It is hypothesised and argued that “the four principles of medical ethics” can explain and justify, alone or in combination, all the substantive and universalisable claims of medical ethics and probably of ethics more generally. A request is renewed for falsification of this hypothesis showing reason to reject any one of the principles or to require any additional principle(s) that can’t be explained by one or some combination of the four principles. This approach is argued to be compatible with a (...) wide variety of moral theories that are often themselves mutually incompatible. It affords a way forward in the context of intercultural ethics, that treads the delicate path between moral relativism and moral imperialism. Reasons are given for regarding the principle of respect for autonomy as “first among equals”, not least because it is a necessary component of aspects of the other three. A plea is made for bioethicists to celebrate the approach as a basis for global moral ecumenism rather than mistakenly perceiving and denigrating it as an attempt at global moral imperialism. (shrink)

In his article 'Specifying, balancing and interpreting bioethical principles' (Richardson, 2000), Henry Richardson claims that the two dominant theories in bioethics - principlism, put forward by Beauchamp and Childress in Principles of Bioethics , and common morality, put forward by Gert, Culver and Clouser in Bioethics: A Return to Fundamentals - are deficient because they employ balancing rather than specification to resolve disputes between principles or rules. We show that, contrary to Richardson's claim, the major problem with principlism, either the (...) original version, or the specified principlism of Richardson, is that it conceives of morality as being composed of free-standing principles, rather than as common morality conceives it, as being a complete public system, composed of rules, ideals, morally relevant features, and a procedure for determining when a rule can be justifiably violated. (shrink)

Definition of the problem The umbrella term “explicability” refers to the reduction of opacity of artificial intelligence (AI) systems. These efforts are challenging for medical AI applications because higher accuracy often comes at the cost of increased opacity. This entails ethical tensions because physicians and patients desire to trace how results are produced without compromising the performance of AI systems. The centrality of explicability within the informed consent process for medical AI systems compels an ethical reflection on the trade-offs. Which (...) levels of explicability are needed to obtain informed consent when utilizing medical AI? Arguments We proceed in five steps: First, we map the terms commonly associated with explicability as described in the ethics and computer science literature, i.e., disclosure, intelligibility, interpretability, and explainability. Second, we conduct a conceptual analysis of the ethical requirements for explicability when it comes to informed consent. Third, we distinguish hurdles for explicability in terms of epistemic and explanatory opacity. Fourth, this then allows to conclude the level of explicability physicians must reach and what patients can expect. In a final step, we show how the identified levels of explicability can technically be met from the perspective of computer science. Throughout our work, we take diagnostic AI systems in radiology as an example. Conclusion We determined four levels of explicability that need to be distinguished for ethically defensible informed consent processes and showed how developers of medical AI can technically meet these requirements. (shrink)

Many artificial intelligence (AI) systems currently used for decision-making are opaque, i.e., the internal factors that determine their decisions are not fully known to people due to the systems’ computational complexity. In response to this problem, several researchers have argued that human decision-making is equally opaque and since simplifying, reason-giving explanations (rather than exhaustive causal accounts) of a decision are typically viewed as sufficient in the human case, the same should hold for algorithmic decision-making. Here, I contend that this argument (...) overlooks that human decision-making is sometimes significantly more transparent and trustworthy than algorithmic decision-making. This is because when people explain their decisions by giving reasons for them, this frequently prompts those giving the reasons to govern or regulate themselves so as to think and act in ways that confirm their reason reports. AI explanation systems lack this self-regulative feature. Overlooking it when comparing algorithmic and human decision-making can result in underestimations of the transparency of human decision-making and in the development of explainable AI that may mislead people by activating generally warranted beliefs about the regulative dimension of reason-giving. (shrink)

