A Commentary on "Does Black Box AI In Medicine Compromise Informed Consent"

A recent series of papers have challenged whether black box AI challenges informed consent. Director has most recently argued that the explicit canonical view of informed consent and the implicit view held by bioethicists neglects a crucial distinction between first-order and higher-order evidence needed to show that black box AI does not threaten efficacious consent. I believe a charitable reconstruction of the canonical view and the implicit view held by bioethicists does not neglect the crucial distinction and, indeed, many clear cases of informed consent involve a notable lack of first-order information but a wealth of second-order information. Thus, it most reasonable to interpret the ‘informed’ portion of ‘informed consent’ as (i) relative to what we know, and (ii) inclusive of both first- and higher-order information. This strengthens the argument for Director’s conclusions about black box AI: its purported threat to informed consent are instead worries about the reliability of black box AI.