A cooperative serious game in which patients, clinicians, developers and regulators agree which values a medical AI tool must protect and turn them into design requirements.
| Website | https:// |
| Developed by | Hogeschool Utrecht (University of Applied Sciences Utrecht), Patiëntenfederatie Nederland, Danielle Sent, Mirjam de Haas, Rijk Mercuur, Ildikó Vajda |
| Type | Serious game: Cooperative tabletop game with value cards |
| Lifecycle phase | Design, Development |
| FUTURE-AI | General recommendations |
| For | AI developers, Healthcare professionals, Patients and communities |
| Time needed | 60-180 minutes |
| Group size | 3-8 |
| Facilitation | Facilitator recommended |
| Skills needed | none |
| Cost | Ask the developers |
| Languages | Dutch |
| Maturity | Emerging |
| Licence | No public licence stated; contact the developers at Hogeschool Utrecht for the game materials |
What it is¶
Moral Medtech is a tabletop game for 3 to 8 players. You play through the development phases of an AI-driven medical technology, using value cards based on the EU requirements for trustworthy AI plus healthcare-specific values such as quality of care and life. In each round the group discusses and weighs the values at stake and ends with shared advice on what the product should offer at that phase. The game draws on Value Sensitive Design and agile methods, and you can replay it at several points during development.
In healthcare¶
Built specifically for AI in healthcare with the Dutch Patient Federation (Patiëntenfederatie Nederland). The developers tested it on eight medtech use cases and report that it helped technical and non-technical stakeholders turn abstract values into concrete requirements.
Where to use it in The ELSA Way¶
Ethical review and approval › Application-specific ethical issues: Playing the game with patients and clinicians surfaces concerns such as autonomy, discrimination and accountability for your specific application and records which ones the group finds most important.
Stakeholder engagement › When to engage: Because you can replay the game at each development phase, it gives patients, clinicians and developers a recurring, structured moment to weigh values together rather than a one-off consultation.
References¶
Sent D, de Haas M, Mercuur R, Vajda I. Moral MedTech: Exploring Ethics-by-Design for Artificial Intelligence in Healthcare via Serious Gaming. Stud Health Technol Inform. 2026;336:544-548. Sent et al. (2026)
Related tools¶
Value Sensitive Design: A design approach, with ready-made methods and card decks, for identifying the people and human values a technology affects and building those values into the design from the start.
Aanpak Begeleidingsethiek: A facilitated workshop method in which the people affected by a new technology map its effects and values together and agree on concrete actions for the technology, its setting and its users.
ALTAI: A self-assessment checklist from the EU High-Level Expert Group on AI that helps you test an AI system against the seven requirements for trustworthy AI and spot where you need extra measures.
Also listed in: RAAIT toolbox.
- Sent, D., de Haas, M., Mercuur, R., & Vajda, I. (2026). Moral MedTech: Exploring Ethics-by-Design for Artificial Intelligence in Healthcare via Serious Gaming. In Studies in Health Technology and Informatics. IOS Press. 10.3233/shti260230