Recent years have witnessed intensive efforts to specify which requirements ethical artificial intelligence (AI) must meet. General guidelines for ethical AI consider a varying number of principles important. A frequent novel element in these guidelines, that we have bundled together under the term explicability, aims to reduce the black-box character of machine learning algorithms. The centrality of this element invites reflection on the conceptual relation between explicability and the four bioethical principles. This is important because the application of general ethical (...) frameworks to clinical decision-making entails conceptual questions: Is explicability a free-standing principle? Is it already covered by the well-established four bioethical principles? Or is it an independent value that needs to be recognized as such in medical practice? We discuss these questions in a conceptual-ethical analysis, which builds upon the findings of an empirical document analysis. On the example of the medical specialty of radiology, we analyze the position of radiological associations on the ethical use of medical AI. We address three questions: Are there references to explicability or a similar concept? What are the reasons for such inclusion? Which ethical concepts are referred to? (shrink)

Machine learning-based AI algorithms lack transparency. In this article, I offer an interpretation of AI’s explainability problem and highlight its ethical saliency. I try to make the case for the legal enforcement of a strong explainability requirement: human organizations which decide to automate decision-making should be legally obliged to demonstrate the capacity to explain and justify the algorithmic decisions that have an impact on the wellbeing, rights, and opportunities of those affected by the decisions. This legal duty can be derived (...) from the demands of Rawlsian public reason. In the second part of the paper, I try to show that the argument from the limitations of human cognition fails to get AI off the hook of public reason. Against a growing trend in AI ethics, my main argument is that the analogy between human minds and artificial neural networks fails because it suffers from an atomistic bias which makes it blind to the social and institutional dimension of human reasoning processes. I suggest that developing interpretive AI algorithms is not the only possible answer to the explainability problem; social and institutional answers are also available and in many cases more trustworthy than techno-scientific ones. (shrink)

Artificial Intelligence (AI) is already having a major impact on society. As a result, many organizations have launched a wide range of initiatives to establish ethical principles for the adoption of socially beneficial AI. Unfortunately, the sheer volume of proposed principles threatens to overwhelm and confuse. How might this problem of ‘principle proliferation’ be solved? In this paper, we report the results of a fine-grained analysis of several of the highest-profile sets of ethical principles for AI. We assess whether these (...) principles converge upon a set of agreed-upon principles, or diverge, with significant disagreement over what constitutes ‘ethical AI.’ Our analysis finds a high degree of overlap among the sets of principles we analyze. We then identify an overarching framework consisting of five core principles for ethical AI. Four of them are core principles commonly used in bioethics: beneficence, non-maleficence, autonomy, and justice. On the basis of our comparative analysis, we argue that a new principle is needed in addition: explicability, understood as incorporating both the epistemological sense of intelligibility (as an answer to the question ‘how does it work?’) and in the ethical sense of accountability (as an answer to the question: ‘who is responsible for the way it works?’). In the ensuing discussion, we note the limitations and assess the implications of this ethical framework for future efforts to create laws, rules, technical standards, and best practices for ethical AI in a wide range of contexts. (shrink)

The last 5 years have seen a series of remarkable achievements in deep-neural-network-based artificial intelligence research, and some modellers have argued that their performance compares favourably to human cognition. Critics, however, have argued that processing in deep neural networks is unlike human cognition for four reasons: they are (i) data-hungry, (ii) brittle, and (iii) inscrutable black boxes that merely (iv) reward-hack rather than learn real solutions to problems. This article rebuts these criticisms by exposing comparative bias within them, in the (...) process extracting some more general lessons that may also be useful for future debates. (shrink)

Should decision-making algorithms be held to higher standards of transparency than human beings? The way we answer this question directly impacts what we demand from explainable algorithms, how we govern them via regulatory proposals, and how explainable algorithms may help resolve the social problems associated with decision making supported by artificial intelligence. Some argue that algorithms and humans should be held to the same standards of transparency and that a double standard of transparency is hardly justified. We give two arguments (...) to the contrary and specify two kinds of situations for which higher standards of transparency are required from algorithmic decisions as compared to humans. Our arguments have direct implications on the demands from explainable algorithms in decision-making contexts such as automated transportation. (shrink)

