NEW BOTTLES, OLD WINE - HIDDEN CULTURAL ASSUMPTIONS IN A COMPUTERIZEDEXPLANATION SYSTEM FOR MIGRAINE SUFFERERS

Sophisticated computer programs known as ''intelligent systems'' have been developed for use in medical settings for over two decades. Such systems explicitly encode information about task domains, problem attr ibutes, and problem-solving strategies. They also embody tacit assumpt ions held by those who build them, reflecting meanings taken for grant ed in particular cultural and disciplinary arenas. This article examin es assumptions built into the design of a patient education system for migraine sufferers, drawing upon extended participant-observation of the development process. Its designers view the system as neutral, bur observation reveals that it embodies a physician's point of view. Whi le intended to support migraine patients by offering useful informatio n not given them by physicians, the system in fact offers information characterized by the same assumptions and deletions as that provided b y neurologists. Thus, although intended to empower migraine patients, this system may actually reinforce rather than reduce the power differ ential between doctor and patient.