Ethical and Legal Issues in Decision Support

Abstract

The use of computers to help humans make diagnoses and prognoses in the practice of medicine or nursing is an exciting and unsettling development in the evolution of clinical and hospital practice. Such use engenders ethical and legal challenges paralleling those challenges seen regularly to arise with the introduction of many new technologies in healthcare. In the case of computational decision support systems, the most salient ethical issues involve standards of care, appropriate uses and users and professional relationships. Balancing patient safety against opportunities to improve care constitutes a tension that mirrors the difficulty encountered in debates about whether and how the government should regulate decision support systems. At ground are questions of accountability, responsibility and liability. In most cases, we lack adequate empirical data to arrive at uncontroversial conclusions. In the context of an exciting new technology, the reduction of that ignorance itself becomes an ethical imperative.