Responsibility and decision-making authority in using clinical decision support systems: an empirical-ethical exploration of German prospective professionals' preferences and concerns.

Autor:	Funer F; Institute of Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany florian.funer@uni-tuebingen.de.; Institute of Ethics and History of Medicine, Eberhard Karls University Tübingen, Tübingen, Germany., Liedtke W; Department of Social Work, Protestant University of Applied Sciences RWL, Bochum, Germany., Tinnemeyer S; Institute of Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany., Klausen AD; Institute of Medical Informatics, RWTH Aachen University, Aachen, Germany., Schneider D; Competence Center Emerging Technologies, Fraunhofer Institute for Systems and Innovation Research ISI, Karlsruhe, Germany., Zacharias HU; Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover Medical School, Hannover, Germany., Langanke M; Department of Social Work, Protestant University of Applied Sciences RWL, Bochum, Germany., Salloch S; Institute of Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany.
Jazyk:	angličtina
Zdroj:	Journal of medical ethics [J Med Ethics] 2023 Dec 14; Vol. 50 (1), pp. 6-11. Date of Electronic Publication: 2023 Dec 14.
DOI:	10.1136/jme-2022-108814
Abstrakt:	Machine learning-driven clinical decision support systems (ML-CDSSs) seem impressively promising for future routine and emergency care. However, reflection on their clinical implementation reveals a wide array of ethical challenges. The preferences, concerns and expectations of professional stakeholders remain largely unexplored. Empirical research, however, may help to clarify the conceptual debate and its aspects in terms of their relevance for clinical practice. This study explores, from an ethical point of view, future healthcare professionals' attitudes to potential changes of responsibility and decision-making authority when using ML-CDSS. Twenty-seven semistructured interviews were conducted with German medical students and nursing trainees. The data were analysed based on qualitative content analysis according to Kuckartz. Interviewees' reflections are presented under three themes the interviewees describe as closely related: (self-)attribution of responsibility, decision-making authority and need of (professional) experience. The results illustrate the conceptual interconnectedness of professional responsibility and its structural and epistemic preconditions to be able to fulfil clinicians' responsibility in a meaningful manner. The study also sheds light on the four relata of responsibility understood as a relational concept. The article closes with concrete suggestions for the ethically sound clinical implementation of ML-CDSS. Competing Interests: Competing interests: HUZ is the scientific coordinator of the junior consortium CKDNapp, which is developing a CDSS for practicing nephrologists which was used for this study. She had no involvement in developing the interview guide, conducting the interviews or analyzing the interviews. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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