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)

This essay warns of eroding accountability in computerized societies. It argues that assumptions about computing and features of situations in which computers are produced create barriers to accountability. Drawing on philosophical analyses of moral blame and responsibility, four barriers are identified: 1) the problem of many hands, 2) the problem of bugs, 3) blaming the computer, and 4) software ownership without liability. The paper concludes with ideas on how to reverse this trend.

Traditionally, the manufacturer/operator of a machine is held (morally and legally) responsible for the consequences of its operation. Autonomous, learning machines, based on neural networks, genetic algorithms and agent architectures, create a new situation, where the manufacturer/operator of the machine is in principle not capable of predicting the future machine behaviour any more, and thus cannot be held morally responsible or liable for it. The society must decide between not using this kind of machine any more (which is not a (...) realistic option), or facing a responsibility gap, which cannot be bridged by traditional concepts of responsibility ascription. (shrink)