Theory of optimising radiation protection among diagnostic radiographers depicted as a model.

Background: When radiation protection practices are suboptimal, it becomes necessary to take additional steps to optimise practices. Aim: Therefore, this study aimed to develop a model to facilitate radiation protection among diagnostic radiographers. Setting: The study was conducted in South Africa. Methods: A theory-generating design consisting of three steps was used to develop the model: (1) the central concept was identified, defined and classified; (2) relationship statements were created and (3) the model was developed, described and evaluated. Results: The model was premised on the central concept of facilitating a transformative radiation protection environment and occurs in four phases: (1) relationship, (2) working, (3) termination and (4) independent phases. The radiography manager and radiographer enter the relationship phase of the model because of discord regarding radiation protection in their department and work together to optimise radiation protection. The model's purpose, assumptions, context, structure and process are described. Conclusion: A model to facilitate radiation protection among radiographers was conceptualised to optimise radiation protection. The model details the steps the radiography manager and radiographer take to co-create optimal radiation protection practices. Radiation protection compliance among radiographers is paramount to ethical radiography practice, and the model provides a guide to optimise radiation protection. Contribution: In any radiography department where radiation protection may be lacking, the model provides a road map of possibilities for change. Ultimately, radiation protection compliance improves patient care and outcomes.

Capturing sources of health system legitimacy in fragmented conflict zones under different governance models: a case study of northwest Syria.

INTRODUCTION: Legitimacy and trust are crucial for resilient health systems in fragmented conflict zones. This study evaluates the legitimacy of health systems in northwest Syria under different governance models. METHODS: Using a deductive and inductive mixed-methods approach, the research team developed a framework with an index, 4 sub-indices and 18 indicators to assess the legitimacy of health systems using different governance models - top-down, bottom-up, and hybrid - in the context of the response to the earthquake that hit Syria in February 2023. The study includes surveys, workshops, stakeholder consultations, and an expert panel conducted in northwest Syria and online. RESULTS: The findings indicate that bottom-up health governance model is perceived as the most legitimate, followed by the mixed model, while top-down model is perceived as the least legitimate. This preference is measured across all legitimacy source sub-indices, including legality, justification, consent and performance and across the overall Health System Legitimacy Index (HSLI). However, the hybrid governance approach showed limited superiority at two indicator levels regarding long-term health system response. CONCLUSION: This study highlights the importance of considering the legitimacy of the health system in fragmented conflict zones. It helps explain the effectiveness of the bottom-up approach and community-based governance in enhancing trust, cooperative behaviour, health interventions and achieving sustainability. Additionally, the study highlighted the role of legitimate health systems in practising civic virtue and promoting social justice, thus contributing to peace-building efforts. These insights are crucial for policymakers and development donors to strengthen health systems in challenging contexts.

Nurses' justifications for morally courageous acts in ethical conflicts: A narrative inquiry.

Background: Moral courage is defined as the courage to act in ethical conflicts based on individual or professional values despite the personal risks involved. Nurses justify their decisions to act morally courageously as part of their ethical decision-making. Objective: To describe registered nurses' justifications for acting morally courageously, or not, in ethical conflicts where they needed moral courage. Research design: A narrative inquiry with a holistic content approach was used. Individual, in-depth interviews were conducted in January-February 2023. The data were analysed using holistic content analysis. Participants and research context: Fourteen registered nurses with experience in situations where they needed moral courage participated. The nurses came from the somatic, palliative, mental health, and substance abuse care fields in Finland. Ethical considerations: Good scientific practice was followed. Ethical approval was obtained before data collection from the university's ethics committee. Findings: The nurses needed moral courage in ethical conflicts with patients present and between professionals. Individual responsibility, professional ethics, and emotions were identified as bases of nurses' justifications for morally courageous acts. The justifications for acting morally courageously, or not, had individual, contextual, and organisational perspectives. Morally courageous acts included starting a discussion about the conflict with other professionals and reporting the situation in writing within one's organisation. Discussion and conclusions: The identified bases and perspectives of justifications illustrate the complexity of nurses' decision-making in ethical conflicts, either leading to morally courageous acts or not. These results can inform nursing practice and research in developing processes to strengthen nurses' moral courage and examining relationships between moral courage and other concepts, such as moral resilience.

Untangling the Dairy Paradox: How Vegetarians Experience and Navigate the Cognitive Dissonance Aroused by Their Dairy Consumption.

