Brent Mittelstadt

Empirical research into the ethics of emerging technologies, often involving foresight studies, technology assessment or application of the precautionary principle, raises significant epistemological challenges by failing to explain the relative epistemic status of contentious normative claims about future states. This weakness means that it is unclear why the conclusions reached by these approaches should be considered valid, for example in anticipatory ethical assessment or governance of emerging technologies. This paper explains and responds to this problem by proposing an account of how the epistemic status of uncertain normative claims can be established in ethical and political discourses based on Jürgen Habermas’ discourse ethics. To better understand the nature of the problem, the relationship between norms, facts and the future is explored in light of potential meta-ethical fallacies faced in the field of empirical ethics. Weaknesses of current approaches to anticipatory ethical assessment and governance are then explored, including the Precautionary Principle and Technology Assessment. We argue that the epistemic status of uncertain normative claims can be understood within Habermas’ approach to political discourse, which requires ‘translation’ of uncertain claims to be comprehensible to other stakeholders in discourse. Translation thus provides a way to allow for uncertain normative claims to be considered alongside other types of validity claims in discourse. The paper contributes a conceptual account of the epistemic status of uncertain normative claims in discourse and begins to develop a ‘methodology of translation’ which can be further developed for approaches to research and ethical assessment supporting anticipatory evidence-based policy, governance and system design

Artificial intelligence (AI) is increasingly relied upon by clinicians for making diagnostic and treatment decisions, playing an important role in imaging, diagnosis, risk analysis, lifestyle monitoring, and health information management. While research has identified biases in healthcare AI systems and proposed technical solutions to address these, we argue that effective solutions require human engagement. Furthermore, there is a lack of research on how to motivate the adoption of these solutions and promote investment in designing AI systems that align with values such as transparency and fairness from the outset. Drawing on insights from psychological theories, we assert the need to understand the values that underlie decisions made by individuals involved in creating and deploying AI systems. We describe how this understanding can be leveraged to increase engagement with de-biasing and fairness-enhancing practices within the AI healthcare industry, ultimately leading to sustained behavioral change via autonomy-supportive communication strategies rooted in motivational and social psychology theories. In developing these pathways to engagement, we consider the norms and needs that govern the AI healthcare domain, and we evaluate incentives for maintaining the status quo against economic, legal, and social incentives for behavior change in line with transparency and fairness values.

Online targeting isolates individual consumers, causing what we call epistemic fragmentation. This phenomenon amplifies the harms of advertising and inflicts structural damage to the public forum. The two natural strategies to tackle the problem of regulating online targeted advertising, increasing consumer awareness and extending proactive monitoring, fail because even sophisticated individual consumers are vulnerable in isolation, and the contextual knowledge needed for effective proactive monitoring remains largely inaccessible to platforms and external regulators. The limitations of both consumer awareness and of proactive monitoring strategies can be attributed to their failure to address epistemic fragmentation. We call attention to a third possibility that we call a civic model of governance for online targeted advertising, which overcomes this problem, and describe four possible pathways to implement this model.

Firms are increasingly personalising their offers and services, leading to an ever finer-grained segmentation of consumers online. Targeted online advertising and online price discrimination are salient examples of this development. While personalisation's overall effects on consumer welfare are expectably ambiguous, it can lead to concentration in the distribution of advertising and commercial offers. Constellations are possible in which a market is generally open to competition, but the targeted consumer is only made aware of one possible seller. For the consumer, such a market could effectively resemble a monopoly. We call such extreme cases ‘targeting pockets’. Competition-law metrics such as the Herfindahl–Hirschman Index and traditional means of public oversight of adverts would not detect this concentration. We, therefore, suggest a novel metric, the Concentration-after-Personalisation Index (CAPI). The CAPI treats every consumer as a separate ‘market’, computes a measure of concentration for personalised adverts and offers for each individual consumer separately, and then averages the result to measure the exposure experienced by an average consumer. We demonstrate how the CAPI can serve as a monitoring tool for regulators and auditors and thus help to enforce existing consumer law as well as proposed new regulations such as the European Union's Digital Services Act and its Artificial Intelligence Act. We further show how adding noise via randomly distributed non-personalised adverts can dilute the potential harm of overly concentrated personalisation. We demonstrate how the CAPI can identify the optimal degree of added noise, balancing the protection of consumer choice with the economic interests of advertisers.