This article considers the issue of opacity as a problem for socially consequential mechanisms of classification and ranking, such as spam filters, credit card fraud detection, search engines, news trends, market segmentation and advertising, insurance or loan qualification, and credit scoring. These mechanisms of classification all frequently rely on computational algorithms, and in many cases on machine learning algorithms to do this work. In this article, I draw a distinction between three forms of opacity: opacity as intentional corporate or state (...) secrecy, opacity as technical illiteracy, and an opacity that arises from the characteristics of machine learning algorithms and the scale required to apply them usefully. The analysis in this article gets inside the algorithms themselves. I cite existing literatures in computer science, known industry practices, and do some testing and manipulation of code as a form of lightweight code audit. I argue that recognizing the distinct forms of opacity that may be coming into play in a given application is a key to determining which of a variety of technical and non-technical solutions could help to prevent harm. (shrink)

In this paper I argue that the search for explainable models and interpretable decisions in AI must be reformulated in terms of the broader project of offering a pragmatic and naturalistic account of understanding in AI. Intuitively, the purpose of providing an explanation of a model or a decision is to make it understandable to its stakeholders. But without a previous grasp of what it means to say that an agent understands a model or a decision, the explanatory strategies will (...) lack a well-defined goal. Aside from providing a clearer objective for XAI, focusing on understanding also allows us to relax the factivity condition on explanation, which is impossible to fulfill in many machine learning models, and to focus instead on the pragmatic conditions that determine the best fit between a model and the methods and devices deployed to understand it. After an examination of the different types of understanding discussed in the philosophical and psychological literature, I conclude that interpretative or approximation models not only provide the best way to achieve the objectual understanding of a machine learning model, but are also a necessary condition to achieve post hoc interpretability. This conclusion is partly based on the shortcomings of the purely functionalist approach to post hoc interpretability that seems to be predominant in most recent literature. (shrink)

The debate about the ethical implications of Artificial Intelligence dates from the 1960s :741–742, 1960; Wiener in Cybernetics: or control and communication in the animal and the machine, MIT Press, New York, 1961). However, in recent years symbolic AI has been complemented and sometimes replaced by Neural Networks and Machine Learning techniques. This has vastly increased its potential utility and impact on society, with the consequence that the ethical debate has gone mainstream. Such a debate has primarily focused on principles—the (...) ‘what’ of AI ethics —rather than on practices, the ‘how.’ Awareness of the potential issues is increasing at a fast rate, but the AI community’s ability to take action to mitigate the associated risks is still at its infancy. Our intention in presenting this research is to contribute to closing the gap between principles and practices by constructing a typology that may help practically-minded developers apply ethics at each stage of the Machine Learning development pipeline, and to signal to researchers where further work is needed. The focus is exclusively on Machine Learning, but it is hoped that the results of this research may be easily applicable to other branches of AI. The article outlines the research method for creating this typology, the initial findings, and provides a summary of future research needs. (shrink)

This article reports the findings of AI4People, an Atomium—EISMD initiative designed to lay the foundations for a “Good AI Society”. We introduce the core opportunities and risks of AI for society; present a synthesis of five ethical principles that should undergird its development and adoption; and offer 20 concrete recommendations—to assess, to develop, to incentivise, and to support good AI—which in some cases may be undertaken directly by national or supranational policy makers, while in others may be led by other (...) stakeholders. If adopted, these recommendations would serve as a firm foundation for the establishment of a Good AI Society. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

The ever-increasing application of algorithms to decision-making in a range of social contexts has prompted demands for algorithmic accountability. Accountable decision-makers must provide their decision-subjects with justifications for their automated system’s outputs, but what kinds of broader principles should we expect such justifications to appeal to? Drawing from political philosophy, I present an account of algorithmic accountability in terms of the democratic ideal of ‘public reason’. I argue that situating demands for algorithmic accountability within this justificatory framework enables us to (...) better articulate their purpose and assess the adequacy of efforts toward them. (shrink)

