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Is risk stratification ever the same as 'profiling'?

R Scott Braithwaite1, Elizabeth R Stevens1, Arthur Caplan1

  • 1Department of Population Health, New York University School of Medicine, New York, New York, USA.

Journal of Medical Ethics
|January 23, 2016
PubMed
Summary
This summary is machine-generated.

Physicians use risk stratification, but it can become harmful

Keywords:
Decision-makingEthics

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Area of Science:

  • Medical Ethics
  • Health Informatics
  • Public Health

Background:

  • Risk stratification is a standard medical practice with potential benefits.
  • However, risk stratification can also lead to ethical harms.
  • The term 'profiling' applies when harms outweigh benefits.

Purpose of the Study:

  • To explore the ethical implications of risk stratification in medicine.
  • To differentiate between beneficial risk stratification and harmful profiling.
  • To identify characteristics of algorithms that may lead to profiling.

Main Methods:

  • Conceptual analysis of risk stratification and profiling.
  • Examination of ethical principles (justice, autonomy, privacy).
  • Discussion of algorithm characteristics (voluntary/non-voluntary, causal/non-causal, historical disadvantage).

Main Results:

  • Risk stratification can become profiling if it threatens justice, autonomy, or privacy.
  • Algorithm design (e.g., use of historical disadvantage) influences the risk of profiling.
  • Ethical challenges arise with unequal subgroup benefits or aggregate benefits over subgroup harms.

Conclusions:

  • Distinguishing between risk stratification and profiling is crucial for ethical medical practice.
  • Careful consideration of algorithm design and potential harms is necessary.
  • Addressing disparities in risk stratification is essential for equitable healthcare.