Göran Collste

In recent years, a plethora of high-profile scientific publications has been reporting about machine learning algorithms outperforming clinicians in medical diagnosis or treatment recommendations. This has spiked interest in deploying relevant algorithms with the aim of enhancing decision-making in healthcare. In this paper, we argue that instead of straightforwardly enhancing the decision-making capabilities of clinicians and healthcare institutions, deploying machines learning algorithms entails trade-offs at the epistemic and the normative level. Whereas involving machine learning might improve the accuracy of medical diagnosis, it comes at the expense of opacity when trying to assess the reliability of given diagnosis. Drawing on literature in social epistemology and moral responsibility, we argue that the uncertainty in question potentially undermines the epistemic authority of clinicians. Furthermore, we elucidate potential pitfalls of involving machine learning in healthcare with respect to paternalism, moral responsibility and fairness. At last, we discuss how the deployment of machine learning algorithms might shift the evidentiary norms of medical diagnosis. In this regard, we hope to lay the grounds for further ethical reflection of the opportunities and pitfalls of machine learning for enhancing decision-making in healthcare.

For liberalism, values such as respect, reciprocity, and tolerance should frame cultural encounters in multicultural societies. However, it is easy to disregard that power differences and political domination also influence the cultural sphere and the relations between cultural groups. In this essay, I focus on some challenges for cultural pluralism. In relation to Indian political theorist Rajeev Bhargava, I discuss the meaning of cultural domination and epistemic injustice and their historical and moral implications. Bhargava argued that as a consequence of colonialism, “indigenous cultures” were inferiorized, marginalized, and anonymized. Although cultures are often changing due to external influences, I argue that epistemic injustice implies that a culture is forced to subjection, disrespected, and considered as inferior and that it threatens the dominated people’s epistemic framework, collective identity, and existential security. Finally, I refer to John Rawls’s theory of political liberalism as a constructive approach to avoid parochialism and Western cultural domination