Principles that provide general normative frameworks in bioethics have been criticized since the late 1980s, when several different methods and types of moral philosophy began to be proposed as alternatives or substitutes. Several accounts have emerged in recent years, including: (1) Impartial Rule Theory (supported in this issue by K. Danner Clouser), (2) Casuistry (supported in this issue by Albert Jonsen), and (3) Virtue Ethics (supported in this issue by Edmund D. Pellegrino). Although often presented as rival methods or theories, (...) these approaches are consistent with and should not be considered adversaries of a principle-based account. (shrink)

We are sceptical of concerns over the opacity of algorithmic decision tools. While transparency and explainability are certainly important desiderata in algorithmic governance, we worry that automated decision-making is being held to an unrealistically high standard, possibly owing to an unrealistically high estimate of the degree of transparency attainable from human decision-makers. In this paper, we review evidence demonstrating that much human decision-making is fraught with transparency problems, show in what respects AI fares little worse or better and argue that (...) at least some regulatory proposals for explainable AI could end up setting the bar higher than is necessary or indeed helpful. The demands of practical reason require the justification of action to be pitched at the level of practical reason. Decision tools that support or supplant practical reasoning should not be expected to aim higher than this. We cast this desideratum in terms of Daniel Dennett’s theory of the “intentional stance” and argue that since the justification of action for human purposes takes the form of intentional stance explanation, the justification of algorithmic decisions should take the same form. In practice, this means that the sorts of explanations for algorithmic decisions that are analogous to intentional stance explanations should be preferred over ones that aim at the architectural innards of a decision tool. (shrink)

Although decision‐making algorithms are not new to medicine, the availability of vast stores of medical data, gains in computing power, and breakthroughs in machine learning are accelerating the pace of their development, expanding the range of questions they can address, and increasing their predictive power. In many cases, however, the most powerful machine learning techniques purchase diagnostic or predictive accuracy at the expense of our ability to access “the knowledge within the machine.” Without an explanation in terms of reasons or (...) a rationale for particular decisions in individual cases, some commentators regard ceding medical decision‐making to black box systems as contravening the profound moral responsibilities of clinicians. I argue, however, that opaque decisions are more common in medicine than critics realize. Moreover, as Aristotle noted over two millennia ago, when our knowledge of causal systems is incomplete and precarious—as it often is in medicine—the ability to explain how results are produced can be less important than the ability to produce such results and empirically verify their accuracy. (shrink)

Unlike the principles of Kant, Mill, and Rawls, those of principlism are not action guides that stem from an underlying, integrated moral theory. Hence problems arise in reconciling the principles with each other and, indeed, in interpreting them as action guides at all, since they have no content in and of themselves. Another approach to "theory and method in bioethics" is presented as an alternative to principlism, though actually the "alternative" predates principlism by about 10 years. The alternative's account of (...) morality stays close to ordinary, common morality with its rules and ideals, which in turn are grounded in aspects of human nature. As such, morality must be understood to be a rational, impartial, and public system that is incumbent on everyone. Morality is a unified and integrated system. The moral rules and ideals are also "culture-" and "profession-sensitive" in that they are interpreted more specifically within these various contexts. (shrink)

The decline in the interest in ethical theory is first outlined, as a background to the author’s discussion of principlism. The author’s own stance, that of a communitarian philosopher, is then described, before the subject of principlism itself is addressed. Two problems stand in the way of the author’s embracing principlism: its individualistic bias and its capacity to block substantive ethical inquiry. The more serious problem the author finds to be its blocking function. Discussing the four scenarios the author finds (...) that the utility of principlism is shown in the two scenarios about Jehovah’s Witnesses but that when it comes to selling kidneys for transplantation and germline enhancement, principlism is of little help. (shrink)

