Dimensions of autonomy in human–algorithm relations

Abstract

This article reorients research on agentic engagements with algorithms from the perspective of autonomy. We separate two horizons of algorithmic relations – the instrumental and the intimate – and analyse how they shape different dimensions of autonomous agency. Against the instrumental horizon, algorithmic systems are technical procedures ordering social life at a distance and using rules that can only partly be known. Autonomy is activated as reflective and informed choice and the ability to enact one’s goals and values amid technological constraints. Meanwhile, the intimate horizon highlights affective aspects of autonomy in relation to algorithmic systems as they creep ever closer to our minds and bodies. Here, quests for autonomy arise from disturbance and comfort in a position of vulnerability. We argue that the dimensions of autonomy guide us towards issues of specific ethical and political importance, given that autonomy is never merely a theoretical concern, but also a public value.

The robot butler: How and why should we study predictive algorithms and artificial intelligence (AI) in healthcare?

“…34 We might understand the cardiologist's insistence on the algorithm as ‘just a tool’ as a way of keeping at a distance the unpleasant feeling that algorithms might erode clinicians’ epistemic authority over their actions and choices and thus give rise to uncertainty about ‘who is the one deciding’. 21 , 35 Henning confirmed this view by responding: ‘Nothing has been taken from us – we’ll just feel better [when making decisions]’. In other words, while welcoming technological tools that might enhance their practice through automated data processing, cardiologists hold on to the value that their decisions should be ‘their own’.…”

“…One of the major concerns voiced by critics and in scholarship on AI is whether artificial forms of reasoning erode human agency and autonomy. 15 , 21 , 33 At a hospital in the Capital Region, a cardiologist responded to Henning's presentation of the PMHnet algorithm with a mix of enthusiasm and concern, saying: ‘The day the algorithm decides whether I should treat the patient with beta-blockers, we [ cardiologists ] are no longer needed. But this [the PMHnet algorithm] is still a tool’.…”

“…Autonomous agency and self-determination are thus not qualities cardiologists can possess, but rather situational achievements that must be re-negotiated in practice on an ongoing basis in the face of new technologies and, particularly, artificial modes of reasoning. 21 , 37 As Figures 1 and 2 demonstrate, visualization techniques are applied to help clinicians use algorithmic risk predictions in a meaningful way when they make decisions and communicate with patients. 38 , 39 The question for further inquiries is therefore not if algorithms reconfigure human agency but rather how they do it: How does the information provided by algorithms inform and shape the decisions of clinicians?…”

“…Empirically, we draw upon ethnographic engagements in the international, Danish-led research project, PM Heart, which since 2019 has developed the PMHnet algorithm and built the software into the EHR system used in Eastern Denmark; that is, in two out of Denmark's five regions responsible for hospital care (the Capital Region and Region Zealand). While our study cannot provide insights into the actual clinical use of the PMHnet algorithm, we pay close empirical attention to both alignment and friction in human-algorithm relations 21 by taking seriously the hopes and concerns of the clinicians who will have to embrace and adapt to AI tools in their everyday work of diagnosing and treating patients. In so doing, our analyses elicit significant methodological questions meriting special attention in future ethnographic explorations of how AI and advanced algorithms are put to use in the healthcare system, with what implications, and for whom.…”

Measuring serendipity with altmetrics and randomness

“…Could it be that opaque Twitter algorithms will interfere with the intended mechanisms, disturbing the machine such that the bot’s postings reach different audiences based on user-targeted algorithms unbeknownst to the public (cf. Gillespie, 2014; Savolainen and Ruckenstein, 2022: 13)?…”