This paper develops an account of how the implementation of ML models into healthcare settings requires revising the methodological apparatus of philosophical bioethics. On this account, ML models are cognitive interventions that provide decision-support to physicians and patients. Due to reliability issues, opaque reasoning processes, and information asymmetries, ML models pose inferential problems for them. These inferential problems lay the grounds for many ethical problems that currently claim centre-stage in the bioethical debate. Accordingly, this paper argues that the best way (...) to make progress in remedying these ethical problems is to distil their epistemic core and to identify appropriate epistemic norms as guardrails. The viability of this approach will be highlighted based on four key issues: trust, responsibility, paternalism, and fairness. In that respect, the paper also contributes to a more pronounced view of the specific methodological challenges for ethical theorizing, when the point of reference are complex statistical models that make predictions, rather than individual agents, acting for reasons. (shrink)

It is well-established that algorithms can be instruments of injustice. It is less frequently discussed, however, how current modes of AI deployment often make the very discovery of injustice difficult, if not impossible. In this article, we focus on the effects of algorithmic profiling on epistemic agency. We show how algorithmic profiling can give rise to epistemic injustice through the depletion of epistemic resources that are needed to interpret and evaluate certain experiences. By doing so, we not only demonstrate how (...) the philosophical conceptual framework of epistemic injustice can help pinpoint potential, systematic harms from algorithmic profiling, but we also identify a novel source of hermeneutical injustice that to date has received little attention in the relevant literature: epistemic fragmentation. Epistemic fragmentation is a structural characteristic of algorithmically-mediated environments that isolate individuals, making it more difficult to develop, uptake and apply new epistemic resources. This, in turn, can impede the identification and conceptualisation of emerging harms in these environments. We trace the occurrence of hermeneutical injustice back to the fragmentation of the epistemic experiences of individuals, who are left more vulnerable by the inability to share, compare, and learn from shared experiences. (shrink)

In this paper I argue that Artificial Intelligence and the many data science methods associated with it, such as machine learning and large language models, are first and foremost epistemic technologies. In order to establish this claim, I first argue that epistemic technologies can be conceptually and practically distinguished from other technologies in virtue of what they are designed for, what they do and how they do it. I then proceed to show that unlike other kinds of technology (_including_ other (...) epistemic technologies) AI can be uniquely positioned as an epistemic technology in that it is primarily designed, developed and deployed to be used in _epistemic contexts_ such as inquiry, it is specifically designed, developed and deployed to manipulate _epistemic content_ such as data, _and_ it is designed, developed and deployed to do so particularly through _epistemic operations_ such as prediction and analysis. As has been shown in recent work in the philosophy and ethics of AI (Alvarado, AI and Ethics, 2022a), understanding AI as an epistemic technology will also have significant implications for important debates regarding our relationship to AI technologies. This paper includes a brief overview of such implications, particularly those pertaining to explainability, opacity, trust and even epistemic harms related to AI technologies. (shrink)

Artificial intelligence (AI) and machine learning (ML) systems increasingly purport to deliver knowledge about people and the world. Unfortunately, they also seem to frequently present results that repeat or magnify biased treatment of racial and other vulnerable minorities. This paper proposes that at least some of the problems with AI’s treatment of minorities can be captured by the concept of epistemic injustice. To substantiate this claim, I argue that (1) pretrial detention and physiognomic AI systems commit testimonial injustice because their (...) target variables reflect inaccurate and unjust proxies for what they claim to measure; (2) classification systems, such as facial recognition, commit hermeneutic injustice because their classification taxonomies, almost no matter how they are derived, reflect and perpetuate racial and other stereotypes; and (3) epistemic injustice better explains what is going wrong in these types of situations than does the more common focus on procedural (un)fairness. (shrink)

