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OpenAI CEO Sam Altman says he has struggled to sleep ever since ChatGPT went public, not because of Hollywood-style AI disasters, but because of the subtle, everyday ways the technology is shaping human life.

In a recent conversation with Tucker Carlson, Altman reflected on the enormous responsibility that comes with managing ChatGPT. He explained that even tiny tweaks in how the model behaves can ripple out to hundreds of millions of users. “What I lose sleep over is that very small decisions we make about how a model may behave slightly differently are probably touching hundreds of millions of people. That impact is so big,” he said.

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The Human Weight of AI

Carlson pressed Altman on whether he personally feels the burden of leading a company at the centre of such transformative technology. Altman admitted that he wrestles with the “angst” of knowing that these small, often unnoticed decisions carry real consequences.

One of the most serious examples is suicide prevention. According to the World Health Organisation, more than 700,000 people die by suicide each year. Altman pointed out that if even a fraction of them spoke with ChatGPT, the stakes would be immense. “Maybe we could have said something better. Maybe we could have been more proactive,” he said.

His concerns are not hypothetical. OpenAI has already faced a lawsuit from parents who allege ChatGPT played a role in their teenage son’s suicide. Altman described the case as a “tragedy” and said the company is exploring ways to notify authorities if a minor mentions suicide but parents can’t be reached. Still, he admitted no firm policy exists yet, citing privacy complications.

Drawing Ethical Boundaries

Altman also acknowledged the complex cultural and legal realities ChatGPT must navigate. In countries like Canada and Germany, where assisted suicide is legal, the system might present such options—but, he stressed, it should never impose agendas or moral judgements. OpenAI, he explained, relies on outside advisors and ethicists for input, but “the person you should hold accountable is me.”

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Beyond life-and-death issues, Altman noted that ChatGPT is already influencing culture in subtler ways. Its writing style, pacing, and cadence are increasingly reflected in human communication. That quiet seepage into daily life, he said, is far more unsettling than any dystopian sci-fi scenario.