Begley, Keith, Begley, Cecily and Smith, Valerie (2021) Shared decision‐making and maternity care in the deep learning age: Acknowledging and overcoming inherited defeaters. Journal of Evaluation in Clinical Practice, 27 (3). pp. 497-503. ISSN 1356-1294
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Abstract
In recent years there has been an explosion of interest in Artificial Intelligence (AI)
both in health care and academic philosophy. This has been due mainly to the rise of
effective machine learning and deep learning algorithms, together with increases in
data collection and processing power, which have made rapid progress in many areas.
However, use of this technology has brought with it philosophical issues and practical
problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds in philosophy, maternity care practice and clinical research, draw upon and
extend a recent framework for shared decision-making (SDM) that identified a duty of
care to the client's knowledge as a necessary condition for SDM. This duty entails
the responsibility to acknowledge and overcome epistemic defeaters. This framework
is applied to the use of AI in maternity care, in particular, the use of machine learning
and deep learning technology to attempt to enhance electronic fetal monitoring
(EFM). In doing so, various sub-kinds of epistemic defeater, namely, transparent,
opaque, underdetermined, and inherited defeaters are taxonomized and discussed. The
authors argue that, although effective current or future AI-enhanced EFM may
impose an epistemic obligation on the part of clinicians to rely on such systems' predictions or diagnoses as input to SDM, such obligations may be overridden by
inherited defeaters, caused by a form of algorithmic bias. The existence of inherited
defeaters implies that the duty of care to the client's knowledge extends to any situation in which a clinician (or anyone else) is involved in producing training data for a
system that will be used in SDM. Any future AI must be capable of assessing women
individually, taking into account a wide range of factors including women's preferences, to provide a holistic range of evidence for clinical decision-making.
Item Type: | Article |
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Keywords: | algorithmic bias; artificial intelligence; duty of care; electronic fetal monitoring; epistemic defeaters; shared decision-making; |
Academic Unit: | Faculty of Arts,Celtic Studies and Philosophy > Philosophy |
Item ID: | 18652 |
Identification Number: | 10.1111/jep.13515 |
Depositing User: | IR Editor |
Date Deposited: | 13 Jun 2024 08:57 |
Journal or Publication Title: | Journal of Evaluation in Clinical Practice |
Publisher: | John Wiley & Sons, Inc |
Refereed: | Yes |
Related URLs: | |
URI: | https://mural.maynoothuniversity.ie/id/eprint/18652 |
Use Licence: | This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here |
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