This paper sets out an account of trust in AI as a relationship between clinicians, AI applications, and AI practitioners in which AI is given discretionary authority over medical questions by clinicians. Compared to other accounts in recent literature, this account more adequately explains the normative commitments created by practitioners when inviting clinicians’ trust in AI. To avoid committing to an account of trust in AI applications themselves, I sketch a reductive view on which discretionary authority is exercised by AI (...) practitioners through the vehicle of an AI application. I conclude with four critical questions based on the discretionary account to determine if trust in particular AI applications is sound, and a brief discussion of the possibility that the main roles of the physician could be replaced by AI. (shrink)

Trust constitutes a fundamental strategy to deal with risks and uncertainty in complex societies. In line with the vast literature stressing the importance of trust in doctor–patient relationships, trust is therefore regularly suggested as a way of dealing with the risks of medical artificial intelligence (AI). Yet, this approach has come under charge from different angles. At least two lines of thought can be distinguished: (1) that trusting AI is conceptually confused, that is, that we cannot trust AI; and (2) (...) that it is also dangerous, that is, that we should not trust AI—particularly if the stakes are as high as they routinely are in medicine. In this paper, we aim to defend a notion of trust in the context of medical AI against both charges. To do so, we highlight the technically mediated intentions manifest in AI systems, rendering trust a conceptually plausible stance for dealing with them. Based on literature from human–robot interactions, psychology and sociology, we then propose a novel model to analyse notions of trust, distinguishing between three aspects: reliability, competence, and intentions. We discuss each aspect and make suggestions regarding how medical AI may become worthy of our trust. (shrink)

The use of black box algorithms in medicine has raised scholarly concerns due to their opaqueness and lack of trustworthiness. Concerns about potential bias, accountability and responsibility, patient autonomy and compromised trust transpire with black box algorithms. These worries connect epistemic concerns with normative issues. In this paper, we outline that black box algorithms are less problematic for epistemic reasons than many scholars seem to believe. By outlining that more transparency in algorithms is not always necessary, and by explaining that (...) computational processes are indeed methodologically opaque to humans, we argue that the reliability of algorithms provides reasons for trusting the outcomes of medical artificial intelligence. To this end, we explain how computational reliabilism, which does not require transparency and supports the reliability of algorithms, justifies the belief that results of medical AI are to be trusted. We also argue that several ethical concerns remain with black box algorithms, even when the results are trustworthy. Having justified knowledge from reliable indicators is, therefore, necessary but not sufficient for normatively justifying physicians to act. This means that deliberation about the results of reliable algorithms is required to find out what is a desirable action. Thus understood, we argue that such challenges should not dismiss the use of black box algorithms altogether but should inform the way in which these algorithms are designed and implemented. When physicians are trained to acquire the necessary skills and expertise, and collaborate with medical informatics and data scientists, black box algorithms can contribute to improving medical care. (shrink)

In his recent article ‘Limits of trust in medical AI,’ Hatherley argues that, if we believe that the motivations that are usually recognised as relevant for interpersonal trust have to be applied to interactions between humans and medical artificial intelligence, then these systems do not appear to be the appropriate objects of trust. In this response, we argue that it is possible to discuss trust in medical artificial intelligence, if one refrains from simply assuming that trust describes human–human interactions. To (...) do so, we consider an account of trust that distinguishes trust from reliance in a way that is compatible with trusting non-human agents. In this account, to trust a medical AI is to rely on it with little monitoring and control of the elements that make it trustworthy. This attitude does not imply specific properties in the AI system that in fact only humans can have. This account of trust is applicable, in particular, to all cases where a physician relies on the medical AI predictions to support his or her decision making. (shrink)

