Panel: “AI-based decision support systems for medicine and healthcare: Negotiations in development and practice” (Digitalization of Society, Society and AI)
B.12 AI-based decision support systems for medicine and healthcare: Negotiations in development and practice
Artificial Intelligence (AI) is an emerging and contested topic in biomedical research and healthcare (Topol 2019, Gianfrancesco et al. 2018, Garvin 2019). Particularly decision support systems (DSSs) are increasingly developed and introduced into the field of healthcare with different ontological and epistemological consequences (e.g., van Baalen et al. 2021). AI-based DSSs are intended to support healthcare professionals in making medical decisions assumedly providing recommendations ranging from diagnosis and treatment to aftercare including medical fields such as lung cancer cardiovascular diseases systemic inflammatory response syndrome or HIV (Baumgartner 2021, Wiggert 2021). Thus covering many relevant fields of healthcare. DSSs are associated with a number of different expectations of the actors involved – from medical professionals patients but also engineers and bioinformaticians (Winter and Carusi 2022). Next to those high expectations questions arise regarding the influence of a DSS on reasoning work routines organizational structures knowledge production use of data and general status of medical experts arise.
Those concerns are part of social processes of negotiation between the actors involved. They can take various shapes: For example they can be argued out verbally become manifest through unequal social relations of power between the involved actors or inscribed into the respective DSS. Therefore this panel aims to look at the manifold processes of negotiation taking place throughout development implementation and practical use of AI-based DSSs. Against this background we would like to raise discussions based (not only) on the following questions:
- Who is part of the development implementation and/or application processes and how are they involved? Which negotiations and conflicts happen in the respective social arenas? How do power dynamics in the field change through the DSS?
- Which negotiations occur around data? How does the (type of) data influence the development of or practices with the tool the results of the DSS the conceptualization of the problem to be solved etc.?
- (How) are patients or medical professionals represented and (re)framed through the DSS? How is their potentially new role negotiated?
- Different types of knowledge may be transferred into the tool and represented by it. (How) Are these new types of knowledge production through the DSS negotiated? How do they change the fields their ontologies and epistemologies?
- Who is perceived as the user? Who is the (actual) user (e.g., doctors, nurses, others)?
- How do clinical DSSs influence the social worlds where they are used in? How does the area where a DSS is applied in affect the tool? Which conflicts emerge?
- What is the social function of the DSS in the field? What other functions exist for different stakeholders beside the ones claimed by the developers?