Algorithms, trust and the use of big data in healthcare decisions

The possibilities of big data have been seductive and ultimately irresistible for governments and corporations alike. The capacity to collect and maintain massive datasets and the ability to search, combine and manipulate such data sets with algorithms has opened up still largely unexplored possibilities. In this chapter we go beyond considering the allocation of responsibility for harm associated with issues of privacy and confidentiality, to a consideration of a responsibility to do good when using big data to inform healthcare decisions. As commercial operators increasingly capture the ground that sits between healthcare professionals and patients, and also between health researchers and data, questions are raised with regard to whether action is sometimes taken for the benefit of business rather than motivated by the ethic of care. This chapter considers the extent to which this threatens not only privacy but also the trustworthiness of healthcare innovation.