The deployment of such a novel home-based screening program, combining hardware, AI, and a cloud-based administrative platform, raises ethical challenges, including considerations of equity, agency, data rights, and, ultimately, responsibility for safe, effective, and trustworthy implementation. The meaningful use of these devices without direct clinician involvement transfers the responsibility for conducting a diagnostic test with potentially life-threatening consequences onto the patient. The use of patients’ own smartphones and internet connections should also meet the data security standards expected of NHS activity. Additional complexity arises from rapidly evolving questions around data “ownership,” according to European law a term applicable only to the patient from whom the data originate, when “controllership” of patient data falls to commercial entities. Clarifying the appropriate consent mechanism requires the reconciliation of commercial, patient, and health system rights and obligations. Oriented to this real-world clinical setting, this chapter evaluates the ethical considerations of extending home-based, self-administered AI diagnostics in the NHS. It discusses the complex field of stakeholders, including patients, academia, and industry, all ultimately beholden to governmental entities. It proposes a multi-agency approach to balance permissive regulation and deployment (to align with the speed of innovation) against ethical and statutory obligations to safeguard public health. It further argues that a strong centralized approach to carefully evaluating and integrating home-based AI diagnostics is necessary to balance the considerations outlined above. The chapter concludes with specific, transferable policy recommendations applicable to NHS stewardship of this novel diagnostic pathway.