Resolving conflicts in clinical guidelines using argumentation

Automatically reasoning with conflicting generic clinical guidelines is a burning issue in patient-centric medical reasoning where patient-specific conditions and goals need to be taken into account. It is even more challenging in the presence of preferences such as patient's wishes and clinician's priorities over goals. We advance a structured argumentation formalism for reasoning with conflicting clinical guidelines, patient-specific information and preferences. Our formalism integrates assumption-based reasoning and goal-driven selection among reasoning outcomes. Specifically, we assume applicability of guideline recommendations concerning the generic goal of patient well-being, resolve conflicts among recommendations using patient's conditions and preferences, and then consider prioritised patient-centered goals to yield non-conflicting, goal-maximising and preference-respecting recommendations. We rely on the state-of-the-art Transition-based Medical Recommendation model for representing guideline recommendations and augment it with context given by the patient's conditions, goals, as well as preferences over recommendations and goals. We establish desirable properties of our approach in terms of sensitivity to recommendation conflicts and patient context

Argumentation-based explanations of multimorbidity treatment plans

We present an argumentation model to explain the optimal treatment plans recommended by a Satisfiability Modulo Theories solver for multimorbid patients. The resulting framework can be queried to obtain supporting reasons for nodes on a path following a model of argumentation schemes. The modelling approach is generic and can be used for justifying similar sequences.Postprin

Dialogue games for explaining medication choices

SMT solvers can be used efficiently to search for optimal paths across multiple graphs when optimising for certain resources. In the medical context, these graphs can represent treatment plans for chronic conditions where the optimal paths across all plans under consideration are the ones which minimize adverse drug interactions. The SMT solvers, however, work as a black-box model and there is a need to justify the optimal plans in a human-friendly way. We aim to fulfill this need by proposing explanatory dialogue protocols based on computational argumentation to increase the understanding and trust of humans interacting with the system. The protocols provide supporting reasons for nodes in a path and also allow counter reasons for the nodes not in the graph, highlighting any potential adverse interactions during the dialogue.Postprin

Naturalizing Moral Justification: Rethinking the Method of Moral Epistemology

The companion piece to this article, “Situating Moral Justification,” challenges the idea that moral epistemology\u27s mission is to establish a single, all‐purpose reasoning strategy for moral justification because no reasoning practice can be expected to deliver authoritative moral conclusions in all social contexts. The present article argues that rethinking the mission of moral epistemology requires rethinking its method as well. Philosophers cannot learn which reasoning practices are suitable to use in particular contexts exclusively by exploring logical relations among concepts. Instead, in order to understand which reasoning practices are capable of justifying moral claims in different types of contexts, we need to study empirically the relationships between reasoning practices and the contexts in which they are used. The article proposes that philosophers investigate case studies of real‐world moral disputes in which people lack shared cultural assumptions and/or are unequal in social power. It motivates and explains the proposed case study method and illustrates the philosophical value of this method through a case study

Ethical challenges in argumentation and dialogue in a healthcare context.

As the average age of the population increases, so too do the number of people living with chronic illnesses. With limited resources available, the development of dialogue-based e-health systems that provide justified general health advice offers a cost-effective solution to the management of chronic conditions. It is however imperative that such systems are responsible in their approach. We present in this paper two main challenges for the deployment of e-health systems, that have a particular relevance to dialogue and argumentation: collecting and handling health data, and trust. For both challenges, we look at specific issues therein, outlining their importance in general, and describing their relevance to dialogue and argumentation. Finally, we go on to propose six recommendations for handling these issues, towards addressing the main challenges themselves, that act both as general advice for dialogue and argumentation research in the e-health domain, and as a foundation for future work on this topic

Gated recurrent unit decision model for device argumentation in ambient assisted living

