Attuning Algorithms: Designing AI for Relational Intelligence for Patient Care
DOI:
https://doi.org/10.22439/jba.v15i1.7811Abstract
This essay – written as a reflexive field report – examines the integration of artificial intelligence (AI) into neonatal intensive care units (NICUs) through PreeMe, a digital health platform grounded in long-term anthropological and epidemiological research on neonatal illness trajectories, parent-infant bonding, and NICU family experiences. In the NICU, premature infants confront physiological fragility while parents navigate radical prognostic uncertainty and profound emotional overwhelm. As PreeMe develops an agentic AI chatbot, a central design question emerges: Should this nonhuman actor be named or personified? To address this, the essay introduces the concept of vi(abilities) to analyze how AI can be attuned to the organizational culture of neonatal care, supporting fragile lives, mediating relational and emotional stakes, and complementing clinical judgment without replacing it. Two additional concepts guide this inquiry: relational ecologies, which frame care as an interconnected system of human interactions critical to survival, and relational return on investment, which revalues affective and relational labor as drivers of both clinical and economic outcomes. The essay argues for designing the chatbot as a relational intelligence bridge – more than a tool, but deliberately not a person.
References
Artz, M. (2023). “The Digital Turn in Business Anthropology.” Journal of Business Anthropology 12(1): 78-91. https://doi.org/10.22439/jba.v12i1.6919
Artz, M. and Ren, Y. (2025). “Beyond the GenAI Gold Rush: Mapping Entrepreneurial Tensions in the Age of Generative Artificial Intelligence.” Annals of Anthropological Practice 49: e70016. https://doi.org/10.1111/napa.70016
Anspach, R. R. (1997). Deciding Who Lives: Fateful Choices in the Intensive-Care Nursery. Berkeley: University of California Press.
Daston, L. (1988). Classical Probability in the Enlightenment. Princeton, NJ: Princeton University Press. https://doi.org/10.1515/9781400844227
Ehsan, U. and Riedl, M. O. (2020). “Human-Centered Explainable AI: Towards a Reflective Sociotechnical Approach.” In Proceedings of the 22nd International Conference on Human-Computer Interaction (HCI International 2020). https://doi.org/10.48550/arXiv.2002.01092
Elish, M. C. (2019). “Moral Crumple Zones: Cautionary Tales in Human-Robot Interaction.” Engaging Science, Technology, and Society 5: 40-60. https://doi.org/10.17351/ests2019.260
Foucault, M. (1972). The Archaeology of Knowledge. New York: Pantheon Books.
Heimer, C. A. and Staffen, L. R. (1995). “Interdependence and Reintegrative Social Control: Labeling and Reforming ‘Inappropriate’ Parents in Neonatal Intensive Care Units.” American Sociological Review 60(5): 635-54. https://doi.org/10.2307/2096315
Heimer, C. A. and Staffen, L. R. (1998). For the Sake of the Children: The Social Organization of Responsibility in the Hospital and the Home. Chicago: University of Chicago Press.
Hindelang, M., Sitaru, S., and Zink, A. (2024). “Transforming Health Care through Chatbots for Medical Applications.” JMIR Medical Informatics 12: e56628. https://doi.org/10.2196/56628
Humes, E. (2004). Baby ER: The Heroic Doctors and Nurses Who Perform Medicine’s Tiniest Miracles. New York: Simon & Schuster.
Ismail, A., Thakkar, D., Madhiwalla, N., and Kumar, N. (2023). “The Public Health Calls for/with AI: An Ethnographic Perspective.” Proceedings of the ACM on Human-Computer Interaction 7 (CSCW2): Article 354. https://doi.org/10.1145/3610203
Jordan, A.T. (2010). “The Importance of Business Anthropology: Its Unique Contributions.” International Journal of Business Anthropology 1(1): 15-25. https://doi.org/10.33423/ijba.v1i1.1202
Jordan, A T. (2012). Business Anthropology (Second Edition). Long Grove, IL: Waveland Press.
Kleinman, A. (1988). The Illness Narratives: Suffering, Healing, and the Human Condition. New York: Basic Books.
Kratz, C. A. (1994). Affecting Performance: Meaning, Movement, and Experience in Okiek Women’s Initiation. Washington, DC: Smithsonian Institution Press.
Lasater, K. B., Jones, C. B., Bryant, A. L., Sonnad, S. S., and Sturgill, K. (2023). “Invisible Economics of Nursing.” In Valuing Nurses and Nursing Care. North Carolina Institute of Medicine Nursing Task Force Report. https://nciom.org/wp-content/uploads/2023/09/NCIOM-Nursing-Task-Force-Report_Chapter-4-Valuing-the-Work-of-Nurses.pdf
Latour, B. (1990). “Technology Is Society Made Durable.” The Sociological Review 38(1 suppl): 103-131. https://doi.org/10.1111/j.1467-954X.1990.tb03350.x
Latour, B. (2005). Reassembling the Social: An Introduction to Actor-Network-Theory. Oxford: Oxford University Press. https://doi.org/10.1093/oso/9780199256044.001.0001
Malefyt, T. d. W. (2023). Business Anthropology: The Basics. New York: Routledge. https://doi.org/10.4324/9781003358930
Meadow, W. L. and Lantos, J. D. (2009). “Moral Reflections on Neonatal Intensive Care.” Pediatrics 123(2): 595-597. https://doi.org/10.1542/peds.2008-1648
Meadow, W. L., Lantos, J. D., and Roper, W. L. (2006). Neonatal Bioethics: The Moral Challenges of Medical Innovation. Baltimore: Johns Hopkins University Press.
Mol, A. (2022). The Body Multiple: Ontology in Medical Practice. Durham, NC: Duke University Press.
Morais, R. J. and Malefyt, T. d. W. (2017). “Business Anthropology Comes of Age.” Anthropology News 58: e192-e195. https://doi.org/10.1111/AN.670
Munk, A. K., Olesen, A. G., and Jacomy, M. (2022). “The Thick Machine: Anthropological AI between Explanation and Explication.” Big Data & Society 9(1): 1-14. https://doi.org/10.1177/20539517211069891
Ren, Y. (2018). Vi(Abilities): Biology, Personhood, and Agency in the Neonatal Intensive Care Unit in the U.S. and Taiwan. PhD dissertation, Emory University. https://etd.library.emory.edu/concern/etds/xk81jk75d?locale=en
Ruiz‑Roqueñi, M. (2022). “The Emotional Dimension of Value: A Proposal for Its Quantitative Measurement.” Frontiers in Psychology 12: Article 807412. https://doi.org/10.3389/fpsyg.2021.807412
Scott, D. (2022). “Hospitals Don’t Profit Off Having Good Nurses. That’s a Big Problem.” Journal of Nursing (June 1). https://www.asrn.org/journal-nursing/2771-hospitals-dont-profit-off-having-good-nurses-that’s-a-big-problem.html
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