DESIREE DEcision Support In Routine and Emergency HEalth Care: Ethical and Social Implications

Decision support systems contribute significantly to the digital transformation of healthcare delivery. However, they raise important normative challenges with respect to responsibility, privacy, safety and autonomy, as well as social challenges in terms of human-machine-interaction, workflows, the professions’ self-perception and the doctor/caregiver-patient-relationship. These ethical and social implications have not been sufficiently studied to date.

This joint project aims to combine empirical and theoretical approaches in three exemplary applied case studies of digital decision support in healthcare - nephrology, surgery and nursing - to explore key ethical, social, professional and technical aspects. During the initial phase of the project, the practical issues arising at the technical and process level are elicited within the three case studies. On this basis, the social, normative-ethical and professional aspects concerning patients, healthcare professionals, IT-designers and -providers and the interactions between them are examined empirically and theoretically. Implications at the level of the healthcare system are also identified and analysed. The project actively involves stakeholders and systematically incorporates their views and expertise.

The project’s cross-cutting analysis of the three cases allows general insights and lessons for the ethically and socially responsible development, use and governance of digital decision support in healthcare, thereby making an important contribution to the ELSA debate.

The project’s interdisciplinary scientific approach is based on the integrated application of five complementary perspectives (ethical, social, professional, technical and systemic) pro-vided by four partners. 

The Partners

Fraunhofer ISI

Fraunhofer ISI is using empirical methods (focus groups, interviews) to investigate the social impact of clinical decision support systems from the perspective of patients and their relatives. In addition, the implications of an increased reliance on digital decision support for the German healthcare system and its development are being analysed from a systemic perspective. Fraunhofer ISI coordinates the DESIREE consortium.


Dr. Tanja Bratan ISI
Dr. Heike Aichinger ISI
Dr. Nils HeyenISI
Diana Schneider


Dr. Tanja Bratan
Leitung Geschäftsfeld Innovationen im Gesundheitssystem
Competence Center Neue Technologien
Fraunhofer-Institut für System- und Innovationsforschung ISI
Breslauer Straße 48
D-76139 Karlsruhe

Medizinische Hochschule Hannover

MHH Medizinische Hochschule Hannover

Hannover Medical focuses on the perspectives of health care professionals and addresses social and ethical implications of decision-support systems for the two major groups of medical doctors and nursing professionals. Aspects of participation (including conference organisation) and dissemination (including publications) of the project results are also being led by Hannover Medical School.


Prof. Dr. Dr. Sabine Salloch MHH
Sara Tinnemeyer MHH


Prof. Dr. Dr. Sabine Salloch
Institut für Ethik, Geschichte und Philosophie der Medizin
Medizinische Hochschule Hannover
Carl-Neuberg-Str. 1
D-30625 Hannover

Protestant University of Applied Sciences Bochum

EVH Evangelische Hochschule Bochum

The Protestant University of Applied Sciences will address normative-ethical aspects of responsibility concerning different stakeholder groups in the application of decision-support systems. This includes analyses regarding the distribution of the responsibility of professional and non-professional caregivers as well as the role of designers and providers of IT-based systems supporting diagnostic or therapeutic decision making in medicine and home care.


Prof. Dr. Dr. Martin Langanke
Dr. Wenke Liedtke


Prof. Dr. Dr. Martin Langanke
Angewandte Ethik/ Fachbereich Soziale Arbeit
Evangelische Hochschule
Immanuel-Kant-Str. 18-20
D-44803 Bochum

Uniklinik RWTH Aachen

Uniklinik RWTH Aachen

The Institute of Medical Informatics at RWTH Aachen University contributes health information technology expertise and detailed know-how of decision support systems and the interactions between the systems and users. It will focus on technical implementation and clinical and organizational processes, opportunities and risks from a medical informatics perspective as well as the view and responsibility of developers.


Prof. Dr. Rainer Röhrig
Dr. Myriam Lipprandt
Andrea Klausen


Dr.-Ing. Myriam Lipprandt, Dipl.-Inform.
Institut für Medizinische Informatik
Uniklinik RWTH Aachen
Rheinisch-Westfälische Technische Hochschule Aachen
Pauwelstraße 30
D-52074 Aachen