Who Gets to Decide What We Trust?

Prior to Alka Menon's presentation “Trust Issues: AI in Medicine and Modern Life”, we were required to read two articles. They seem completely unrelated. One discusses the infiltration of AI in mental healthcare and the other discusses how we measure public trust in science. However, by reading them one after the other, I have a revelation: both have the same question, albeit from different perspectives: Who is responsible for defining trustworthiness?

Mira Vale’s “Building the Moral Infrastructure of Mental Health AI” resonated with me the most. Vale argues that those developing mental health AI technologies, including chatbot therapy applications, are not merely solving ethical problems one by one. They are actually establishing defaults for the entire field prior to the involvement of regulators. An example she gives is the emerging belief that sensor data, such as phone movement or activity, is more trustworthy than patients’ self-reports. Although this might seem like a technical issue, it is primarily a moral issue since this innovation determines which accounts of one’s suffering are considered legitimatized. When this belief is normalized, it becomes a mere fact rather than a decision.

The second reading by Gil Eyal et al. shifts the focus toward us as the public. The authors claim that the common belief that people lose their trust in science is overly simplistic. Questioning a certain threshold of safety does not mean rejecting science entirely. Trust cannot be thought of as something one either has or does not have, but rather as something that is visible in concrete decisions made in particular circumstances.

Combining the two texts, the idea of the lecture changed significantly. I thought 'trust issues' meant people do not believe in their doctors and technology but the readings indicate that the greater issue is that trust is created, calculated and implemented by people whom we do not see. Vale illustrates how trust is created in companies and Eyal - how survey results ruin it.

Thus, one of the most important things I take away from Menon’s speech is a question I want to ponder. When the algorithm or chatbot gains patients' trust in medicine did it really earn it or did someone just decide for them to trust technology?