Most people eat meat, yet report valuing the environment, animal life, and their health which contradicts this dietary behaviour. The psychological discomfort aroused by this value-behaviour inconsistency, and the strategies meat eaters use to resolve this unpleasant state, is termed the 'meat paradox'. Vegetarians eschew meat consumption, but the negative implications of dairy are comparable to meat. We investigated the 'dairy paradox' in a sample of vegetarians (N = 378) using an experimental design. Specifically, we tested whether vegetarians experienced cognitive dissonance after reading about the environmental, animal welfare, and health impacts of dairy consumption when compared to a control group not exposed to this information. Then, we examined to what extent perceiving dairy consumption as Natural, Necessary, Normal, Nice, or Neglectable, and denial of cows' mental states (Experience or Agency) predicted reduced cognitive dissonance. Vegetarians in the dissonance-induction condition reported experiencing significantly greater dissonance, though they more strongly rejected the justification strategies. Instead, they reported greater intentions to reduce their dairy consumption than vegetarians in the control condition. Rather than replicating findings from the meat paradox literature, these results suggest that vegetarians respond to uncomfortable feelings about their value-behaviour conflict with a greater intention to abandon the incongruent behaviour, rather than endorsing the cognitions that justify it. This research provides evidence that vegetarians experience a dairy paradox. Given the success of our study in shifting participants away from behavioural justification and toward behavioural change intentions, our findings can help guide the design of interventions seeking to reduce dairy consumption.

Effects of system-sanctioned framing on climate awareness and environmental action in the United States and beyond.

Despite growing scientific alarm about anthropogenic climate change, the world is not on track to solve the crisis. Inaction may be partially explained by skepticism about climate change and resistance to proenvironmental policies from people who are motivated to maintain the status quo (i.e., conservative-rightists). Therefore, practical interventions are needed. In the present research program, we tested an experimental manipulation derived from system justification theory in which proenvironmental initiatives were framed as patriotic and necessary to maintain the American "way of life." In a large, nationally representative U.S. sample, we found that the system-sanctioned change intervention successfully increased liberal-leftists' as well as conservative-rightists' belief in climate change; support for proenvironmental policies; and willingness to share climate information on social media. Similar messages were effective in an aggregated analysis involving 63 countries, although the overall effect sizes were small. More granular exploratory analyses at the country level revealed that while the intervention was moderately successful in some countries (e.g., Brazil, France, Israel), it backfired in others (Germany, Belgium, Russia). Across the three outcome variables, the effects of the intervention were consistent and pronounced in the United States, in support of the hypothesis that system justification motivation can be harnessed on behalf of social change. Potential explanations for divergent country-level effects are discussed. The system-sanctioned change intervention holds considerable promise for policymakers and communicators seeking to increase climate awareness and action.

Influences on the Decision to Euthanize a Compromised Pig.

The decision to euthanize a compromised pig can be challenging for pig farmers and veterinarians. To understand more about the challenges in Germany, a cross-sectional online survey was conducted. Based on a hybrid design, the responses of 39 veterinarians and 62 pig farmers were analyzed to generate a list of common clinical signs associated with the euthanasia of sows, fatteners, and piglets. Moreover, a set of influences on the farm, due to economic and personal considerations, were found to shape the decision-making process. The two most salient reasons outlined for the delay of timely euthanasia were uncertainty and misinterpretation of the chance for healing. The lack of valid clinical signs or a sound justification was most frequently mentioned as a challenge to the general decision-making process. In summation, this study highlights the need to generate a valid taxonomy for clinical signs that includes their development in a compromised pig over time. Future studies should elaborate on the justification of euthanasia decisions to facilitate the resolution of ethical dilemmas among the involved pig farmers and veterinarians. Lastly, the results suggest that clinical reasoning and consultation skills should be included when decision-making behavior is to be trained.

Improvement in paediatric CT use and justification: a single-centre experience.

