This paper develops an account of the opacity problem in medical machine learning (ML). Guided by pragmatist assumptions, I argue that opacity in ML models is problematic insofar as it potentially undermines the achievement of two key purposes: ensuring generalizability and optimizing clinician–machine decision-making. Three opacity amelioration strategies are examined, with explainable artificial intelligence (XAI) as the predominant approach, challenged by two revisionary strategies in the form of reliabilism and the interpretability by design. Comparing the three strategies, I argue that (...) interpretability by design is most promising to overcome opacity in medical ML. Looking beyond the individual opacity amelioration strategies, the paper also contributes to a deeper understanding of the problem space and the solution space regarding opacity in medical ML. (shrink)

Deep neural networks have become increasingly successful in applications from biology to cosmology to social science. Trained DNNs, moreover, correspond to models that ideally allow the prediction of new phenomena. Building in part on the literature on ‘eXplainable AI’, I here argue that these models are instrumental in a sense that makes them non-explanatory, and that their automated generation is opaque in a unique way. This combination implies the possibility of an unprecedented gap between discovery and explanation: When unsupervised models (...) are successfully used in exploratory contexts, scientists face a whole new challenge in forming the concepts required for understanding underlying mechanisms. (shrink)

The difficulty of explaining the outputs of artificial intelligence (AI) models and what has led to them is a notorious ethical problem wherever these technologies are applied, including in the medical domain, and one that has no obvious solution. This paper examines the proposal, made by Luciano Floridi and colleagues, to include a new ‘principle of explicability’ alongside the traditional four principles of bioethics that make up the theory of ‘principlism’. It specifically responds to a recent set of criticisms that (...) challenge the supposed need for such a principle to perform an enabling role in relation to the traditional four principles and therefore suggest that these four are sufficient without the addition of explicability. The paper challenges the critics’ premise that explicability cannot be an ethical principle like the classic four because it is explicitly subordinate to them. It argues instead that principlism in its original formulation locates the justification for ethical principles in a midlevel position such that they mediate between the most general moral norms and the contextual requirements of medicine. This conception of an ethical principle then provides a mold for an approach to explicability on which it functions as an enabling principle that unifies technical/epistemic demands on AI and the requirements of high-level ethical theories. The paper finishes by anticipating an objection that decision-making by clinicians and AI fall equally, but implausibly, under the principle of explicability’s scope, which it rejects on the grounds that human decisions, unlike AI’s, can be explained by their social environments. (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)