Near-horizon speculative technology meets empirical bioethics: policy, methodology and normativity

Ms Stacy Carter1

1Australian Centre for Health Engagement Evidence and Values (ACHEEV), University of Wollongong, Wollongong , Australia

This presentation draws on a current project to consider the challenges of engaging with emerging technologies in empirical bioethics. Our focus is machine learning (ML) for mammogram reading in breast screening, which is expected to be implemented within 5 years. Breast screening has been an early target for ML development: image recognition is a particular strength for ML, and large quantities of image data with ascertained outcomes are held by breast screening programs. All Australian women aged 40+ can access free biennial breast screening and women 50-74 are actively invited to participate, making breast screening a potentially highly consequential population-level intervention. Breast screening policymakers are currently caught in a moment of normative tension, as: 1) breast screening algorithm developers are promoting their products to screening programs; 2) public programs are keenly receptive, as they have difficulty retaining enough expert radiologists to read mammograms; but 3) evidence of effectiveness and safety in real-world settings remains weak; and 4) public values on ML in breast screening are poorly understood. This creates a powerful opportunity for empirical bioethics to provide meaningful and timely guidance to decision-makers. We recruited eight groups of women to dialogue groups about the impending use of ML in breast screening. We will discuss both the methodological challenges in researching speculative technologies with publics, and the normative challenges of producing guidance that reflects the practical realities of emerging technology, the moral intuitions and priorities of publics, and the needs of decision-makers. This work is funded by NHMRC 1181960.


Stacy Carter is the Founding Director of the Australian Centre for Health Engagement, Evidence and Values (ACHEEV) at the University of Wollongong, a centre for deliberative and values-based research in health. Her background is in public health, applied ethics and social science. She is a chief investigator on NHMRC and ARC-funded projects and collaborations including Wiser Healthcare and The Algorithm Will See You Now. She works especially on contentious or contested health issues including overdiagnosis and overtreatment, screening, vaccine refusal, and artificial intelligence in healthcare. Twitter: @stacymcarter.

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