The increasing elderly population worldwide is facing a variety of social, physical, and cognitive issues, such as walking problems, falls, and difficulties in performing daily activities. To support elderly people, continuous monitoring and supervision are needed. Due to the busy modern lifestyle of caretakers, taking care of elderly people is difficult. As a result, many elderly people prefer to live independently at home without any assistance. To help such people, an ambient assisted living (AAL) environment is provided that monitors and evaluates the daily activities of elderly individuals. An AAL environment has heterogeneous devices that interact, and exchange information of the activities performed by the users. The devices can be involve in an argumentation about the occurrence of an activity thus leading to generate conflicts. To address this issue, the paper proposes a gated recurrent unit (GRU) learning techniques to facilitate decision-making for device argumentation during activity occurrences. The proposed model is used to initially classify user activities and each sensor value status. Then a novel method is used to identify argumentation among devices for activity occurrences in the classified user activities. Later, the GRU decision making model is used to resolve the argumentation and to identify the target activity that occurred. The result of the proposed model is compared with other existing techniques. The proposed model outperformed the other existing methods with an accuracy of 85.45%, precision of 72.32%, recall of 65.83%, and F1-Score of 60.22%

Negotiating About Charges and Pleas: Balancing Interests and Justice

There is a worldwide movement towards alternatives to judicial decision-making for legal disputes. In the domain of criminal sentencing, in Western countries more than 95 % of cases are guilty pleas, with many being decided by negotiations over charges and pleas, rather than a decision being made after a judge or jury has heard all relevant evidence in a trial. Because decisions are being made, and people incarcerated on the basis of negotiations, it is important that such negotiations be just and fair. In this paper we discuss issues of fairness in plea-bargaining and how we can develop systems to support the process of plea and charge negotiation. We discuss how we are using Toulmin’s theory of argumentation and Lodder and Zeleznikow’s model of online dispute resolution to develop just plea bargaining systems. A specific investigation of the process of charge mentions is discussed

Argumentation Schemes for Clinical Decision Support

This paper demonstrates how argumentation schemes can be used in decision support systems that help clinicians in making treatment decisions. The work builds on the use of computational argumentation, a rigorous approach to reasoning with complex data that places strong emphasis on being able to justify and explain the decisions that are recommended. The main contribution of the paper is to present a novel set of specialised argumentation schemes that can be used in the context of a clinical decision support system to assist in reasoning about what treatments to offer. These schemes provide a mechanism for capturing clinical reasoning in such a way that it can be handled by the formal reasoning mechanisms of formal argumentation. The paper describes how the integration between argumentation schemes and formal argumentation may be carried out, sketches how this is achieved by an implementation that we have created, and illustrates the overall process on a small set of case studies

Moral Distress and the Health Care Organization

A health care professional may experience moral distress when she believes she knows the ethical course of action in a given situation, but is unable to enact that plan, or must do otherwise. This dissertation argues that health care organizations have an ethical obligation to address moral distress in their health care professionals, and that common responses to moral distress are ethically insufficient due to their reliance on hierarchical solutions when hierarchies are, in fact, often a cause of moral distress. Thus, health care organizations, as moral agents, have a responsibility to find a non-hierarchical response to moral distress. In this dissertation, a non-hierarchical response to moral distress is developed, based on the concept of a content-thin common moral framework shared by health care professionals, which arises from their common professional morality. In the tradition stemming from Engelhardt’s “moral friends” and “moral strangers,” this content-thin common moral framework implies that health care professionals are “moral acquaintances” who understand each others’ moral viewpoints and share them in part, as they work together to fulfill the goals and values of professional health care. Given this moral acquaintanceship, this dissertation shows that Habermas’ theory of discourse ethics can provide the rules and grammar for a non-hierarchical content-thin procedural response that health care organizations can appeal to in order to resolve moral distress in health care professionals

Proceedings ICPW'07: 2nd International Conference on the Pragmatic Web, 22-23 Oct. 2007, Tilburg: NL

Proceedings ICPW'07: 2nd International Conference on the Pragmatic Web, 22-23 Oct. 2007, Tilburg: N