What is morally at stake when using algorithms to make medical diagnoses? Expanding the discussion beyond risks and harms

What is morally at stake when using algorithms to make medical diagnoses? Expanding the discussion beyond risks and harms

de Boer, Bas (University of Twente)
Kudina, O. (TU Delft Ethics & Philosophy of Technology)

2022

In this paper, we examine the qualitative moral impact of machine learning-based clinical decision support systems in the process of medical diagnosis. To date, discussions about machine learning in this context have focused on problems that can be measured and assessed quantitatively, such as by estimating the extent of potential harm or calculating incurred risks. We maintain that such discussions neglect the qualitative moral impact of these technologies. Drawing on the philosophical approaches of technomoral change and technological mediation theory, which explore the interplay between technologies and morality, we present an analysis of concerns related to the adoption of machine learning-aided medical diagnosis. We analyze anticipated moral issues that machine learning systems pose for different stakeholders, such as bias and opacity in the way that models are trained to produce diagnoses, changes to how health care providers, patients, and developers understand their roles and professions, and challenges to existing forms of medical legislation. Albeit preliminary in nature, the insights offered by the technomoral change and the technological mediation approaches expand and enrich the current discussion about machine learning in diagnostic practices, bringing distinct and currently underexplored areas of concern to the forefront. These insights can contribute to a more encompassing and better informed decision-making process when adapting machine learning techniques to medical diagnosis, while acknowledging the interests of multiple stakeholders and the active role that technologies play in generating, perpetuating, and modifying ethical concerns in health care.

Algorithms
Ethics
Machine learning
Medical diagnosis
Technological mediation
Technomoral change

http://resolver.tudelft.nl/uuid:c644ee12-f5da-4ef3-ad73-54c2c0e7c802

https://doi.org/10.1007/s11017-021-09553-0

1386-7415

Theoretical Medicine and Bioethics: philosophy of medical research and practice, 42 (5-6), 245-266

Institutional Repository

journal article

© 2022 Bas de Boer, O. Kudina