Nyrup Rune
Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge, United Kingdom.
Front Digit Health. 2021 Jul 2;3:690417. doi: 10.3389/fdgth.2021.690417. eCollection 2021.
Most existing work in digital ethics is modeled on the "principlist" approach to medical ethics, seeking to articulate a small set of general principles to guide ethical decision-making. Critics have highlighted several limitations of such principles, including (1) that they mask ethical disagreements between and within stakeholder communities, and (2) that they provide little guidance for how to resolve trade-offs between different values. This paper argues that efforts to develop responsible digital health practices could benefit from paying closer attention to a different branch of medical ethics, namely public health ethics. In particular, I argue that the influential "accountability for reasonableness" (A4R) approach to public health ethics can help overcome some of the limitations of existing digital ethics principles. A4R seeks to resolve trade-offs through decision-procedures designed according to certain shared procedural values. This allows stakeholders to recognize decisions reached through these procedures as legitimate, despite their underlying disagreements. I discuss the prospects for adapting A4R to the context of responsible digital health and suggest questions for further research.
数字伦理领域的大多数现有工作都以医学伦理的“原则主义”方法为蓝本，试图阐明一小套通用原则来指导伦理决策。批评者强调了此类原则的若干局限性，包括：（1）它们掩盖了利益相关者群体之间以及群体内部的伦理分歧；（2）它们对于如何解决不同价值观之间的权衡几乎没有提供指导。本文认为，为制定负责任的数字健康实践所做的努力，若能更密切地关注医学伦理的另一个分支，即公共卫生伦理，将会有所助益。具体而言，我认为公共卫生伦理中具有影响力的“合理性问责”（A4R）方法有助于克服现有数字伦理原则的一些局限性。A4R试图通过根据某些共享的程序价值设计的决策程序来解决权衡问题。这使得利益相关者能够将通过这些程序达成的决策视为合法，尽管他们存在潜在分歧。我讨论了将A4R应用于负责任的数字健康背景的前景，并提出了进一步研究的问题。
