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)

According to most accounts of trust, you can only trust other people (or groups of people). To trust is to think that another has goodwill, or something to that effect. I sketch a different form of trust: the unquestioning attitude. What it is to trust, in this sense, is to settle one’s mind about something, to stop questioning it. To trust is to rely on a resource while suspending deliberation over its reliability. Trust lowers the barrier of monitoring, challenging, checking, (...) and questioning. Trust sets up open pipelines between yourself and parts of the external world. Trust permits external resources to have a similar relationship to one as one’s internal cognitive faculties. This creates efficiency, but at the price of exquisite vulnerability. We must trust in this way because we are cognitively limited beings in a cognitively overwhelming world. Crucially, we can hold the unquestioning attitude towards objects and technologies. When I trust my climbing rope, I stop worrying about its reliability. When I trust my online calendaring system, I simply go to the events indicated, without question. But, one might worry, how could one ever hold such a normatively loaded attitude as trust towards mere objects? How could it ever make sense to feel betrayed by an object? Trust is our engine for expanding and outsourcing our agency — for binding external processes into our practical selves. Thus, we can be betrayed by our smartphones in the same way that we can be betrayed by our memory. When we trust, we try to make something a part of our agency, and we are betrayed when our part lets us down. To unquestioningly trust something is to let it in—to attempt to bring it inside one’s practical functioning. This suggests a new form of gullibility: agential gullibility, which occurs when agents too hastily and carelessly integrate external resources into their own agency. (shrink)

This paper defends the view that trust is a moral attitude, by putting forward the Obligation-Ascription Thesis: If E trusts F to do X, this implies that E ascribes an obligation to F to do X. I explicate the idea of obligation-ascription in terms of requirement and the appropriateness of blame. Then, drawing a distinction between attitude and ground, I argue that this account of the attitude of trust is compatible with the possibility of amoral trust, that is, trust held (...) among amoral persons on the basis of amoral grounds. It is also compatible with trust adopted on purely predictive grounds. Then, defending the thesis against a challenge of motivational inefficacy, I argue that obligation-ascription can motivate people to act even in the absence of definite, mutually-known agreements. I end by explaining, briefly, the advantages of this sort of moral account of trust over a view based on reactive attitudes such as resentment. (shrink)

In this paper we raise the question whether technological artifacts can properly speaking be trusted or said to be trustworthy. First, we set out some prevalent accounts of trust and trustworthiness and explain how they compare with the engineer’s notion of reliability. We distinguish between pure rational-choice accounts of trust, which do not differ in principle from mere judgments of reliability, and what we call “motivation-attributing” accounts of trust, which attribute specific motivations to trustworthy entities. Then we consider some examples (...) of technological entities that are, at first glance, best suited to serve as the objects of trust: intelligent systems that interact with users, and complex socio-technical systems. We conclude that the motivation-attributing concept of trustworthiness cannot be straightforwardly applied to these entities. Any applicable notion of trustworthy technology would have to depart significantly from the full-blown notion of trustworthiness associated with interpersonal trust. (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)

On the whole, the US Algorithmic Accountability Act of 2022 (US AAA) is a pragmatic approach to balancing the benefits and risks of automated decision systems. Yet there is still room for improvement. This commentary highlights how the US AAA can both inform and learn from the European Artificial Intelligence Act (EU AIA).

In combating the ongoing global health threat of the COVID-19 pandemic, decision-makers have to take actions based on a multitude of relevant health data with severe potential consequences for the affected patients. Because of their presumed advantages in handling and analyzing vast amounts of data, computer systems of algorithmic decision-making are implemented and substitute humans in decision-making processes. In this study, we focus on a specific application of ADM in contrast to human decision-making, namely the allocation of COVID-19 vaccines to (...) the public. In particular, we elaborate on the role of trust and social group preference on the legitimacy of vaccine allocation. We conducted a survey with a 2 × 2 randomized factorial design among n = 1602 German respondents, in which we utilized distinct decision-making agents and prioritization of a specific social group as design factors. Our findings show that general trust in ADM systems and preference for vaccination of a specific social group influence the legitimacy of vaccine allocation. However, contrary to our expectations, trust in the agent making the decision did not moderate the link between social group preference and legitimacy. Moreover, the effect was also not moderated by the type of decision-maker. We conclude that trustworthy ADM systems must not necessarily lead to the legitimacy of ADM systems. (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)

