Scientific and ‘intuitive’ or ‘folk’ theories are typically characterized as serving three critical functions: prediction, explanation, and control. While prediction and control have clear instrumental value, the value of explanation is less transparent. This paper reviews an emerging body of research from the cognitive sciences suggesting that the process of seeking, generating, and evaluating explanations in fact contributes to future prediction and control, albeit indirectly by facilitating the discovery and confirmation of instrumentally valuable theories. Theoretical and empirical considerations also suggest (...) why explanations may nonetheless feel intrinsically valuable. The paper concludes by considering some implications of the psychology of explanation for a naturalized philosophy of explanation. (shrink)

Artificial intelligence (AI) is increasingly being developed for use in medicine, including for diagnosis and in treatment decision making. The use of AI in medical treatment raises many ethical issues that are yet to be explored in depth by bioethicists. In this paper, I focus specifically on the relationship between the ethical ideal of shared decision making and AI systems that generate treatment recommendations, using the example of IBM’s Watson for Oncology. I argue that use of this type of system (...) creates both important risks and significant opportunities for promoting shared decision making. If value judgements are fixed and covert in AI systems, then we risk a shift back to more paternalistic medical care. However, if designed and used in an ethically informed way, AI could offer a potentially powerful way of supporting shared decision making. It could be used to incorporate explicit value reflection, promoting patient autonomy. In the context of medical treatment, we need value-flexible AI that can both respond to the values and treatment goals of individual patients and support clinicians to engage in shared decision making. (shrink)

Diagnoses in medicine are often taken to serve as explanations of patients’ symptoms and signs. This article examines how they do so. I begin by arguing that although some instances of diagnostic explanation can be formulated as covering law arguments, they are explanatory neither in virtue of their argumentative structures nor in virtue of general regularities between diagnoses and clinical presentations. I then consider the theory that medical diagnoses explain symptoms and signs by identifying their actual causes in particular cases. (...) While I take this to be largely correct, I argue that for a diagnosis to function as a satisfactory causal explanation of a patient’s symptoms and signs, it also needs to be supplemented by understanding the mechanisms by which the identified cause produces the symptoms and signs. This mechanistic understanding comes not from the diagnosis itself, but rather from the theoretical framework within which the physician operates. (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)

The increasing use of Artificial Intelligence for making decisions in public affairs has sparked a lively debate on the benefits and potential harms of self-learning technologies, ranging from the hopes of fully informed and objectively taken decisions to fear for the destruction of mankind. To prevent the negative outcomes and to achieve accountable systems, many have argued that we need to open up the “black box” of AI decision-making and make it more transparent. Whereas this debate has primarily focused on (...) how transparency can secure high-quality, fair, and reliable decisions, far less attention has been devoted to the role of transparency when it comes to how the general public come to perceive AI decision-making as legitimate and worthy of acceptance. Since relying on coercion is not only normatively problematic but also costly and highly inefficient, perceived legitimacy is fundamental to the democratic system. This paper discusses how transparency in and about AI decision-making can affect the public’s perception of the legitimacy of decisions and decision-makers and produce a framework for analyzing these questions. We argue that a limited form of transparency that focuses on providing justifications for decisions has the potential to provide sufficient ground for perceived legitimacy without producing the harms full transparency would bring. (shrink)

Although science supplies medicine's “gold standard,” knowledge exercised in the care of patients is, like moral knowing, a matter of narrative, practical reason. Physicians draw on case narrative to store experience and to apply and qualify the general rules of medical science. Literature aids in this activity by stimulating moral imagination and by requiring its readers to engage in the retrospective construction of a situated, subjective account of events. Narrative truths are provisional, uncertain, derived from narrators whose standpoints are always (...) situated, particular, and uncertain, but open to comparison and reinterpretation. Reading is thus a model for knowing in both morality and clinical medicine. While principles remain essential to bioethics and science must always inform good clinical practice, the tendency to collapse morality into principles and medicine into science impoverishes both practices. Moral knowing is not separable from clinical judgment. While ethics must be open to discussion and interpretation by patients, families, and society, it is nevertheless substantively and epistemologically an inextricable part of a physician's clinical practice. (shrink)

In recent years, a plethora of high-profile scientific publications has been reporting about machine learning algorithms outperforming clinicians in medical diagnosis or treatment recommendations. This has spiked interest in deploying relevant algorithms with the aim of enhancing decision-making in healthcare. In this paper, we argue that instead of straightforwardly enhancing the decision-making capabilities of clinicians and healthcare institutions, deploying machines learning algorithms entails trade-offs at the epistemic and the normative level. Whereas involving machine learning might improve the accuracy of medical (...) diagnosis, it comes at the expense of opacity when trying to assess the reliability of given diagnosis. Drawing on literature in social epistemology and moral responsibility, we argue that the uncertainty in question potentially undermines the epistemic authority of clinicians. Furthermore, we elucidate potential pitfalls of involving machine learning in healthcare with respect to paternalism, moral responsibility and fairness. At last, we discuss how the deployment of machine learning algorithms might shift the evidentiary norms of medical diagnosis. In this regard, we hope to lay the grounds for further ethical reflection of the opportunities and pitfalls of machine learning for enhancing decision-making in healthcare. (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 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)

