Designing Worlds, Worlding Design: The Politics of Value Creation in Artificial Intelligence for Health

Abstract

In this dissertation I examine the politics of value creation in the design and governance of health-related artificial intelligence (AI). Drawing on perspectives from the interdisciplinary field of Science and Technology Studies, I aim to advance a clearer understanding of how to promote collective public value in data-intensive health systems. Three research papers are presented: two qualitative studies focused on an empirical case involving the commercialization of a hospital-developed AI technology, and one conceptually-oriented structured literature review. In the first paper, I critically engage with process-oriented ‘lifecycle’ approaches to the responsible development and oversight of AI systems in health care. Through the empirical case, I suggest that a shift in focus to ‘events’ can direct attention to specific, temporally-bound junctures that have disproportionate impacts on development and use. In the second paper, I examine the valuation practices that inform different data monetization strategies in the context of the same empirical case. I especially engage with theoretical perspectives on assetization, which I suggest can help elucidate the potential role of AI technologies in emerging health data markets. In the third paper, I review the scholarly and grey literature on algorithmic accountability and propose five normative logics characterizing its application in health policy and governance. In doing so, I aim to clarify the myriad ambitions of accountability regimes in practice, and the associated expectations of those tasked with pursuing or evaluating them. I conclude the dissertation with a discussion of ‘worlding’, where value-laden practices of design and governance bring certain realities into being, and may therefore also be capable of generating alternative, more inclusive health futures. I offer three focal points in particular that can sensitize practices of responsible design and governance to multiple worlds.

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