Chapter 2. Incorporate Societal Context

Technology changes how people behave.1 Twenty years ago, if we saw a person standing on a street corner all alone, arguing loudly and flinging their arms around, we figured they were talking to themselves or even hallucinating. Today, we just assume they’re on the phone.

Likewise, people change how technology behaves. Build a system in-house, test it thoroughly, and it seems to work fine. Then release the system into our complex world, where it interacts with a vast assortment of people, and new and surprising effects may emerge that no one foresaw.

Some of those effects have serious consequences too. The U.S. healthcare industry, for example, commonly uses algorithms to predict the kinds of care a patient might need. One prominent algorithm in the 2010s was designed to reduce healthcare costs, and it was applied to about 200 million people per year, according to a 2019 paper in the journal Science. The algorithm computed a value, called a risk score, ...

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