Abstracts

Rationale: To improve care in patients with severe epilepsy, a new medical device for in-home detection of nocturnal seizures is currently developed in the Netherlands. It is well-known that the design of medical technology is not value-neutral: perspectives of users and developers are influential in design, and design choices influence these perspectives. However, during development processes, this interaction is generally ignored and perspective-related choices remain implicit and poorly argued for. Methods: To facilitate a process of development in which perspectives of stakeholders are explicitly accounted for, we performed a parallel ethics study, using the method of value sensitive design and led by a medical ethicist (GT). From the start of the project all stakeholders were involved. Results: Through observation and analysis of stakeholder communication in meetings and e-mail messages, five values regarding the device were extracted: health, trust, autonomy, accessibility and reliability. These were presented at a meeting and stakeholders were asked to give their feedback. In a next step, the values were made operative into design choices and corresponding risks and benefits. For example, the use of remote sensors (camera and sound) instead of on-body sensors (heart rate and movement sensors) gives less reliable detection of seizures but is also physically less burdensome for the patient. On the other hand, camera and sound are a larger invasion of privacy. Conclusions: The method of value sensitive design is feasible for the development of new medical technology in epilepsy and can help the developers to account for the value-related effects of their choices in design.