Selecting venues for AMIA events and conferences: guiding ethical principles

Abstract

A discussion and debate on the American Medical Informatics Association’s (AMIA) Ethical, Legal, and Social Issues (ELSI) Working Group listserv in 2021 raised important issues related to a forthcoming conference in Texas. Texas had recently enacted a restrictive abortion law and restricted voting rights. Several AMIA members advocated for a boycott of the state and the scheduled conference. The discussion led the AMIA Board of Directors to request that the organization’s Ethics Committee provide general guidance for principle-based venue selection. This document recommends overarching principles for the venue selection for future AMIA events and conferences. Discussions by the AMIA Board, the Ethics Committee, and the ELSI Working Group informed these recommendations, and this document on guiding principles was approved by the AMIA Board of Directors in April 2022.

GUIDING PRINCIPLES

The needs of members and the financial viability of a conference venue are important considerations for any academic society. However, when deciding where to hold conferences, professional organizations ought also to be guided by a set of overarching principles that communicate institutional values. Professional scientific organizations must identify principles and values important to and supported by their members. Principles designed to further the dissemination of science will help ensure an unfettered scientific conference.

Nonetheless, identifying apt principles and values to support the many kinds of decision-making processes that go into organizing a conference is complex. To be useful, principles are enacted by a decision process that is well informed and deliberate and in which ample opportunities exist to assess the applicability of the principles. This document provides an attempt to delineate the principles and describe how they might be applied to venue selection decision-making.

The commitment to informed decision-making requires that AMIA provide members with channels to comment and respond to venue selections and potentially to raise concerns about venues. One recommendation in this document is that AMIA publish the list of venues being explored for future conferences with an opportunity for members to comment prior to final selection.

We drew from and added to the principles identified by the International Medical Informatics Association (IMIA).¹ We envisioned these principles to be acceptable to most informaticians and AMIA members and to serve as a minimum set of requirements for selecting a geographic location or venues for conferences and meetings. The principles are likely to be valuable to other scientific or professional organizations in their decision-making. The order of principles listed here does not reflect their importance. The principles are framed as commitments to:

1. Right to benefit from science²

2. Right to safety and security

3. Freedom to travel

4. Freedom of speech

5. Right to nondiscrimination and civil discourse

6. Human Rights

7. Access to Professional development

8. Transparency and veracity

This list is not exhaustive and is offered as a foundation to guide discussion and debate around challenges faced by professional organizations, their members, and their leadership in selecting venues for professional gatherings.

RIGHT TO BENEFIT FROM SCIENCE

As an organization, AMIA is committed “through education, training, accreditation, and certification, [to support] the current and next generation of informatics professionals” by:

• Providing members with opportunities to grow professionally, regardless of career stage, professional level, or discipline.

• Fostering collaboration and networking to support members’ work to improve people’s lives.

• Expanding members’ leadership opportunities within the association and in the field.²

These commitments require AMIA to conduct meetings that permit and enable members to congregate, exchange, and debate scientific information, and to enjoy the Right to Benefit from Science. In 2012, the United Nations codified this right as “(a) access by everyone without discrimination to the benefits of science and its application, including scientific knowledge; (b) opportunities for all to contribute to the scientific enterprise and freedom indispensable for scientific research; (c) participation of individuals and communities in decision-making and the related right to information; and (d) an enabling environment fostering the conservation, development and diffusion of science and technology.”³

The United Nations’ definition entails several obligations for any scientific organization conducting a meeting. The meeting must be accessible to anyone who wants to participate and learn about the science being discussed. It also must provide for a way to offer the materials presented at the meeting in a fashion that is free of bias, which could be assured through the process of peer review by other scientists (eg, a Scientific Program Committee).

In the same way that a robust scientific process requires the ability of scientists freely to challenge and question the results presented and the methods used, the meeting should enable scientists to express their opinions in a free and uncensored manner and in accord with standards for professional decorum.

