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Main Authors: Bhardwaj, Anand, Faraj, Samer
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2510.21843
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author Bhardwaj, Anand
Faraj, Samer
author_facet Bhardwaj, Anand
Faraj, Samer
contents In high stakes organizational contexts like healthcare, artificial intelligence (AI) systems are increasingly being designed to augment complex coordination tasks. This paper investigates how the ethical stakes of such systems are shaped by their epistemic framings: what aspects of work they represent, and what they exclude. Drawing on an embedded study of AI development for operating room (OR) scheduling at a Canadian hospital, we compare scheduling-as-imagined in the AI design process: rule-bound, predictable, and surgeon-centric, with scheduling-as-practiced as a fluid, patient-facing coordination process involving ethical discretion. We show how early representational decisions narrowed what the AI could support, resulting in epistemic foreclosure: the premature exclusion of key ethical dimensions from system design. Our findings surface the moral consequences of abstraction and call for a more situated approach to designing healthcare process-specialized artificial intelligence systems.
format Preprint
id arxiv_https___arxiv_org_abs_2510_21843
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle A quality of mercy is not trained: the imagined vs. the practiced in healthcare process-specialized AI development
Bhardwaj, Anand
Faraj, Samer
Computers and Society
General Economics
Economics
In high stakes organizational contexts like healthcare, artificial intelligence (AI) systems are increasingly being designed to augment complex coordination tasks. This paper investigates how the ethical stakes of such systems are shaped by their epistemic framings: what aspects of work they represent, and what they exclude. Drawing on an embedded study of AI development for operating room (OR) scheduling at a Canadian hospital, we compare scheduling-as-imagined in the AI design process: rule-bound, predictable, and surgeon-centric, with scheduling-as-practiced as a fluid, patient-facing coordination process involving ethical discretion. We show how early representational decisions narrowed what the AI could support, resulting in epistemic foreclosure: the premature exclusion of key ethical dimensions from system design. Our findings surface the moral consequences of abstraction and call for a more situated approach to designing healthcare process-specialized artificial intelligence systems.
title A quality of mercy is not trained: the imagined vs. the practiced in healthcare process-specialized AI development
topic Computers and Society
General Economics
Economics
url https://arxiv.org/abs/2510.21843