One of the main difficulties in assessing artificial intelligence (AI) is the tendency for people to anthropomorphise it. This becomes particularly problematic when we attach human moral activities to AI. For example, the European Commission’s High-level Expert Group on AI (HLEG) have adopted the position that we should establish a relationship of trust with AI and should cultivate trustworthy AI (HLEG AI Ethics guidelines for trustworthy AI, 2019, p. 35). Trust is one of the most important and defining activities in (...) human relationships, so proposing that AI should be trusted, is a very serious claim. This paper will show that AI cannot be something that has the capacity to be trusted according to the most prevalent definitions of trust because it does not possess emotive states or can be held responsible for their actions—requirements of the affective and normative accounts of trust. While AI meets all of the requirements of the rational account of trust, it will be shown that this is not actually a type of trust at all, but is instead, a form of reliance. Ultimately, even complex machines such as AI should not be viewed as trustworthy as this undermines the value of interpersonal trust, anthropomorphises AI, and diverts responsibility from those developing and using them. (shrink)

Artificial intelligence (AI) is expected to revolutionise the practice of medicine. Recent advancements in the field of deep learning have demonstrated success in variety of clinical tasks: detecting diabetic retinopathy from images, predicting hospital readmissions, aiding in the discovery of new drugs, etc. AI’s progress in medicine, however, has led to concerns regarding the potential effects of this technology on relationships of trust in clinical practice. In this paper, I will argue that there is merit to these concerns, since AI (...) systems can be relied on, and are capable of reliability, but cannot be trusted, and are not capable of trustworthiness. Insofar as patients are required to rely on AI systems for their medical decision-making, there is potential for this to produce a deficit of trust in relationships in clinical practice. (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.

Edmund Gettier is Professor Emeritus at the University of Massachusetts, Amherst. This short piece, published in 1963, seemed to many decisively to refute an otherwise attractive analysis of knowledge. It stimulated a renewed effort, still ongoing, to clarify exactly what knowledge comprises.

I outline a number of parallels between trust and distrust, emphasising the significance of situations in which both trust and distrust would be an imposition upon the (dis)trustee. I develop an account of both trust and distrust in terms of commitment, and argue that this enables us to understand the nature of trustworthiness. Note that this article is available open access on the journal website.

My claim in this article is that, contra what I take to be the orthodoxy in the wider literature, we do trust inanimate objects – per the example in the title, there are cases where people really do trust a ladder (to hold their weight, for instance), and, perhaps most importantly, that this poses a challenge to that orthodoxy. My argument consists of four parts. In Section 2 I introduce an alleged distinction between trust as mere reliance and trust as (...) a rich, morally loaded notion. In the course of doing so, I briefly sketch some models of trust. This will help us to get a handle on how some of the mainstream models of trust preclude or ignore the trusting of inanimate objects. In Section 3 I introduce cases designed to show that we have reason to think that we do trust inanimate objects. In Section 4 I consider an objection, and in Section 5 I discuss some consequences of this finding, before concluding in Section 6. (shrink)

Several philosophical issues in connection with computer simulations rely on the assumption that results of simulations are trustworthy. Examples of these include the debate on the experimental role of computer simulations :483–496, 2009; Morrison in Philos Stud 143:33–57, 2009), the nature of computer data Computer simulations and the changing face of scientific experimentation, Cambridge Scholars Publishing, Barcelona, 2013; Humphreys, in: Durán, Arnold Computer simulations and the changing face of scientific experimentation, Cambridge Scholars Publishing, Barcelona, 2013), and the explanatory power of (...) computer simulations :277–292, 2008; Durán in Int Stud Philos Sci 31:27–45, 2017). The aim of this article is to show that these authors are right in assuming that results of computer simulations are to be trusted when computer simulations are reliable processes. After a short reconstruction of the problem of epistemic opacity, the article elaborates extensively on computational reliabilism, a specified form of process reliabilism with computer simulations located at the center. The article ends with a discussion of four sources for computational reliabilism, namely, verification and validation, robustness analysis for computer simulations, a history of successful implementations, and the role of expert knowledge in simulations. (shrink)