Objectives: To analyse changes in the use of paediatric (≤16 years) CT over the past decade and to evaluate the appropriateness of CT examinations at a tertiary teaching hospital. Methods: Data from 290 paediatric CTs were prospectively collected in 2022 and compared with data from 2017 (358 cases) and 2012 (538 cases). The justification of CTs was evaluated with regard to medical imaging referral guidelines and appropriateness rates were calculated. Results: Paediatric CTs decreased 39.4% over the 10 years, contrasting with a 27.6% increase in overall CTs. Paediatric CTs as the share of overall CTs dropped from 2.5% in 2012 to 1.1% in 2022 (P < .0001), with a concurrent rise in paediatric MRIs (P < .0001). Notable reductions in CT use occurred for head trauma (P = .0003), chronic headache (P < .0001), epilepsy (P = .037), hydrocephalus (P = .0078), chest tumour (P = .0005), and whole-body tumour (P = .0041). The overall appropriateness of CTs improved from 73.1% in 2017 to 79.0% in 2022 (P = .0049). In 15.4% of the cases, no radiological examination was deemed necessary, and in 8.7% of the cases, another modality was more appropriate. Appropriateness rates were the highest for the head and neck angiography (100%) and the chest (96%) and the lowest for the neck (66%) and the head (67%). Conclusions: Justification of CT scans can be improved by regular educational interventions, increasing MRI accessibility, and evaluating the appropriateness of the requested CT before the examination. Interventions for a more effective implementation of referral guidelines are needed. Advances in knowledge: The focus for improvement should be CTs for head and cervical spine trauma, accounting for the majority of inappropriate requests in the paediatric population.

Understanding the support for gender-based harassment perpetrators: the role of closeness and empathy.

Introduction: Gender-based harassment is a pressing social challenge urgently demanding eradication. While social movements emphasize supporting victims, societal responses sometimes lean toward exculpating perpetrators. This study examines two factors influencing this exoneration: closeness to perpetrators and empathy focus. Methods: A total of 345 participants took part in an experimental design to assess how closeness to perpetrators (close vs. distant) and empathy focus (on the perpetrator vs. victim vs. control) impact the moral justification of harassment and the dehumanization of both parties. Results and discussion: Results indicate that closeness and empathizing with perpetrators lead to greater leniency-more moral justification and less dehumanization of the perpetrator. Heightened moral justification for close perpetrators is mediated by increased empathy toward them and decreased empathy for victims, and reduced dehumanization of close perpetrators corresponds to heightened empathy toward them. This research highlights how closeness and empathy, two initially positive factors, can foster tolerance toward gender harassment.

Assessing MRI referrals' appropriateness for low back pain post a radiology-initiated intervention.

INTRODUCTION: This study evaluated a pilot intervention to reduce low-value Magnetic Resonance Imaging (MRI) referrals for Low Back Pain (LBP). METHODS: This before-after intervention study analysed MRI referrals for LBP at two private imaging centres in Norway. MRI referrals for LBP obtained before and after an intervention of information campaigns and sending a return letter to clinicians for declined referrals were evaluated on information, quality, and justification rates. Four radiologists and two radiographers assessed the referrals. A point system was used to calculate referral quality. Each referral was given a score 'good' when rated above 5.5 and 'poor' below 2.5. Justification was based on assessors categorised rating as justified, unjustified or need more information. Stata Statistical Software (Release 18) was used for analysis. A mixed model analysed variations of the referrals pre- and post-intervention. A p-value of <.05 in variations was considered statistically significant. RESULTS: A total n = 300 patients' referrals (150 referrals pre- and post-intervention) were collected and assessed. Post-intervention, 68% of referrals were justified, up from 63% pre-intervention. The assessment showed a 4% decrease in referrals with poor scores and a 2% increase in those rated as good or intermediate quality post-intervention. These changes were not statistically significant. CONCLUSION: It is important to state that it was not possible in our study to identify the subgroup of referrals that are known to be from clinicians who had received a return letter, although the information campaign targeted all referrers. Despite the limitations our findings suggest that providing reasons for declined referrals can serve as an educational tool for clinicians and contribute to the reduction of low value MRI for LBP. IMPLICATIONS FOR PRACTICE: Radiology department initiatives that raise awareness and offer referral criteria guidance to clinicians can serve as valuable educational tools, and further emphasize the importance of providing comprehensive information in MRI referrals for LBP.

Right-wing authoritarianism, social dominance, system justification, and conservative political ideology as predictors of mental health stigma: The Hungarian case.