This book presents cutting edge research on the new ethical challenges posed by biomedical Big Data technologies and practices. 'Biomedical Big Data' refers to the analysis of aggregated, very large datasets to improve medical knowledge and clinical care. The book describes the ethical problems posed by aggregation of biomedical datasets and re-use/re-purposing of data, in areas such as privacy, consent, professionalism, power relationships, and ethical governance of Big Data platforms. Approaches and methods are discussed that can be used to address these problems to achieve the appropriate balance between the social goods of biomedical Big Data research and the safety and privacy of individuals. Seventeen original contributions analyse the ethical, social and related policy implications of the analysis and curation of biomedical Big Data, written by leading experts in the areas of biomedical research, medical and technology ethics, privacy, governance and data protection. The book advances our understanding of the ethical conundrums posed by biomedical Big Data, and shows how practitioners and policy-makers can address these issues going forward.

The capacity to collect and analyse data is growing exponentially. Referred to as ‘Big Data’, this scientific, social and technological trend has helped create destabilising amounts of information, which can challenge accepted social and ethical norms. Big Data remains a fuzzy idea, emerging across social, scientific, and business contexts sometimes seemingly related only by the gigantic size of the datasets being considered. As is often the case with the cutting edge of scientific and technological progress, understanding of the ethical implications of Big Data lags behind. In order to bridge such a gap, this article systematically and comprehensively analyses academic literature concerning the ethical implications of Big Data, providing a watershed for future ethical investigations and regulations. Particular attention is paid to biomedical Big Data due to the inherent sensitivity of medical information. By means of a meta-analysis of the literature, a thematic narrative is provided to guide ethicists, data scientists, regulators and other stakeholders through what is already known or hypothesised about the ethical risks of this emerging and innovative phenomenon. Five key areas of concern are identified: informed consent, privacy, ownership, epistemology and objectivity, and ‘Big Data Divides’ created between those who have or lack the necessary resources to analyse increasingly large datasets. Critical gaps in the treatment of these themes are identified with suggestions for future research. Six additional areas of concern are then suggested which, although related have not yet attracted extensive debate in the existing literature. It is argued that they will require much closer scrutiny in the immediate future: the dangers of ignoring group-level ethical harms; the importance of epistemology in assessing the ethics of Big Data; the changing nature of fiduciary relationships that become increasingly data saturated; the need to distinguish between ‘academic’ and ‘commercial’ Big Data practices in terms of potential harm to data subjects; future problems with ownership of intellectual property generated from analysis of aggregated datasets; and the difficulty of providing meaningful access rights to individual data subjects that lack necessary resources. Considered together, these eleven themes provide a thorough critical framework to guide ethical assessment and governance of emerging Big Data practices

In information societies, operations, decisions and choices previously left to humans are increasingly delegated to algorithms, which may advise, if not decide, about how data should be interpreted and what actions should be taken as a result. More and more often, algorithms mediate social processes, business transactions, governmental decisions, and how we perceive, understand, and interact among ourselves and with the environment. Gaps between the design and operation of algorithms and our understanding of their ethical implications can have severe consequences affecting individuals as well as groups and whole societies. This paper makes three contributions to clarify the ethical importance of algorithmic mediation. It provides a prescriptive map to organise the debate. It reviews the current discussion of ethical aspects of algorithms. And it assesses the available literature in order to identify areas requiring further work to develop the ethics of algorithms.

This book presents cutting edge research on the new ethical challenges posed by biomedical Big Data technologies and practices. ‘Biomedical Big Data’ refers to the analysis of aggregated, very large datasets to improve medical knowledge and clinical care. The book describes the ethical problems posed by aggregation of biomedical datasets and re-use/re-purposing of data, in areas such as privacy, consent, professionalism, power relationships, and ethical governance of Big Data platforms. Approaches and methods are discussed that can be used to address these problems to achieve the appropriate balance between the social goods of biomedical Big Data research and the safety and privacy of individuals. Seventeen original contributions analyse the ethical, social and related policy implications of the analysis and curation of biomedical Big Data, written by leading experts in the areas of biomedical research, medical and technology ethics, privacy, governance and data protection. The book advances our understanding of the ethical conundrums posed by biomedical Big Data, and shows how practitioners and policy-makers can address these issues going forward.

