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. 2023 Mar;49(3):165-174.
doi: 10.1136/jme-2022-108371. Epub 2022 Nov 8.

Ethics of the algorithmic prediction of goal of care preferences: from theory to practice

Andrea Ferrario  1   2 , Sophie Gloeckler  3 , Nikola Biller-Andorno  3
Affiliations

Ethics of the algorithmic prediction of goal of care preferences: from theory to practice

Andrea Ferrario et al. J Med Ethics. 2023 Mar.

Abstract

Artificial intelligence (AI) systems are quickly gaining ground in healthcare and clinical decision-making. However, it is still unclear in what way AI can or should support decision-making that is based on incapacitated patients' values and goals of care, which often requires input from clinicians and loved ones. Although the use of algorithms to predict patients' most likely preferred treatment has been discussed in the medical ethics literature, no example has been realised in clinical practice. This is due, arguably, to the lack of a structured approach to the epistemological, ethical and pragmatic challenges arising from the design and use of such algorithms. The present paper offers a new perspective on the problem by suggesting that preference predicting AIs be viewed as sociotechnical systems with distinctive life-cycles. We explore how both known and novel challenges map onto the different stages of development, highlighting interdisciplinary strategies for their resolution.

Keywords: Advance Directives; Clinical Ethics; Decision-making; Ethics; Ethics- Medical.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The AI system life-cycle. At each step, we highlight the main theoretical and pragmatic challenges. The normative requirements for clinical AIs underline all steps of the life-cycle. AI, artificial intelligence.
Figure 2
Figure 2
The steps of the AI system life-cycle, their challenges and our recommendations. AI, artificial intelligence.
See this image and copyright information in PMC

Comment in

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