Can we trust robots? Responding to the literature on trust and e-trust, this paper asks if the question of trust is applicable to robots, discusses different approaches to trust, and analyses some preconditions for trust. In the course of the paper a phenomenological-social approach to trust is articulated, which provides a way of thinking about trust that puts less emphasis on individual choice and control than the contractarian-individualist approach. In addition, the argument is made that while robots are neither human (...) nor mere tools, we have sufficient functional, agency-based, appearance-based, social-relational, and existential criteria left to evaluate trust in robots. It is also argued that such evaluations must be sensitive to cultural differences, which impact on how we interpret the criteria and how we think of trust in robots. Finally, it is suggested that when it comes to shaping conditions under which humans can trust robots, fine-tuning human expectations and robotic appearances is advisable. (shrink)

Machine Learning (ML) is on the rise in medicine, promising improved diagnostic, therapeutic and prognostic clinical tools. While these technological innovations are bound to transform health care, they also bring new ethical concerns to the forefront. One particularly elusive challenge regards discriminatory algorithmic judgements based on biases inherent in the training data. A common line of reasoning distinguishes between justified differential treatments that mirror true disparities between socially salient groups, and unjustified biases which do not, leading to misdiagnosis and erroneous (...) treatment. In the curation of training data this strategy runs into severe problems though, since distinguishing between the two can be next to impossible. We thus plead for a pragmatist dealing with algorithmic bias in healthcare environments. By recurring to a recent reformulation of William James’s pragmatist understanding of truth, we recommend that, instead of aiming at a supposedly objective truth, outcome-based therapeutic usefulness should serve as the guiding principle for assessing ML applications in medicine. (shrink)

Bioethics, Volume 36, Issue 2, Page 154-161, February 2022.

Assistive systems based on Artificial Intelligence (AI) are bound to reshape decision-making in all areas of society. One of the most intricate challenges arising from their implementation in high-stakes environments such as medicine concerns their frequently unsatisfying levels of explainability, especially in the guise of the so-called black-box problem: highly successful models based on deep learning seem to be inherently opaque, resisting comprehensive explanations. This may explain why some scholars claim that research should focus on rendering AI systems understandable, rather (...) than explainable. Yet, there is a grave lack of agreement concerning these terms in much of the literature on AI. We argue that the seminal distinction made by the philosopher and physician Karl Jaspers between different types of explaining and understanding in psychopathology can be used to promote greater conceptual clarity in the context of Machine Learning (ML). Following Jaspers, we claim that explaining and understanding constitute multi-faceted epistemic approaches that should not be seen as mutually exclusive, but rather as complementary ones as in and of themselves they are necessarily limited. Drawing on the famous example of Watson for Oncology we highlight how Jaspers’ methodology translates to the case of medical AI. Classical considerations from the philosophy of psychiatry can therefore inform a debate at the centre of current AI ethics, which in turn may be crucial for a successful implementation of ethically and legally sound AI in medicine. (shrink)

Real engines of the artificial intelligence revolution, machine learning models, and algorithms are embedded nowadays in many services and products around us. As a society, we argue it is now necessary to transition into a phronetic paradigm focused on the ethical dilemmas stemming from the conception and application of AIs to define actionable recommendations as well as normative solutions. However, both academic research and society-driven initiatives are still quite far from clearly defining a solid program of study and intervention. In (...) this contribution, we will focus on selected ethical investigations around AI by proposing an incremental model of trust that can be applied to both human-human and human-AI interactions. Starting with a quick overview of the existing accounts of trust, with special attention to Taddeo’s concept of “e-trust,” we will discuss all the components of the proposed model and the reasons to trust in human-AI interactions in an example of relevance for business organizations. We end this contribution with an analysis of the epistemic and pragmatic reasons of trust in human-AI interactions and with a discussion of kinds of normativity in trustworthiness of AIs. (shrink)