Since approval of the EU General Data Protection Regulation (GDPR) in 2016, it has been widely and repeatedly claimed that the GDPR will legally mandate a ‘right to explanation’ of all decisions made by automated or artificially intelligent algorithmic systems. This right to explanation is viewed as an ideal mechanism to enhance the accountability and transparency of automated decision-making. However, there are several reasons to doubt both the legal existence and the feasibility of such a right. In contrast to the right to explanation of specific automated decisions claimed elsewhere, the GDPR only mandates that data subjects receive meaningful, but properly limited, information (Articles 13-15) about the logic involved, as well as the significance and the envisaged consequences of automated decision-making systems, what we term a ‘right to be informed’. Further, the ambiguity and limited scope of the ‘right not to be subject to automated decision-making’ contained in Article 22 (from which the alleged ‘right to explanation’ stems) raises questions over the protection actually afforded to data subjects. These problems show that the GDPR lacks precise language as well as explicit and well-defined rights and safeguards against automated decision-making, and therefore runs the risk of being toothless. We propose a number of legislative and policy steps that, if taken, may improve the transparency and accountability of automated decision-making when the GDPR comes into force in 2018.

In October 2016, the White House, the European Parliament, and the UK House of Commons each issued a report outlining their visions on how to prepare society for the widespread use of artificial intelligence. In this article, we provide a comparative assessment of these three reports in order to facilitate the design of policies favourable to the development of a ‘good AI society’. To do so, we examine how each report addresses the following three topics: the development of a ‘good AI society’; the role and responsibility of the government, the private sector, and the research community in pursuing such a development; and where the recommendations to support such a development may be in need of improvement. Our analysis concludes that the reports address adequately various ethical, social, and economic topics, but come short of providing an overarching political vision and long-term strategy for the development of a ‘good AI society’. In order to contribute to fill this gap, in the conclusion we suggest a two-pronged approach.

In ‘Represent me: please! Towards an ethics of digital twins in medicine’,1 Braun analyses the potential for simulations of human organs and bodies, or ‘digital twins,’ to faithfully a person. Drawing from several French philosophers, he introduces ‘first conditions for digital twins to take on an ethically justifiable form of representation’.1 The analysis predominantly focuses on challenges that arise in terms of representation, embodiment, control by the patients after which the twin is modelled. Many challenges are posited on the existence of digital twins as autonomous technologies capable of acting on behalf of the patient. One may be reasonably sceptical about the potential to achieve ‘digital twins’ in the near future; the author, to his credit, acknowledges this fact in the section ‘Simulating a precise efficacy’ while still providing a faithful overview of a nascent field of development. Given the state of development described in the paper, the risk of autonomous digital twins in the near future seems remote. There are two clear ethical risks of digital twin which, to my reading, deserve more attention than they receive in Braun’s analysis. Let us refer to these as the ‘near-term’ challenges of digital twins, in the sense that their significance does not turn on the degree of agency or embodiment of digital twins, but rather their mere existence and potential …

This paper poses the question of whether people have a duty to participate in digital epidemiology. While an implied duty to participate has been argued for in relation to biomedical research in general, digital epidemiology involves processing of non-medical, granular and proprietary data types that pose different risks to participants. We first describe traditional justifications for epidemiology that imply a duty to participate for the general public, which take account of the immediacy and plausibility of threats, and the identifiability of data. We then consider how these justifications translate to digital epidemiology, understood as an evolution of traditional epidemiology that includes personal and proprietary digital data alongside formal medical datasets. We consider the risks imposed by re-purposing such data for digital epidemiology and propose eight justificatory conditions that should be met in justifying a duty to participate for specific digital epidemiological studies. The conditions are then applied to three hypothetical cases involving usage of social media data for epidemiological purposes. We conclude with a list of questions to be considered in public negotiations of digital epidemiology, including the application of a duty to participate to third-party data controllers, and the important distinction between moral and legal obligations to participate in research.