The dominant practice of AI alignment assumes (1) that preferences are an adequate representation of human values, (2) that human rationality can be understood in terms of maximizing the satisfaction of preferences, and (3) that AI systems should be aligned with the preferences of one or more humans to ensure that they behave safely and in accordance with our values. Whether implicitly followed or explicitly endorsed, these commitments constitute what we term a preferentist approach to AI alignment. In this paper, (...) we characterize and challenge the preferentist approach, describing conceptual and technical alternatives that are ripe for further research. We first survey the limits of rational choice theory as a descriptive model, explaining how preferences fail to capture the thick semantic content of human values, and how utility representations neglect the possible incommensurability of those values. We then critique the normativity of expected utility theory (EUT) for humans and AI, drawing upon arguments showing how rational agents need not comply with EUT, while highlighting how EUT is silent on which preferences are normatively acceptable. Finally, we argue that these limitations motivate a reframing of the targets of AI alignment: Instead of alignment with the preferences of a human user, developer, or humanity-writ-large, AI systems should be aligned with normative standards appropriate to their social roles, such as the role of a general-purpose assistant. Furthermore, these standards should be negotiated and agreed upon by all relevant stakeholders. On this alternative conception of alignment, a multiplicity of AI systems will be able to serve diverse ends, aligned with normative standards that promote mutual benefit and limit harm despite our plural and divergent values. (shrink)

Smartphone apps might offer a low-threshold approach to the detection of mental health conditions, such as depression. Based on the gathering of ‘passive data,’ some apps generate a user’s ‘digital phenotype,’ compare it to those of users with clinically confirmed depression and issue a warning if a depressive episode is likely. These apps can, thus, serve as epistemic tools for affected users. From an ethical perspective, it is crucial to consider epistemic injustice to promote socially responsible innovations within digital mental (...) healthcare. In cases of epistemic injustice, people are wronged specifically as epistemic agents, i.e., agents of the production and distribution of knowledge. We suggest that epistemic agency relies on different resource- and uptake-related preconditions which can be impacted by the functionality of passive self-tracking apps. We consider how this can lead to different forms of epistemic injustice (testimonial, hermeneutical, and contributory injustice) and analyze the influence of the apps’ use on epistemic practices on an individual level, in mental healthcare settings, and on the structural level. (shrink)

In their article, Sedlakova and Trachsel (2023) propose a holistic, ethical, and epistemic analysis of conversational artificial intelligence (CAI) in psychotherapeutic settings. They mainly descri...

This article aims to provide a coherent and comprehensive theoretical framework of the main socio-epistemic features of social media. The first part consists of a concise discussion of the main epistemic consequences of personalised information filtering, with a focus on echo chambers and their many different implications. The middle section instead hosts an analytical investigation of the cognitive and epistemic environments of these platforms aimed at establishing whether, and to what extent, they allow their users to be epistemically vigilant with (...) respect to their sources and the content recommended to them. Finally, in the last part, of a more exquisitely normative nature, some strategies are proposed and discussed that, by reducing the epistemic opacity of social media, could contribute to greater epistemic justice within social media and, concurrently, to augmenting the epistemic autonomy of users. (shrink)

In this paper we, an epistemologist and a machine learning scientist, argue that we need to pursue a novel area of philosophical research in AI – the ethics of belief for AI. Here we take the ethics of belief to refer to a field at the intersection of epistemology and ethics concerned with possible moral, practical, and other non-truth-related dimensions of belief. In this paper we will primarily be concerned with the normative question within the ethics of belief regarding what (...) agents – both human and artificial – ought to believe, rather than with questions concerning whether beliefs meet certain evaluative standards such as being true, being justified, constituting knowledge, etc. We suggest four topics in extant work in the ethics of (human) belief that can be applied to an ethics of AI belief: doxastic wronging by AI (morally wronging someone in virtue of beliefs held about them); morally owed beliefs (beliefs that agents are morally obligated to hold); pragmatic and moral encroachment (cases where the practical or moral features of a belief is relevant to its epistemic status, and in our case specifically to whether an agent ought to hold the belief); and moral responsibility for AI beliefs. We also indicate two relatively nascent areas of philosophical research that haven’t yet been generally recognized as ethics of AI belief research, but that do fall within this field of research in virtue of investigating various moral and practical dimensions of belief: the epistemic and ethical decolonization of AI; and epistemic injustice in AI. (shrink)

Cho and Martinez-Martin (2023) discuss the ethical challenges associated with the use of digital simulacra (also known as digital twins) in biomedicine, specifically focusing on the issue of episte...

