伸张正义:在保险理赔数据中识别和研究变性人和不同性别者的伦理考虑。

IF 3.5 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Journal of Medical Systems Pub Date : 2024-10-12 DOI:10.1007/s10916-024-02111-w
Ash B Alpert, Gray Babbs, Rebecca Sanaeikia, Jacqueline Ellison, Landon Hughes, Jonathan Herington, Robin Dembroff
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引用次数: 0

摘要

有关变性者和性别多元化者(TGD)健康状况的数据很少。研究人员越来越多地利用保险理赔数据来调查变性人的疾病负担。由于理赔不包括性别自我认同或方式(即是否变性),研究人员开发了算法,试图通过诊断、手术和处方代码来识别变性人,有时还推断出生时的性别和性别分配。基于声称的算法带来了认识论和伦理方面的复杂性,这些问题在数据信息学、流行病学或健康服务研究中尚未得到解决。我们讨论了基于声称的算法对 TGD 群体进行识别和分类的影响,包括延续顺式规范偏见和否定 TGD 个人的自我认同。利用认识论不公正的框架,我们概述了在开展基于诉求的 TGD 健康研究时应考虑的伦理问题,并提出了一些建议,以最大限度地减少对 TGD 个人和社区的伤害,最大限度地增加其收益。
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Doing Justice: Ethical Considerations Identifying and Researching Transgender and Gender Diverse People in Insurance Claims Data.

Data on the health of transgender and gender diverse (TGD) people are scarce. Researchers are increasingly turning to insurance claims data to investigate disease burden among TGD people. Since claims do not include gender self-identification or modality (i.e., TGD or not), researchers have developed algorithms to attempt to identify TGD individuals using diagnosis, procedure, and prescription codes, sometimes also inferring sex assigned at birth and gender. Claims-based algorithms introduce epistemological and ethical complexities that have yet to be addressed in data informatics, epidemiology, or health services research. We discuss the implications of claims-based algorithms to identify and categorize TGD populations, including perpetuating cisnormative biases and dismissing TGD individuals' self-identification. Using the framework of epistemic injustice, we outline ethical considerations when undertaking claims-based TGD health research and provide suggestions to minimize harms and maximize benefits to TGD individuals and communities.

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来源期刊
Journal of Medical Systems
Journal of Medical Systems 医学-卫生保健
CiteScore
11.60
自引率
1.90%
发文量
83
审稿时长
4.8 months
期刊介绍: Journal of Medical Systems provides a forum for the presentation and discussion of the increasingly extensive applications of new systems techniques and methods in hospital clinic and physician''s office administration; pathology radiology and pharmaceutical delivery systems; medical records storage and retrieval; and ancillary patient-support systems. The journal publishes informative articles essays and studies across the entire scale of medical systems from large hospital programs to novel small-scale medical services. Education is an integral part of this amalgamation of sciences and selected articles are published in this area. Since existing medical systems are constantly being modified to fit particular circumstances and to solve specific problems the journal includes a special section devoted to status reports on current installations.
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