Ethics as Discursive Work: The Role of Ethical Framing in the Promissory Future of Data-driven Healthcare Technologies

Abstract

The allure of a “data-driven” future healthcare system continues to seduce many. Increasingly, work in Science & Technology Studies and related fields started to interrogate the saliency of this promissory rhetoric by raising ethical questions concerning epistemology, bias, surveillance, security, and opacity. Less visible is how ethical arguments are used as part of discursive work by various practitioners engaged in data-driven initiatives in healthcare. This article argues for more explicit attention to such discursive work in shaping the promissory future of data-driven healthcare technologies. Bringing together the hitherto separated themes of promissory futures and an emic approach to ethics as discursive work, we study how actors engaged various data-driven healthcare initiatives discursively conduct such ethics work, implicitly or explicitly assigning tasks and roles for stakeholders. We conceptualize this with the notion of “ethical framing” and identify three widely recurring types: ethics as “balancing act,” the technical “fix,” and ethics as “collective thought process.” We outline the characteristics of these acts of framing and discuss their implications for the envisaged roles and responsibilities of various actors. In the Discussion section, we outline the added value of bringing the distinct bodies of literature on promissory futures and ethical framing together and outline themes for new research.