In the 21st century, such decisions are more often made by a committee, a rulebook, an off-site consultant, or an algorithm. This procedural approach was adopted in the name of fairness, justice, efficiency, and scale. But it has also created a gap between individuals and the moral consequences of their actions.
That gap must collapse. Bankers must walk with families through their foreclosed homes; technologists must spend time amongst the users whose lives they structure. A just society requires everyone to develop themselves morally. This means everyone must be given power, allowed to make mistakes, and then be exposed to the human consequences of their actions.
Here's an excerpt from a conversation between Michael and Chase at Watsi when we were implementing fingerprint verification for the Coverage program:
> @liangmichael: @chase, @neodude, curious about your thoughts on this:
> A question @byronium and I have been pondering is: assuming fingerprints verification is solid from the tech perspective, who decides whether fingerprints gates care? Is this a provider or payer decision?
> @chase: Good question. I think we want to aim to have the technology solve the user's problem over solving our own problem. Ideally, we can align incentives so that by solving the user's problem, we also solve our own.
> @chase: In the instance of fingerprints, capitation incentivizes the clinic to verify a patient’s identity so they don't lose funds (since they're paid per enrolled member not per visit). We should provide them a tool that enables them to do that as efficiently and accurately as possible. If we succeed at that, then a by-product will be accurate data about when patients access care, and which patients access care.
> @chase: However, if we prioritize our own problem over the clinic's (getting accurate data), eventually our system will start to erode because users will start to view technology as a barrier to treating patients, rather than a way of treating them better. This is how the HMIS registers are viewed now and is likely a reason the data collection is so unreliable. Will De Klerk has experienced fingerprint scanners breaking, disappearing, etc. more often in systems that mandate them. What would the clinic do in those cases if it was required?
> @chase: Of course, there will be some things that we require of the clinic that don't solve their immediate problem, but the fewer of those the better.