Recent work on interpretability in machine learning and AI has focused on the building of simplified models that approximate the true criteria used to make decisions. These models are a useful pedagogical device for teaching trained professionals how to predict what decisions will be made by the complex system, and most importantly how the system might break. However, when considering any such model it’s important to remember Box’s maxim that "All models are wrong but some are useful." We focus on the distinction between these models and explanations in philosophy and sociology. These models can be understood as a "do it yourself kit" for explanations, allowing a practitioner to directly answer "what if questions" or generate contrastive explanations without external assistance. Although a valuable ability, giving these models as explanations appears more difficult than necessary, and other forms of explanation may not have the same trade-offs. We contrast the different schools of thought on what makes an explanation, and suggest that machine learning might benefit from viewing the problem more broadly.

The internet of things is increasingly spreading into the domain of medical and social care. Internet-enabled devices for monitoring and managing the health and well-being of users outside of traditional medical institutions have rapidly become common tools to support healthcare. Health-related internet of things (H-IoT) technologies increasingly play a key role in health management, for purposes including disease prevention, real-time tele-monitoring of patient’s functions, testing of treatments, fitness and well-being monitoring, medication dispensation, and health research data collection. H-IoT promises many benefits for health and healthcare. However, it also raises a host of ethical problems stemming from the inherent risks of Internet enabled devices, the sensitivity of health-related data, and their impact on the delivery of healthcare. This paper maps the main ethical problems that have been identified by the relevant literature and identifies key themes in the on-going debate on ethical problems concerning H-IoT.

The conjunction of wireless computing, ubiquitous Internet access, and the miniaturisation of sensors have opened the door for technological applications that can monitor health and well-being outside of formal healthcare systems. The health-related Internet of Things (H-IoT) increasingly plays a key role in health management by providing real-time tele-monitoring of patients, testing of treatments, actuation of medical devices, and fitness and well-being monitoring. Given its numerous applications and proposed benefits, adoption by medical and social care institutions and consumers may be rapid. However, a host of ethical concerns are also raised that must be addressed. The inherent sensitivity of health-related data being generated and latent risks of Internet-enabled devices pose serious challenges. Users, already in a vulnerable position as patients, face a seemingly impossible task to retain control over their data due to the scale, scope and complexity of systems that create, aggregate, and analyse personal health data. In response, the H-IoT must be designed to be technologically robust and scientifically reliable, while also remaining ethically responsible, trustworthy, and respectful of user rights and interests. To assist developers of the H-IoT, this paper describes nine principles and nine guidelines for ethical design of H-IoT devices and data protocols.

Mature information societies are characterised by mass production of data that provide insight into human behaviour. Analytics has arisen as a practice to make sense of the data trails generated through interactions with networked devices, platforms and organisations. Persistent knowledge describing the behaviours and characteristics of people can be constructed over time, linking individuals into groups or classes of interest to the platform. Analytics allows for a new type of algorithmically assembled group to be formed that does not necessarily align with classes or attributes already protected by privacy and anti-discrimination law or addressed in fairness- and discrimination-aware analytics. Individuals are linked according to offline identifiers and shared behavioural identity tokens, allowing for predictions and decisions to be taken at a group rather than individual level. This article examines the ethical significance of such ad hoc groups in analytics and argues that the privacy interests of algorithmically assembled groups in inviolate personality must be recognised alongside individual privacy rights. Algorithmically grouped individuals have a collective interest in the creation of information about the group, and actions taken on its behalf. Group privacy is proposed as a third interest to balance alongside individual privacy and social, commercial and epistemic benefits when assessing the ethical acceptability of analytics platforms.

Personal Health Monitoring (PHM) uses electronic devices which monitor and record health-related data outside a hospital, usually within the home. This paper examines the ethical issues raised by PHM. Eight themes describing the ethical implications of PHM are identified through a review of 68 academic articles concerning PHM. The identified themes include privacy, autonomy, obtrusiveness and visibility, stigma and identity, medicalisation, social isolation, delivery of care, and safety and technological need. The issues around each of these are discussed. The system / lifeworld perspective of Habermas is applied to develop an understanding of the role of PHMs as mediators of communication between the institutional and the domestic environment. Furthermore, links are established between the ethical issues to demonstrate that the ethics of PHM involves a complex network of ethical interactions. The paper extends the discussion of the critical effect PHMs have on the patient’s identity and concludes that a holistic understanding of the ethical issues surrounding PHMs will help both researchers and practitioners in developing effective PHM implementations.