Nov 8 2018
Artificial intelligence platforms mimic human intelligence by learning, reasoning, and self-correction. Compared to doctors, this technology shows the potential to be more accurate at making diagnoses and executing surgical interventions, says Jörg Goldhahn, MD, MAS, deputy head of the Institute for Translational Medicine at ETH Zurich, Switzerland.
It has a “near unlimited capacity” for data processing and subsequent learning, and can accomplish this at a speed that humans cannot challenge.
Increasing amounts of health data from apps, electronic medical records, personal monitoring devices, and social media platforms are being collated to offer machines as much information as possible about people and their illnesses. Simultaneously, machines are “reading” and taking account of the quickly growing scientific literature.
The notion that today's physicians could approximate this knowledge by keeping abreast of current medical research while maintaining close contacts with their patients is an illusion not least because of the sheer volume of data.
Jörg Goldhahn, MD, MAS, Deputy Head of the Institute for Translational Medicine, ETH Zurich, Switzerland.
Machine learning is also not inclined to the same level of potential prejudice seen in human learning that reflects cultural influences and relates to specific institutions, for instance.
While the ability to develop relationships with patients is frequently presented as an argument in support of human doctors, this may also be their “Achilles heel”, Goldhahn highlights. Trust is crucial to patients but machines and systems can be more trustworthy than humans if they can be seen as unprejudiced and without conflicts of interest.
Moreover, some patients, especially younger ones and those with minor conditions, may rate precise diagnosis higher than continuity of care or empathy, he says. “In some very personal situations, the services of a robot could help patients avoid feeling shame.
The main challenges for present-day healthcare systems are increasing costs and inadequate numbers of doctors.
Introducing AI-driven systems could be cheaper than hiring and training new staff. They are also universally available, and can even monitor patients remotely. Doctors as we now know them will become obsolete eventually.
Jörg Goldhahn, MD, MAS, Deputy Head of the Institute for Translational Medicine, ETH Zurich, Switzerland.
But Vanessa Rampton at the McGill Institute for Health and Social Policy in Montréal, Canada and Professor Giatgen Spinas at University Hospital in Zürich, Switzerland, state that machines will never substitute doctors completely because the inter-relational quality of the doctor-patient relationship is essential and cannot be replicated.
They agree that machines will progressively be able to do tasks that human doctors accomplish at present, such as diagnosis and treatment, but say doctors will remain as they are adept at handling with the patient as a whole person.
Doctors can associate with the patient as a fellow human being and can gather holistic knowledge of their sickness as it relates to the patient's life, they explain.
A doctor-patient relationship where the doctor thinks laterally and takes into consideration an individual patient's values, preferences, and social circumstances is vital for healing, especially for complex conditions, when there are symptoms with no apparent cause, and if there is a high risk of unfavorable effects.
“Feeling they've been heard by someone who understands the seriousness of the problem and whom they can trust can be crucial for patients,” Rampton and Spinas argue.
“Computers aren't able to care for patients in the sense of showing devotion or concern for the other as a person, because they are not people and do not care about anything. Sophisticated robots might show empathy as a matter of form, just as humans might behave nicely in social situations yet remain emotionally disengaged because they are only performing a social role.”
Most significantly there will be no cure for some patients—care will be about assisting them to have the best quality of life possible with their condition and for the maximum period of time. “Here doctors are irreplaceable,” they emphasize. “Robots cannot understand our concern with relating illness to the task of living a life.”
Regulated and well-executed, machines that learn have the potential to offer massive benefit to patients, however, who wants to receive a terminal diagnosis from a robot, ask Michael Mittelman and colleagues in a patient commentary?
“Patients need to be cared for by people, especially when we are ill and at our most vulnerable. A machine will never be able to show us true comfort,” they say.
They admit that AI may have the potential to become an extremely useful and advanced aide in healthcare, but they hope there will always be space for humanity—human healthcare specialists.
“Ultimately, no one wants to be told he or she is dying by an entity that can have no understanding of what that means. We see AI as the servant rather than the director of our medical care,” they explain.
Source: http://www.bmj.com