RIGHT TO SAFETY AND SECURITY

Participants in a scientific meeting must have a reasonable expectation for their personal safety and security. We interpret the statement that participants should be confident that attending the conference does not put the average attendee at risk of substantial harm compared to other potential venues. A location’s crime rate or the risk of natural disasters or pandemics may be salient factors in deciding its suitability to serve as a venue. A location’s response to a potential health threat through laws or regulations that increase health risk to attendees by banning accepted public health measures for individuals (eg, banning masks) may also be an important factor for its suitability.

The right to safety and security includes an obligation to provide adequate local planning and security to reduce the risk of personal injury. As large gathering venues may provide opportunity for and attract petty crime, a venue selection may consider past reports. Security may also be important considering the risk of civil unrest or protest that a gathering of scientists might elicit.

The safety of all conference participants is of utmost priority. AMIA, as a convener of scientific conferences, could incur liability and suffer reputational damage if participants were harmed or wronged because they attended the conference. Therefore, “AMIA may reassess a conference venue based on this requirement after it has been chosen and before the conference commences.” For example, an imminent risk (eg, of natural disaster, pandemic, or civil unrest) requires organizers at least to revisit their decision.

AMIA in the past has demonstrated great care and attention to this requirement and canceled several in-person conferences (AMIA Annual Symposium, ACMI conference) due to the health risk to participants. These cancelations were made over concerns to the financial effect on the organization demonstrating the importance of the principle on safety and security to AMIA.

FREEDOM TO TRAVEL

The right to science includes the ability to physically attend and participate in scientific meetings. This is especially important for an international discipline, such as medical informatics. Absent a pandemic or other compelling health or scientific reasons, scientists from around the world should be able to attend scientific meetings or send appropriate representatives.

Travel or attendance restrictions based on religion, gender, sexual orientation, disability, race, ethnicity, etc., are morally unacceptable and ethically impermissible. Any such restrictions would be adequate grounds for excluding a region or venue as a meeting or conference site.

FREEDOM OF SPEECH

Freedom of speech is fundamental to conduct of any scientific endeavor. Scientific meeting attendees must be able to share their scientific results and conclusions in a free and unfettered manner free from censorship (eg, state or local government-ordered censorship). Attendees to AMIA’s conferences may present scientific findings, express their opinions and beliefs, and discuss controversial ideas in presentations.

Freedom of speech also includes the freedom to determine the proper attribution of credits (eg, the freedom to select a country that is not recognized by another country as the country of origin for one of the researchers). Although scientific peer-reviewers will provide many suggestions about how to improve the quality of a paper or presentation, the criticism should be limited to the scientific merits of the research.

RIGHT TO NONDISCRIMINATION AND CIVIL DISCOURSE

Freedom of speech is fundamental to the scientific process, where findings must be presented, analyzed, criticized, challenged, and reinterpreted. Conference attendees have the right to question the merit or methods or relevance of scientific research.

Freedom of Speech, however, does not entail unfettered or unlimited speech or permission to act in a hurtful, discriminatory, or offensive manner and does not give conference attendees the right to harass or abuse others, including through insinuations or allegations that are likely to damage the reputation of others.

Attacking a conference participant based on gender, gender orientation, race, ethnicity, sexual preference, immigration status, disability, religious, or other beliefs, or other personal attributes is not acceptable, and venues that permit such behavior are unfit for AMIA conferences. All participants should be protected from hate speech, discrimination, and bias.

AMIA will follow the recommendations of the NIH’s “Plans to Promote Safe Environments at Conferences Supported by NIH Grants and Cooperative Agreements” by providing information about how the organization will “assess allegations and the consequences for those who are found to violate the expectations of behavior.”⁴ AMIA will apply the NIH’s guidelines to all interactions related to its conferences and venues including interactions among AMIA members and between AMIA members and AMIA staff.

COMMITMENT TO HUMAN RIGHTS

AMIA is committed to the protection of human rights in law and practice.⁵ A conference region or venue must not permit laws, policies, practices, or rules that undermine that commitment or allow violations of these rights (eg, discrimination before the law, arbitrary arrest, or violation of privacy).

A region or location in which laws assign or allocate rights based on race or ethnicity, for example, is not an acceptable location for an AMIA meeting. Scientific conference participants must have a reasonable expectation that human rights will be protected.

