标题： 医疗过程专业化人工智能开发中的想象与实践：仁慈的品质并非训练而成 显示英文标题

标题： A quality of mercy is not trained: the imagined vs. the practiced in healthcare process-specialized AI development

摘要： 在高风险的组织情境如医疗保健中，人工智能（AI）系统正被越来越多地设计用来增强复杂的协调任务。 本文研究了此类系统的伦理重要性如何受到其认识论框架的影响：它们代表了工作的哪些方面，又排除了哪些方面。 基于对加拿大一家医院手术室（OR）排班AI开发的嵌入式研究，我们比较了AI设计过程中设想的排班方式：规则导向、可预测且以外科医生为中心，与实际操作中的排班方式：一种涉及伦理判断的流动的、以患者为中心的协调过程。 我们展示了早期的表征决策如何限制了AI能够支持的内容，导致认识论封闭：关键伦理维度过早地被排除在系统设计之外。 我们的研究结果揭示了抽象化的道德后果，并呼吁采用更加具体的方法来设计专门针对医疗流程的人工智能系统。 显示英文摘要

摘要： 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.