Digital phenotyping will potentially enable earlier detection and prediction of mental illness by monitoring human interaction with and through digital devices. Notwithstanding its promises, it is certain that a person’s digital phenotype will at times be at odds with their first-person testimony of their psychological states. In this paper, we argue that there are features of digital phenotyping in the context of psychiatry which have the potential to exacerbate the tendency to dismiss patients’ testimony and treatment preferences, which can be (...) instances of epistemic injustice. We first explain what epistemic injustice is, and why it is argued to be an extensive problem in health and disability settings. We then explain why epistemic injustice is more likely to apply with even greater force in psychiatric contexts, and especially where digital phenotyping may be involved. Finally, we offer some tentative suggestions of how epistemic injustice can be minimised in digital psychiatry. (shrink)

A growing number of technologies are currently being developed to improve and distribute thinking and decision-making. Rapid progress in brain-to-brain interfacing and swarming technologies promises to transform how we think about collective and collaborative cognitive tasks across domains, ranging from research to entertainment, and from therapeutics to military applications. As these tools continue to improve, we are prompted to monitor how they may affect our society on a broader level, but also how they may reshape our fundamental understanding of agency, (...) responsibility, and other key concepts of our moral landscape.In this paper we take a closer look at this class of technologies – Technologies for Collective Minds – to see not only how their implementation may react with commonly held moral values, but also how they challenge our underlying concepts of what constitutes collective or individual agency. We argue that prominent contemporary frameworks for understanding collective agency and responsibility are insufficient in terms of accurately describing the relationships enabled by Technologies for Collective Minds, and that they therefore risk obstructing ethical analysis of the implementation of these technologies in society. We propose a more multidimensional approach to better understand this set of technologies, and to facilitate future research on the ethics of Technologies for Collective Minds. (shrink)

Artificial intelligence-based (AI) technologies such as machine learning (ML) systems are playing an increasingly relevant role in medicine and healthcare, bringing about novel ethical and epistemological issues that need to be timely addressed. Even though ethical questions connected to epistemic concerns have been at the center of the debate, it is going unnoticed how epistemic forms of injustice can be ML-induced, specifically in healthcare. I analyze the shortcomings of an ML system currently deployed in the USA to predict patients’ likelihood (...) of opioid addiction and misuse (PDMP algorithmic platforms). Drawing on this analysis, I aim to show that the wrong inflicted on epistemic agents involved in and affected by these systems’ decision-making processes can be captured through the lenses of Miranda Fricker’s account of hermeneutical injustice. I further argue that ML-induced hermeneutical injustice is particularly harmful due to what I define as an automated hermeneutical appropriation from the side of the ML system. The latter occurs if the ML system establishes meanings and shared hermeneutical resources without allowing for human oversight, impairing understanding and communication practices among stakeholders involved in medical decision-making. Furthermore and very much crucially, an automated hermeneutical appropriation can be recognized if physicians are strongly limited in their possibilities to safeguard patients from ML-induced hermeneutical injustice. Overall, my paper should expand the analysis of ethical issues raised by ML systems that are to be considered epistemic in nature, thus contributing to bridging the gap between these two dimensions in the ongoing debate. (shrink)

Machine learning (ML) systems play an increasingly relevant role in medicine and healthcare. As their applications move ever closer to patient care and cure in clinical settings, ethical concerns about the responsibility of their use come to the fore. I analyse an aspect of responsible ML use that bears not only an ethical but also a significant epistemic dimension. I focus on ML systems’ role in mediating patient–physician relations. I thereby consider how ML systems may silence patients’ voices and relativise (...) the credibility of their opinions, which undermines their overall credibility status without valid moral and epistemic justification. More specifically, I argue that withholding credibilitydue tohow ML systems operate can be particularly harmful to patients and, apart from adverse outcomes, qualifies as a form of testimonial injustice. I make my case for testimonial injustice in medical ML by considering ML systems currently used in the USA to predict patients’ risk of misusing opioids (automated Prediction Drug Monitoring Programmes, PDMPs for short). I argue that the locus of testimonial injustice in ML-mediated medical encounters is found in the fact that these systems are treated asmarkers of trustworthinesson which patients’ credibility is assessed. I further show how ML-based PDMPs exacerbate and further propagate social inequalities at the expense of vulnerable social groups. (shrink)