BACKGROUND: Insights from mental health stigma research indicate the importance of societal and political views on mental health perceptions. Most studies originate from typical Western neo-liberal settings and focus on generic mental health issues. Our research explores these associations in Hungary, an understudied post-communist context with significant stigma levels, examining a broad range of stigmas related to both general and three specific mental illnesses: schizophrenia, depression, and alcohol use disorder (AUD). AIMS: The study aims to connect a wide array of political dispositions to stigma associated with both general and specific mental illnesses, exploring both attitudes and behavioral intentions. METHODS: We surveyed 492 participants (147 males, 342 females) on their political dispositions, including Right-Wing Authoritarianism (RWA), Social Dominance Orientation (SDO), general and economic system justification, and conservative political ideology, and their attitudes toward general and specific mental illnesses. Regression analyses identified key political dispositions influencing stigma. RESULTS: RWA was significantly linked to most stigma outcomes, while conservative political ideology showed a selective impact. Other predictors had minimal influence on stigma outcomes. CONCLUSION: Our findings suggest that perceptions of danger, threat, and unconventionality, as indicated by RWA, are crucial for mental health stigmatization in Hungary. Intervention programs should target these factors, particularly in similar contexts.

Childbirth as Fault Lines: Justifications in Physician-Patient Interactions About Postnatal Rehabilitation.

Research on justifications has shown their significance in advice-giving, decision-making and children disputes. However, the majority of studies gloss over practical functions of justifications in patient-physician interactions as they are often expected and pursued by patients and in turn, are adopted by physicians to support their stance and authority. This study, through conversation analysis (CA), aims to explore a) what are pragmatic functions of justifications in patient-physician interaction? b) how and when do physicians unfold their justifications for treatment recommendations? c) how do physicians deal with different responses based on their epistemic and deontic domains?. A total of 32 video-recordings between postpartum women and physicians are collected and studied. Four pragmatic functions of justifications drawn upon by physicians are explored: justifications as face-saving, reassurance, risk discussion and clarification-seeking. Despite physicians' attempts to justify their positions as less challenged by patients, this is not the entire picture as they demonstrate their desire to resolve patients' concerns and coordinate their viewpoints to achieve the best practice that facilitates patients' well-being.

Attitudes towards wife-beating justification and its association with female genital mutilation - analysis of ever-married Somali women in the 2020 Somali Health and Demographic Survey.

BACKGROUND: In Somalia, despite its prohibition, female circumcision persists alongside significant intimate partner violence. This study examines the prevalence of wife-beating justification among Somali women and its link to the perception that female genital mutilation/cutting (FGM/C) is a religious obligation. METHODS: We studied 7726 married Somali women 15-49 y of age from the 2020 Somali Health and Demographic Survey. Using χ2 tests and logistic regression, we examined wife-beating justification by covariates and its connection to the perception that FGM/C is a religious obligation. RESULTS: The prevalence of women justifying wife-beating for any of six reasons was 56.5% (95% confidence interval [CI] 55.3 to 57.6). A higher prevalence of wife-beating justification was found among women 35-49 y of age (59.9% [95% CI 57.8 to 61.9]), without education (57.7% [95% CI 56.5 to 59.0]), rural residents (57.8% [95% CI 56.3 to 59.2]), with lower socio-economic status (60.4% [95% CI 58.7 to 62.1]) and married before age 18 y (58.4% [95% CI 56.7 to 60.1]). Adjusted for covariates, logistic regression analyses indicated a significant association between wife-beating justification and the belief that FGM/C is mandated by religion (adjusted odds ratio 1.40 [95% CI 1.17 to 1.68], p<0.001). CONCLUSIONS: Wife-beating justification is alarmingly common among Somali women and significantly associated with the belief that FGM/C is mandated by religion. Further research is necessary to investigate the drivers behind the acceptance of domestic violence, its impact on women's mental health and well-being and its association with FGM/C acceptance.

Machine learning and deep learning for classifying the justification of brain CT referrals.