ACCESS TO PROFESSIONAL DEVELOPMENT

AMIA is committed to professional development “through education, training, accreditation, and certification, [of] the current and next generation of informatics professionals.” AMIA’s conferences not only offer an opportunity to teach by sharing the research but also—equally important—an opportunity to learn and grow. An optimal environment to foster teaching and learning must be an important factor in venue selection. A venue must have adequate space, a variety of settings that allow for different size groups and must accommodate an AMIA plenary session.

COMMITMENT TO TRANSPARENCY AND VERACITY

Transparency and honesty in decision-making are paramount for a scientific society. Members must be able to question and scrutinize (within reason and without jeopardizing the organization’s ability to function) decisions and the processes by which they were derived, which can only occur if the process is transparent and honest. AMIA’s conflict of interest policy⁶ is an important tool to provide ongoing transparency. Initiatives to achieve transparency should include a way for members to inquire and understand how different tradeoffs weighed in the decision-making processes.

For example, for the selection of a venue, it is important that conflicts that decision-makers may have (eg, the desire to bring an AMIA conference to their hometown) are known in advance and result in the appropriate management of the conflict (eg, recusal, discontinuation).

In the interest of reducing burden for AMIA staff, the AMIA Ethics committee is available to review the list of proposed venues and determine the venues’ viability about the principles outlined in this document. The Ethics committee’s discussion will be preserved in the committee minutes available to members and staff in the interest of transparency.

IMPLEMENTATION OF PRINCIPLES

If conditions in a location violate the principles listed above, AMIA generally will not plan or schedule a conference in that location. While AMIA generally does not maintain a list of “excluded” or “boycotted” locations, the publication of this requirement document allows candidate venues to determine their eligibility and likelihood of a successful bid based on their ability to support the principles. As part of the venue selection process, AMIA reserves the rights to request in writing the principles of potential venue vendors to assure that they align with AMIA principles.

As these principles are implemented, it is important to recognize that they may come into conflict with one another. Further, other considerations that may be critical to the survival of the organization, such as financial considerations, may play an important role in initial venue selection or in subsequent decisions about a potential change in venue. How to approach such tradeoffs will need to be handled on an emergent basis and can be done with input from the AMIA Ethics Committee.

OTHER CONSIDERATIONS

Political or religious considerations

Absent violations of the principles described above, political factors (eg, the dominant political party or that of the governor) should generally not be included in the decision-making process. Similarly, religious factors (eg, predominance of a religious belief) should generally not be included in the decision-making process unless such a consideration would violate any of the principles listed.

Conditions at a venue that are offensive to some AMIA members may result in decisions not to attend the conference. Thus, it is AMIA’s fiduciary obligation to consider these issues when planning future conferences. Appraising membership’s objection to a particular location and venue prior to selection is good practice.

Responding to changing circumstances

As hotel contracts require AMIA to plan and schedule conferences at least 5 years in advance, a decision in favor of a conference venue may be based on circumstances that are no longer accurate or applicable when the conference date approaches. It is important that AMIA is prepared for such turn of events, including monitoring for any changes that result in a violation of the principles outlined in this document. Generally, AMIA should consider a change to the previously decided venue for a conference if the principle(s) in this document are violated. It is the AMIA Board of Directors’ responsibility to be aware of changing circumstances, make any changes and modifications to the conference or venue, and deal with the tradeoffs (including weighing ethical principles against other considerations such as financial) from these decisions. The Board may call upon the AMIA Ethics Committee or other AMIA groups or individuals to consult and advise.

CONCLUSIONS

AMIA will be guided in its decisions about venues for all its meetings and conferences by the principles laid out in this document. For future venue selection, venue nonadherence to the outlined principles will preclude consideration of a location. AMIA will consider a change in venue—weighing ethical principles against other considerations—if changing circumstances result in violation of these principle(s).

AUTHOR CONTRIBUTION

KG, CL, and KFH wrote the first draft of the manuscript. All authors participated in conference calls discussing the content and all authors provided critical edits and approval to the final manuscript.