ETHICAL FADING Is UX the remedy for at the clinical interface? Nicole Jess Women in UX - 26th April 2022 

v 2 WHAT IS ETHICAL FADING? The Organizational act of dehumanising a person or human centred event in order to reduce the impact or sense of severity (in moral/ethical regards) of the decisions that are made in association with those people or events. 

v 3 PSYCHOLOGICAL NUMBING Reflex response to persistent overwhelming pain or fear which, due to the ongoing nature, results in a significantly reduce or absent response “It’s just constant. Every day I see people suffering more than they need to. I just have to turn off sometimes in order to stay sane” 

v 4 SELF DECEPTION By avoiding or disguising the moral implications of a decision, an individual can behave in a self-interested manner while maintaining a firm conviction that they are an ethical person ”I can't do anything more than I am doing to help the patients on the ward. It’s beyond my control” 

v 5 MORAL DISENGAGEMENT Process by which an individual or group first distances themselves from the normal or usual ethical standards of behaviour then form the belief that new unethical behaviours is justified due often to some perceived extenuating circumstances ” I did what I had to do to get through the shift. Sure, some patients wouldn't have been didn't get the best care but they’re still alive” 

How can UX REMEDY Ethical fading? 

7 Accurate problem space scoping requires in-depth research through an lens aware of the subtleties of ethical fading. As designers, we can use a systems thinking approach to expand the proposed scope, while using these findings to explore the peripheries for hard to find stakeholders who may play a subtle but important role. WHAT’S THE PROBLEM? ETHICAL FADING & DESIGN RESEARCH DEFINE STAKEHOLDER LABELS DIVE INTO NUANCES ● Include multiple perspectives ● Understand the complexity & interconnectedness ● Removes assumptions ● Define human cost ● Clarify internal hierarchies ● Engage internal stakeholders ● Take the time to learn the subtle differences ● Nuances can moral disengagement & ethical fading ● Beware of euphemisms, palliative comparison, the minimisation of consequences ETHICAL FADING CAN LEAD TO LIMITED PERSPECTIVE OF THE PROBLEM SPACE 

8 Reducing the proximity of decision makers to the interface can be achieved by physically, cognitively and emotive means. As designers, it is our responsibility to carry the authentic voice of the research and cohort participants to the client and beyond the point of package delivery WHAT’S THE DISTANCE? ETHICAL FADING & KNOW YOUR NARRATIVES LANGUAGE LEVERAGES PROXIMITY MAP THE MEANING ● Ensure opposing or diverse voices to be heard ● Authenticity speaks in direct quotes ● Beware of bias when summarizing ● Point of view impacts perspective ● Proximity impacts terminology ● Terminology indicates proximity ● Proximity is effectively highlighted with visual aids ● and problem space THE GREATER THE DISTANCE BETWEEN DECISION MAKERS AND THE PROBLEM SPACE, THE GREAT THE RISK OF ETHICAL FADING 

9 Collaboration and co-design should include clinicians and non- clinical support staff to ensure efficacy of solutions across shared pain points. Engaging all functional stakeholders improves continuity of care WHO’S ON BOARD? ETHICAL FADING & INVITE, DON'T IMPOSE RECRUIT INCLUSIVELY ENGAGE ACROSS THE JOURNEY ● Co-design with people at the pain point ● Ensure safety in sharing ● Meet stakeholders where they are ● Seek suggestions! ● Use internal panels ● Ensure inclusivity within cohorts ● Find edge users ● Cold call if necessary ● Carry stakeholders across the journey ● Iterate at the scene (or) ● Recreate the scene ● Close the loop EXCLUSION OF FUNCTIONAL STAKEHOLDERS CARRIES ETHICAL FADING THROUGH TO THE SOLUTION PHASE AND BEYOND 

KEY TAKEAWAYS - Ensure authentic narratives are not compromised for comfort - Challenge scope to ensure inclusive engagement practices - Beware of bias, and allow for contradictions to emerge - Ethical fading occurs from the top down - Scope and Map internal hierarchy to identify proximity and complexity - Use language to reduce proximity to minimise the potential for ethical fading 

NICOLE JESS YOU! THANK With illustrations by Patience Loh