In the medical field, software is used to analyze data to help doctors make clinical decisions and improve patient care. Robots are used to perform complex surgical procedures and make them less invasive. And in China, a robot recently passed the medical licensing exam with flying colors.
Could machines using artificial intelligence one day make doctors obsolete?
According to Dr. Jörg Goldhahn, deputy head of the Institute for Translational Medicine at ETH Zurich, Switzerland, AI has the potential to be more accurate than doctors at making diagnoses and performing surgical interventions. Goldhahn points to the fact that AI has a “near unlimited capacity” for data processing and subsequent learning, at a speed that humans cannot match.
Indeed, the amount of available health data has increased by leaps and bounds in recent years: Information from apps, personal monitoring devices, electronic medical records and social media platforms are being brought together to give machines as much information as possible about people and their diseases. Machines are also learning from their ability to absorb the knowledge of rapidly expanding 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," Goldhahn said.
Human learning is also subject to biases that reflect cultural influences and other factors which do not hold influence over machines. Although the ability to form relationships with patients can be seen as a uniquely human trait, machines could also be considered as more trustworthy than humans because of their ability to remain unbiased and free from conflicts of interest.
For some patients — particularly younger ones and those with minor conditions — the assurance of accurate diagnoses, where machines excel, may be more important than characteristics such as empathy and continuity of care that characterize the human approach.
In addition, key challenges facing today’s healthcare systems include rising costs and insufficient numbers of doctors. “Introducing AI-driven systems could be cheaper than hiring and training new staff,” Goldhahn noted, adding that such systems are universally available and able to monitor patients remotely.
"Doctors as we now know them will become obsolete eventually," Goldhahn said.
Of course, not everyone agrees with this assessment. Vanessa Rampton at the McGill Institute for Health and Social Policy in Montréal and Prof. Giatgen Spinas at University Hospital in Zürich believe that there are vital qualities of the doctor-patient relationship that cannot be replicated by machines. These include an ability to relate to patients as fellow human beings and to gain holistic knowledge of illness as it relates to patients’ lives.
This is particularly relevant for complex conditions, where there are symptoms with no obvious cause or a high risk of adverse effects.
Taking part in a debate on the subject published in the peer-reviewed medical journal BMJ, Rampton and Spinas stated, "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.” While acknowledging that some sophisticated robots might be capable of displaying “empathy,” they characterized this as merely a role they are playing, without true emotional engagement.
Also important is the role doctors play in helping patients with conditions for which there is no cure, where quality of life becomes the focus of care. "Here doctors are irreplaceable," they said. "Robots cannot understand our concern with relating illness to the task of living a life."
A patient commentary by Michael Mittelman, executive director of the American Living Organ Donor Fund, and colleagues, added another voice to the debate. It stated that machines will never be capable of showing “true comfort” — particularly in instances when a patient must be given a terminal diagnosis.
"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," the commentary said.
A BMJ podcast entitled "HAL Will See You Now," which features discussion by Goldhahn, Rampton and Mittelman, is also available.
