Results for 'PDMPs'

10 found
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  1.  14
    PDMP causes more than just testimonial injustice.Tina Nguyen - 2023 - Journal of Medical Ethics 49 (8):549-550.
    In the article ‘Testimonial injustice in medical machine learning’, Pozzi argues that the prescription drug monitoring programme (PDMP) leads to testimonial injustice as physicians are more inclined to trust the PDMP’s risk scores over the patient’s own account of their medication history.1 Pozzi further develops this argument by discussing how credibility shifts from patients to machine learning (ML) systems that are supposedly neutral. As a result, a sense of distrust is now formed between patients and physicians. While there are merits (...)
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  2.  8
    Challenging Disability Discrimination in the Clinical Use of PDMP Algorithms.Elizabeth Pendo & Jennifer Oliva - 2024 - Hastings Center Report 54 (1):3-7.
    State prescription drug monitoring programs (PDMPs) use proprietary, predictive software platforms that deploy algorithms to determine whether a patient is at risk for drug misuse, drug diversion, doctor shopping, or substance use disorder (SUD). Clinical overreliance on PDMP algorithm‐generated information and risk scores motivates clinicians to refuse to treat—or to inappropriately treat—vulnerable people based on actual, perceived, or past SUDs, chronic pain conditions, or other disabilities. This essay provides a framework for challenging PDMP algorithmic discrimination as disability discrimination under (...)
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  3.  24
    Testimonial injustice in medical machine learning.Giorgia Pozzi - 2023 - Journal of Medical Ethics 49 (8):536-540.
    Machine learning (ML) systems play an increasingly relevant role in medicine and healthcare. As their applications move ever closer to patient care and cure in clinical settings, ethical concerns about the responsibility of their use come to the fore. I analyse an aspect of responsible ML use that bears not only an ethical but also a significant epistemic dimension. I focus on ML systems’ role in mediating patient–physician relations. I thereby consider how ML systems may silence patients’ voices and relativise (...)
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  4.  41
    Automated opioid risk scores: a case for machine learning-induced epistemic injustice in healthcare.Giorgia Pozzi - 2023 - Ethics and Information Technology 25 (1):1-12.
    Artificial intelligence-based (AI) technologies such as machine learning (ML) systems are playing an increasingly relevant role in medicine and healthcare, bringing about novel ethical and epistemological issues that need to be timely addressed. Even though ethical questions connected to epistemic concerns have been at the center of the debate, it is going unnoticed how epistemic forms of injustice can be ML-induced, specifically in healthcare. I analyze the shortcomings of an ML system currently deployed in the USA to predict patients’ likelihood (...)
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  5.  17
    Testimonial injustice in medical machine learning: a perspective from psychiatry.George Gillett - 2023 - Journal of Medical Ethics 49 (8):541-542.
    Pozzi provides a thought-provoking account of how machine-learning clinical prediction models (such as Prediction Drug Monitoring Programmes (PDMPs)) may exacerbate testimonial injustice.1 In this response, I generalise Pozzi’s concerns about PDMPs to traditional models of clinical practice and question the claim that inaccurate clinicians are necessarily preferential to inaccurate machine-learning models. I then explore Pozzi’s concern that such models may deprive patients of a right to ‘convey information’. I suggest that machine-learning tools may be used to enhance, rather (...)
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  6.  18
    The Impact of Prescription Drug Monitoring Programs on U.S. Opioid Prescriptions.Ian Ayres & Amen Jalal - 2018 - Journal of Law, Medicine and Ethics 46 (2):387-403.
    This paper seeks to understand the treatment effect of Prescription Drug Monitoring Programs on opioid prescription rates. Using county-level panel data on all opioid prescriptions in the U.S. between 2006 and 2015, we investigate whether state interventions like PDMPs have heterogeneous treatment effects at the sub-state level, based on regional and temporal variations in policy design, extent of urbanization, race, and income. Our models comprehensively control for a set of county and time fixed effects, countyspecific and time-varying demographic controls, (...)
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  7.  44
    Big Data and the Opioid Crisis: Balancing Patient Privacy with Public Health.John Matthew Butler, William C. Becker & Keith Humphreys - 2018 - Journal of Law, Medicine and Ethics 46 (2):440-453.
    Parts I through III of this paper will examine several, increasingly comprehensive forms of aggregation, ranging from insurance reimbursement “lock-in” programs to PDMPs to completely unified electronic medical records. Each part will advocate for the adoption of these aggregation systems and provide suggestions for effective implementation in the fight against opioid misuse. All PDMPs are not made equal, however, and Part II will, therefore, focus on several elements — mandating prescriber usage, streamlining the user interface, ensuring timely data (...)
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  8.  17
    Further remarks on testimonial injustice in medical machine learning: a response to commentaries.Giorgia Pozzi - 2023 - Journal of Medical Ethics 49 (8):551-552.
    In my paper entitled ‘Testimonial injustice in medical machine learning’,1 I argued that machine learning (ML)-based Prediction Drug Monitoring Programmes (PDMPs) could infringe on patients’ epistemic and moral standing inflicting a testimonial injustice.2 I am very grateful for all the comments the paper received, some of which expand on it while others take a more critical view. This response addresses two objections raised to my consideration of ML-induced testimonial injustice in order to clarify the position taken in the paper. (...)
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  9.  16
    Ubuntu as a complementary perspective for addressing epistemic (in)justice in medical machine learning.Brandon Ferlito & Michiel De Proost - 2023 - Journal of Medical Ethics 49 (8):545-546.
    Pozzi1 has thoroughly analysed testimonial injustices in the automated Prediction Drug Monitoring Programmes (PDMPs) case. Although Pozzi1 suggests that ‘the shift from an interpersonal to a structural dimension … bears a significant moral component’, her topical investigation does not further conceptualise the type of collective knowledge practices necessary to achieve epistemic justice. As Pozzi1 concludes: ‘this paper shows the limitations of systems such as automated PDMPs, it does not provide possible solutions’. In this commentary, we propose that an (...)
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  10.  7
    ‘Can I trust my patient?’ Machine Learning support for predicting patient behaviour.Florian Funer & Sabine Salloch - 2023 - Journal of Medical Ethics 49 (8):543-544.
    Giorgia Pozzi’s feature article1 on the risks of testimonial injustice when using automated prediction drug monitoring programmes (PDMPs) turns the spotlight on a pressing and well-known clinical problem: physicians’ challenges to predict patient behaviour, so that treatment decisions can be made based on this information, despite any fallibility. Currently, as one possible way to improve prognostic assessments of patient behaviour, Machine Learning-driven clinical decision support systems (ML-CDSS) are being developed and deployed. To make her point, Pozzi discusses ML-CDSSs that (...)
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