As the use of algorithmic decision‐making becomes more commonplace, so too does the worry that these algorithms are often inscrutable and our use of them is a threat to our agency. Since we do not understand why an inscrutable process recommends one option over another, we lose our ability to judge whether the guidance is appropriate and are vulnerable to being led astray. In response, I claim that a process being inscrutable does not automatically make its guidance inappropriate. This phenomenon (...) is not restricted to algorithms, and there are many social processes which we should conform to but are similarly unable to judge for ourselves. I provide a framework for how we can depend on inscrutable processes by introducing a distinction between knowing conformity (where I understand what justifies the guidance) from mere conformity (where I merely do what I am told) and showing how mere conformity is often positively valuable because it allows for extended processes that in turn allow us to accomplish more than we could on our own. This is in effect a division of deliberative labour, which I argue is something commonplace but not often recognised, of which algorithmic guidance can be an example. (shrink)

In this article, we develop the concept of Transparency by Design that serves as practical guidance in helping promote the beneficial functions of transparency while mitigating its challenges in automated-decision making environments. With the rise of artificial intelligence and the ability of AI systems to make automated and self-learned decisions, a call for transparency of how such systems reach decisions has echoed within academic and policy circles. The term transparency, however, relates to multiple concepts, fulfills many functions, and holds different (...) promises that struggle to be realized in concrete applications. Indeed, the complexity of transparency for ADM shows tension between transparency as a normative ideal and its translation to practical application. To address this tension, we first conduct a review of transparency, analyzing its challenges and limitations concerning automated decision-making practices. We then look at the lessons learned from the development of Privacy by Design, as a basis for developing the Transparency by Design principles. Finally, we propose a set of nine principles to cover relevant contextual, technical, informational, and stakeholder-sensitive considerations. Transparency by Design is a model that helps organizations design transparent AI systems, by integrating these principles in a step-by-step manner and as an ex-ante value, not as an afterthought. (shrink)

Although prediction has been largely absent from discussions of explanation for the past 40 years, theories of explanation can gain much from a reintroduction. I review the history that divorced prediction from explanation, examine the proliferation of models of explanation that followed, and argue that accounts of explanation have been impoverished by the neglect of prediction. Instead of a revival of the symmetry thesis, I suggest that explanation should be understood as a cognitive tool that assists us in generating new (...) predictions. This view of explanation and prediction clarifies what makes an explanation scientific and why inference to the best explanation makes sense in science. *Received August 2009; revised September 2009. †To contact the author, please write to: Department of Philosophy, University of Tennessee, 801 McClung Tower, Knoxville, TN 37920‐0480; e‐mail: [email protected]. (shrink)

Advanced AI systems are rapidly making their way into medical research and practice, and, arguably, it is only a matter of time before they will surpass human practitioners in terms of accuracy, reliability, and knowledge. If this is true, practitioners will have a prima facie epistemic and professional obligation to align their medical verdicts with those of advanced AI systems. However, in light of their complexity, these AI systems will often function as black boxes: the details of their contents, calculations, (...) and procedures cannot be meaningfully understood by human practitioners. When AI systems reach this level of complexity, we can also speak of black-box medicine. In this paper, we want to argue that black-box medicine conflicts with core ideals of patient-centered medicine. In particular, we claim, black-box medicine is not conducive for supporting informed decision-making based on shared information, shared deliberation, and shared mind between practitioner and patient. (shrink)

Transparency is now a fundamental principle for data processing under the General Data Protection Regulation. We explore what this requirement entails for artificial intelligence and automated decision-making systems. We address the topic of transparency in artificial intelligence by integrating legal, social, and ethical aspects. We first investigate the ratio legis of the transparency requirement in the General Data Protection Regulation and its ethical underpinnings, showing its focus on the provision of information and explanation. We then discuss the pitfalls with respect (...) to this requirement by focusing on the significance of contextual and performative factors in the implementation of transparency. We show that human–computer interaction and human-robot interaction literature do not provide clear results with respect to the benefits of transparency for users of artificial intelligence technologies due to the impact of a wide range of contextual factors, including performative aspects. We conclude by integrating the information- and explanation-based approach to transparency with the critical contextual approach, proposing that transparency as required by the General Data Protection Regulation in itself may be insufficient to achieve the positive goals associated with transparency. Instead, we propose to understand transparency relationally, where information provision is conceptualized as communication between technology providers and users, and where assessments of trustworthiness based on contextual factors mediate the value of transparency communications. This relational concept of transparency points to future research directions for the study of transparency in artificial intelligence systems and should be taken into account in policymaking. (shrink)

Recent work on interpretability in machine learning and AI has focused on the building of simplified models that approximate the true criteria used to make decisions. These models are a useful pedagogical device for teaching trained professionals how to predict what decisions will be made by the complex system, and most importantly how the system might break. However, when considering any such model it’s important to remember Box’s maxim that "All models are wrong but some are useful." We focus on (...) the distinction between these models and explanations in philosophy and sociology. These models can be understood as a "do it yourself kit" for explanations, allowing a practitioner to directly answer "what if questions" or generate contrastive explanations without external assistance. Although a valuable ability, giving these models as explanations appears more difficult than necessary, and other forms of explanation may not have the same trade-offs. We contrast the different schools of thought on what makes an explanation, and suggest that machine learning might benefit from viewing the problem more broadly. (shrink)

This article described three heuristics that are employed in making judgements under uncertainty: representativeness, which is usually employed when people are asked to judge the probability that an object or event A belongs to class or process B; availability of instances or scenarios, which is often employed when people are asked to assess the frequency of a class or the plausibility of a particular development; and adjustment from an anchor, which is usually employed in numerical prediction when a relevant value (...) is available. These heuristics are highly economical and usually effective, but they lead to systematic and predictable errors. A better understanding of these heuristics and of the biases to which they lead could improve judgements and decisions in situations of uncertainty. (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)