OBJECTIVES: To train the machine and deep learning models to automate the justification analysis of radiology referrals in accordance with iGuide categorisation, and to determine if prediction models can generalise across multiple clinical sites and outperform human experts. METHODS: Adult brain computed tomography (CT) referrals from scans performed in three CT centres in Ireland in 2020 and 2021 were retrospectively collected. Two radiographers analysed the justification of 3000 randomly selected referrals using iGuide, with two consultant radiologists analysing the referrals with disagreement. Insufficient or duplicate referrals were discarded. The inter-rater agreement among radiographers and consultants was computed. A random split (4:1) was performed to apply machine learning (ML) and deep learning (DL) techniques to unstructured clinical indications to automate retrospective justification auditing with multi-class classification. The accuracy and macro-averaged F1 score of the best-performing classifier of each type on the training set were computed on the test set. RESULTS: 42 referrals were ignored. 1909 (64.5%) referrals were justified, 811 (27.4%) were potentially justified, and 238 (8.1%) were unjustified. The agreement between radiographers (κ = 0.268) was lower than radiologists (κ = 0.460). The best-performing ML model was the bag-of-words-based gradient-boosting classifier achieving a 94.4% accuracy and a macro F1 of 0.94. DL models were inferior, with bi-directional long short-term memory achieving 92.3% accuracy, a macro F1 of 0.92, and outperforming multilayer perceptrons. CONCLUSION: Interpreting unstructured clinical indications is challenging necessitating clinical decision support. ML and DL can generalise across multiple clinical sites, outperform human experts, and be used as an artificial intelligence-based iGuide interpreter when retrospectively vetting radiology referrals. CLINICAL RELEVANCE STATEMENT: Healthcare vendors and clinical sites should consider developing and utilising artificial intelligence-enabled systems for justifying medical exposures. This would enable better implementation of imaging referral guidelines in clinical practices and reduce population dose burden, CT waiting lists, and wasteful use of resources. KEY POINTS: Significant variations exist among human experts in interpreting unstructured clinical indications/patient presentations. Machine and deep learning can automate the justification analysis of radiology referrals according to iGuide categorisation. Machine and deep learning can improve retrospective and prospective justification auditing for better implementation of imaging referral guidelines.

Norwegian general practitioners' and radiologists' perspectives on the referral, justification, and unnecessary imaging-a survey.

AIM: This study aimed to survey general practitioners' (GPs) and radiologists' perspectives on referrals, imaging justification, and unnecessary imaging in Norway. MATERIALS AND METHODS: The survey covered access to imaging, responsibilities, attitudes toward justification assessment, referral process, and demographics using multiple choice questions, statements to report agreement with using the Likert scale and one open question. RESULTS: Forty radiologists and 58 GPs attending national conferences completed a web-based survey, with a 20/15% response rate, respectively. Both radiologists (97%) and GPs (100%) considered avoiding unnecessary examinations essential to their role in the healthcare service. Still, 91% of GPs admitted that they referred to imaging they thought was not helpful, while about 60% of the radiologists agreed that unnecessary imaging was conducted in their workplace. GPs reported pressure from patients and patients having private insurance as the most common reasons for doing unnecessary examinations. In contrast, radiologists reported a lack of clinical information and the inability to discuss patient cases with the GPs as the most common reasons. CONCLUSION: This study adds to our understanding of radiologists' and GPs' perspectives on unnecessary imaging and referrals. Better guidelines and, even more importantly, better communication between the referrer and the radiologist are needed. Addressing these issues can reduce unnecessary imaging and improve the quality and safety of care.

Column setting and text justification influence return-sweep eye movement behavior during Chinese multi-line reading.

People regularly read multi-line texts in different formats and publishers, internationally, must decide how to present text to make reading most effective and efficient. Relatively few studies have examined multi-line reading, and fewer still Chinese multi-line reading. Here, we examined whether texts presented in single or double columns, and either left-justified or fully-justified affect Chinese reading. Text format had minimal influence on overall reading time; however, it significantly impacted return-sweeps (large saccades moving the eyes from the end of one line of text to the beginning of the next). Return-sweeps were launched and landed further away from margins and involved more corrective saccades in single- than double-column format. For left- compared to fully-justified format, return-sweeps were launched and landed closer to margins. More corrective saccades also occurred. Our results showed more efficient return-sweep behavior for fully- than left-justified text. Moreover, there were clear trade-off effects such that formats requiring increased numbers of shorter return-sweeps produced more accurate targeting and reduced numbers of corrective fixations, whereas formats requiring reduced numbers of longer return-sweeps caused less accurate targeting and an increased rate of corrective fixations. Overall, our results demonstrate that text formats substantially affect return-sweep eye movement behavior during Chinese reading without affecting efficiency and effectiveness, that is, the overall time it takes to read and understand the text.

Assessing Public Reason Approaches to Conscientious Objection in Healthcare.

