Watson, autonomy and value flexibility: revisiting the debate
- 15 September 2021
- journal article
- research article
- Published by BMJ in Journal of Medical Ethics
- Vol. 48 (12), 1043-1047
- https://doi.org/10.1136/medethics-2021-107513
Abstract
Many ethical concerns have been voiced about Clinical Decision Support Systems (CDSSs). Special attention has been paid to the effect of CDSSs on autonomy, responsibility, fairness and transparency. This journal has featured a discussion between Rosalind McDougall and Ezio Di Nucci that focused on the impact of IBM’s Watson for Oncology (Watson) on autonomy. The present article elaborates on this discussion in three ways. First, using Jonathan Pugh’s account of rational autonomy we show that how Watson presents its results might impact decisional autonomy, while how Watson produces knowledge might affect practical autonomy. Second, by drawing an analogy with patient decision aids we identify an empirical way of estimating Watson’s impact on autonomy (ie, value-congruence). Lastly, McDougall introduced the notion of value-flexible design as a way to account for the diverging preferences patients hold. We will clarify its relation with the established domain of value-sensitive design. In terms of the tripartite methodology of value-sensitive design, we offer a conceptual clarification using Pugh’s account of rational autonomy, an empirical tool to evaluate Watson’s impact on autonomy and situate a group of technical options to incorporate autonomy in Watson’s design.Keywords
Funding Information
- Universiteit Gent (BOFSTG2020002501)
This publication has 14 references indexed in Scilit:
- On the ethics of algorithmic decision-making in healthcareJournal of Medical Ethics, 2019
- Should we be afraid of medical AI?Journal of Medical Ethics, 2019
- No we shouldn’t be afraid of medical AI; it involves risks and opportunitiesJournal of Medical Ethics, 2019
- Value Sensitive DesignPublished by MIT Press ,2019
- Computer knows best? The need for value-flexibility in medical AIJournal of Medical Ethics, 2018
- Watson for Oncology and breast cancer treatment recommendations: agreement with an expert multidisciplinary tumor boardAnnals of Oncology, 2018
- Decision aids for people facing health treatment or screening decisionsEmergencias, 2017
- Measuring patient-centered care: An updated systematic review of how studies define and report concordance between patients’ preferences and medical treatmentsPatient Education and Counseling, 2015
- Exploiting order effects to improve the quality of decisionsPatient Education and Counseling, 2014
- Envisioning Watson As a Rapid-Learning System for OncologyJournal of Oncology Practice, 2013