Moral conflicts occur in theories that involve more than one principle. I examine basic ways of dealing with moral dilemmas in medical ethics and in ethics generally, and propose a different approach based on a principle I call the "mutuality principle". It is offered as an addition to Tom Beauchamp and James Childress' principlism. The principle calls for the mutual enhancement of basic moral values. After explaining the principle and its strengths, I test it by way of an examination of (...) three responses—in the recent Festschrift for Dr Raanon Gillon—to a case involving parental refusal of a blood transfusion. The strongest response is the one that comes closest to the requirements of the mutuality principle but yet falls short. I argue that the mutuality principle provides an explicit future orientation in principlism and gives it greater moral coherence. (shrink)

Developing and implementing artificial intelligence (AI) systems in an ethical manner faces several challenges specific to the kind of technology at hand, including ensuring that decision-making systems making use of machine learning are just, fair, and intelligible, and are aligned with our human values. Given that values vary across cultures, an additional ethical challenge is to ensure that these AI systems are not developed according to some unquestioned but questionable assumption of universal norms but are in fact compatible with the (...) societies in which they operate. This is particularly pertinent for AI research and implementation across Africa, a ground where AI systems are and will be used but also a place with a history of imposition of outside values. In this paper, we thus critically examine one proposal for ensuring that decision-making systems are just, fair, and intelligible—that we adopt a principle of explicability to generate specific recommendations—to assess whether the principle should be adopted in an African research context. We argue that a principle of explicability not only can contribute to responsible and thoughtful development of AI that is sensitive to African interests and values, but can also advance tackling some of the computational challenges in machine learning research. In this way, the motivation for ensuring that a machine learning-based system is just, fair, and intelligible is not only to meet ethical requirements, but also to make effective progress in the field itself. (shrink)

Artificial intelligence (AI) based clinical decision support systems (CDSS) are becoming ever more widespread in healthcare and could play an important role in diagnostic and treatment processes. For this reason, AI‐based CDSS has an impact on the doctor–patient relationship, shaping their decisions with its suggestions. We may be on the verge of a paradigm shift, where the doctor–patient relationship is no longer a dual relationship, but a triad. This paper analyses the role of AI‐based CDSS for shared decision‐making to better (...) comprehend its promises and associated ethical issues. Moreover, it investigates how certain AI implementations may instead foster the inappropriate paradigm of paternalism. Understanding how AI relates to doctors and influences doctor–patient communication is essential to promote more ethical medical practice. Both doctors' and patients' autonomy need to be considered in the light of AI. (shrink)

It is widely acknowledged that high-level AI principles are difficult to translate into practices via explicit rules and design guidelines. Consequently, many AI research and development groups that claim to adopt ethics principles have been accused of unwarranted “ethics washing”. Accordingly, there remains a question as to if and how high-level principles should be expected to influence the development of safe and beneficial AI. In this short commentary I discuss two roles high-level principles might play in AI ethics and governance. (...) The first and most often discussed “start-point” function quickly succumbs to the complaints outlined above. I suggest, however, that a second “cultural influence” function is where the primary value of high-level principles lies. (shrink)

The purpose of this paper is to discuss the responsibility of AI experts for guiding the development of AI in a desirable direction. More specifically, the aim is to answer the following research question: To what extent are AI experts responsible in a forward-looking way for effects of AI technology that go beyond the immediate concerns of the programmer or designer? AI experts, in this paper conceptualised as experts regarding the technological aspects of AI, have knowledge and control of AI (...) technology that non-experts do not have. Drawing on responsibility theory, theories of the policy process, and critical algorithm studies, we discuss to what extent this capacity, and the positions that these experts have to influence the AI development, make AI experts responsible in a forward-looking sense for consequences of the use of AI technology. We conclude that, as a professional collective, AI experts, to some extent, are responsible in a forward-looking sense for consequences of use of AI technology that they could foresee, but with the risk of increased influence of AI experts at the expense of other actors. It is crucial that a diversity of actors is included in democratic processes on the future development of AI, but for this to be meaningful, AI experts need to take responsibility for how the AI technology they develop affects public deliberation. (shrink)