Sometimes healthcare professionals conscientiously refuse to treat patients despite the patient requesting legal, medically indicated treatments within the professionals' remit. Recently, there has been a proliferation of views using the concept of public reason to specify which conscientious refusals of treatment should be accommodated. Four such views are critically assessed, namely, those of Robert Card, Massimo Reichlin, David Scott, and Doug McConnell. This paper argues that McConnell's view has advantages over the other approaches because it combines the requirement that healthcare professionals publicly justify the grounds of their conscientious refusals of treatment with the requirement that those grounds align with minimally decent healthcare. This relatively restrictive approach accommodates conscientious refusals from minimally decent healthcare professionals while still protecting good healthcare, the independence of the healthcare professions, and the fiduciary relationships.

Collective action against corruption in Western and non-Western countries: cross-cultural implications of the Axiological-Identitary Collective Action Model.

People sometimes protest government corruption, yet our current understanding of why they do so is culturally constrained. Can we separate pancultural factors influencing people's willingness to protest government corruption from factors culturally specific to each socioecological context? Surprisingly little cross-cultural data exist on this important question. To fill this gap, we performed a cross-cultural test of the Axiological-Identitary Collective Action Model (AICAM) regarding the intention to protest against corruption. As a collective action framework, AICAM integrates three classical antecedents of collective action (injustice, efficacy, identity) with axiological variables (ideology and morality). A total sample of 2,316 participants from six countries (Nigeria, Russia, India, Spain, United States, Germany) in a multilevel analysis of AICAM predictions showed that the positive relationship of the intention to protest corruption with moral obligation, system-based anger, and national identification can be considered pancultural. In contrast, the relationships between system justification and perceived efficacy are culturally specific. System justification negatively predicted the intention to participate only in countries with high levels of wealth, while perceived efficacy positively predicted it only in countries perceived as less corrupt. These findings highlight the importance of accounting features of socioecology and separating pancultural from culture-specific effects in understanding collective action.

Wife-Beating Endorsements Among African Youths: Current Prevalence and Predictors in 14 Sub-Saharan African Countries From 2015 to 2021.

This study investigates the prevalence and predictors of wife-beating endorsements among never-in-union male and female African youths, aged 15-24 years. Demographic and Health Survey data from 14 Sub-Saharan African countries (female = 55,387; male = 29,128) were analyzed using multiple logistic regression analyses. Approximately 37% of male and 42% of female African youths justified wife-beating, ranging from Mali (female = 71.1%, male = 58.7%) to Malawi (female = 21.4%, male = 22.3%). Young age, low education, limited Internet access, poverty, and rural residence were commonly associated with acceptance. Eliminating violence against women in Africa requires timely and adequate interventions.

The Transformative Role of Information and Communication Technologies in Shaping Gender Norms and Empowering Women: Evidence From Pakistan and Nepal.

This study explores how information and communication technologies (ICTs) influence transforming attitudes toward intimate partner violence (IPV) and women's empowerment in Pakistan and Nepal. By analyzing data from married women using recent Demographic and Health Surveys, the research reveals that owning multiple ICTs is associated with decreased experiences of physical IPV and reduced acceptance of wife-beating. Notably, increased ownership of ICTs corresponds to heightened participation in household decisions. Furthermore, regular internet use further diminishes the likelihood of experiencing physical IPV and justifying wife-beating. These findings underscore ICTs' potential to empower women, reshape gender norms, and enhance decision-making autonomy. The study advocates for gender-inclusive policy interventions that leverage the transformative influence of ICTs in fostering positive sociocultural changes.

AI and the need for justification (to the patient).

This paper argues that one problem that besets black-box AI is that it lacks algorithmic justifiability. We argue that the norm of shared decision making in medical care presupposes that treatment decisions ought to be justifiable to the patient. Medical decisions are justifiable to the patient only if they are compatible with the patient's values and preferences and the patient is able to see that this is so. Patient-directed justifiability is threatened by black-box AIs because the lack of rationale provided for the decision makes it difficult for patients to ascertain whether there is adequate fit between the decision and the patient's values. This paper argues that achieving algorithmic transparency does not help patients bridge the gap between their medical decisions and values. We introduce a hypothetical model we call Justifiable AI to illustrate this argument. Justifiable AI aims at modelling normative and evaluative considerations in an explicit way so as to provide a stepping stone for patient and physician to jointly decide on a course of treatment. If our argument succeeds, we should prefer these justifiable models over alternatives if the former are available and aim to develop said models if not.