Mr Louis Taffs1,2, Dr Vince Istvan Madai2
1Sydney Health Ethics, Camperdown, Australia, 2Berlin Institute of Health at Charité , Berlin, Germany
Biography:
Louis Taffs is a postgraduate medical student at the University of Sydney. He is also an early career researcher, whose academic work is engaging with the debates surrounding what constitutes good patient care, how we should achieve it, and who is afforded such a privilege.
Abstract:
Background:
There are many doctors who are more knowledgeable than you; they have more experience, and are up to date on the literature. Other doctors are specialists in their field; they know more than you about specific illnesses or organs. Finally, there are some doctors who are your perfect equal – only vaguely competent and highly unsure about what to do with their patient.
In clinical practice, it is common to call upon colleagues for a second opinion. Does their relative position on the epistemological ladder of medicine compared to you change your obligation to act on the advice you receive?
Aims:
To theorise how clinical decisions are made in light of the medical epistemic hierarchy, and explore the ethical and (potentially medico-legal?) consequences of making insubordinate decisions.
Methods:
A virtue and professional role ethics analysis of medical decision making and sociology literature.
Results:
One is obligated as a doctor to act on best information for the good of your patient, however your role as a professional does grant you some freedom to discern what (or who) you believe to be the best source of that information. Issues arise when two different sources with apparent equal epistemic authority tell you competing things. This is complicated further when one source is non-human, such as an Artificial Intelligence designed as a clinical decision support system.
Conclusions:
A consultation with a person or artificial intelligence that you have deemed to hold epistemic authority over you obliges you to act on their advice.