Recent scholarship in philosophy of science and technology has shown that scientific and technological decision making are laden with values, including values of a social, political, and/or ethical character. This paper examines the role of value judgments in the design of machine-learning systems generally and in recidivism-prediction algorithms specifically. Drawing on work on inductive and epistemic risk, the paper argues that ML systems are value laden in ways similar to human decision making, because the development and design of ML systems (...) requires human decisions that involve tradeoffs that reflect values. In many cases, these decisions have significant—and, in some cases, disparate—downstream impacts on human lives. After examining an influential court decision regarding the use of proprietary recidivism-prediction algorithms in criminal sentencing, Wisconsin v. Loomis, the paper provides three recommendations for the use of ML in penal systems. (shrink)

The need for fair and just AI is often related to the possibility of understanding AI itself, in other words, of turning an opaque box into a glass box, as inspectable as possible. Transparency and explainability, however, pertain to the technical domain and to philosophy of science, thus leaving the ethics and epistemology of AI largely disconnected. To remedy this, we propose an integrated approach premised on the idea that a glass-box epistemology should explicitly consider how to incorporate values and (...) other normative considerations, such as intersectoral vulnerabilities, at critical stages of the whole process from design and implementation to use and assessment. To connect ethics and epistemology of AI, we perform a double shift of focus. First, we move from trusting the output of an AI system to trusting the process that leads to the outcome. Second, we move from expert assessment to more inclusive assessment strategies, aiming to facilitate expert and non-expert assessment. Together, these two moves yield a framework usable for experts and non-experts when they inquire into relevant epistemological and ethical aspects of AI systems. We dub our framework ‘epistemology-cum-ethics’ to signal the equal importance of both aspects. We develop it from the vantage point of the designers: how to create the conditions to internalize values into the whole process of design, implementation, use, and assessment of an AI system, in which values (epistemic and non-epistemic) are explicitly considered at each stage and inspectable by every salient actor involved at any moment. (shrink)

The operations of deep networks are widely acknowledged to be inscrutable. The growing field of Explainable AI has emerged in direct response to this problem. However, owing to the nature of the opacity in question, XAI has been forced to prioritise interpretability at the expense of completeness, and even realism, so that its explanations are frequently interpretable without being underpinned by more comprehensive explanations faithful to the way a network computes its predictions. While this has been taken to be a (...) shortcoming of the field of XAI, I argue that it is broadly the right approach to the problem. (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)

Strategies for improving the explainability of artificial agents are a key approach to support the understandability of artificial agents’ decision-making processes and their trustworthiness. However, since explanations are not inclined to standardization, finding solutions that fit the algorithmic-based decision-making processes of artificial agents poses a compelling challenge. This paper addresses the concept of trust in relation to complementary aspects that play a role in interpersonal and human–agent relationships, such as users’ confidence and their perception of artificial agents’ reliability. Particularly, this (...) paper focuses on non-expert users’ perspectives, since users with little technical knowledge are likely to benefit the most from “post-hoc”, everyday explanations. Drawing upon the explainable AI and social sciences literature, this paper investigates how artificial agent’s explainability and trust are interrelated at different stages of an interaction. Specifically, the possibility of implementing explainability as a trust building, trust maintenance and restoration strategy is investigated. To this extent, the paper identifies and discusses the intrinsic limits and fundamental features of explanations, such as structural qualities and communication strategies. Accordingly, this paper contributes to the debate by providing recommendations on how to maximize the effectiveness of explanations for supporting non-expert users’ understanding and trust. (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)

Fueled by ever-growing amounts of (digital) data and advances in artificial intelligence, decision-making in contemporary societies is increasingly delegated to automated processes. Drawing from social science theories and from the emerging body of research about algorithmic appreciation and algorithmic perceptions, the current study explores the extent to which personal characteristics can be linked to perceptions of automated decision-making by AI, and the boundary conditions of these perceptions, namely the extent to which such perceptions differ across media, (public) health, and judicial (...) contexts. Data from a scenario-based survey experiment with a national sample (N = 958) show that people are by and large concerned about risks and have mixed opinions about fairness and usefulness of automated decision-making at a societal level, with general attitudes influenced by individual characteristics. Interestingly, decisions taken automatically by AI were often evaluated on par or even better than human experts for specific decisions. Theoretical and societal implications about these findings are discussed. (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 (AI), 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)

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)

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

The concept of autonomy is crucial for the theoretical characterization of robots and, more in general, complex technological artifacts. The aim of this paper is to provide a conceptual and logical framework in which it is possible to define two concepts of autonomy: autonomy of performance and autonomy of process. The analysis is carried out exploiting the logical resources of the counterfactual semantics-developed by Lewis' and Stalnaker's seminal works-and branching structures of the possible courses of actions. It allows to differentiate (...) the autonomy of a robotic arm from the autonomy of a highly complex machine-like rovers for the explorations of the planets. The clarification of the concept of autonomy is, moreover, an essential precondition for the investigation concerning the ethics of artificial agents. (shrink)