There is a current debate about if, and in what sense, machine learning systems used in the medical context need to be explainable. Those arguing in favor contend these systems require post hoc explanations for each individual decision to increase trust and ensure accurate diagnoses. Those arguing against suggest the high accuracy and reliability of the systems is sufficient for providing epistemic justified beliefs without the need for explaining each individual decision. But, as we show, both solutions have limitations—and it (...) is unclear either address the epistemic worries of the medical professionals using these systems. We argue these systems do require an explanation, but an institutional explanation. These types of explanations provide the reasons why the medical professional should rely on the system in practice—that is, they focus on trying to address the epistemic concerns of those using the system in specific contexts and specific occasions. But ensuring that these institutional explanations are fit for purpose means ensuring the institutions designing and deploying these systems are transparent about the assumptions baked into the system. This requires coordination with experts and end-users concerning how it will function in the field, the metrics used to evaluate its accuracy, and the procedures for auditing the system to prevent biases and failures from going unaddressed. We contend this broader explanation is necessary for either post hoc explanations or accuracy scores to be epistemically meaningful to the medical professional, making it possible for them to rely on these systems as effective and useful tools in their practices. (shrink)

This article takes up Winch’s exploration of a certain dialectic in philosophical accounts of social inquiry, the poles of which I refer to as the under-laborer and over-laborer conceptions of philosophy. I argue that these conceptions, shown in Risjord and Reed, respectively, are caught in a dialectic of treating philosophy’s roles as either modestly clarifying or broadly determining the claims of social science. A third conception of philosophy, the therapeutic conception, is exemplified by Read et al.’s “New Wittgensteinian” interpretation of (...) Winch’s work as a way out of the dialectic. Discussing the strengths and weaknesses of the latter, I conclude that a stronger development of the therapeutic approach is needed to move past the dialectic. (shrink)