Nicely earlier than the appearance of chat GPT, fashionable tradition has explored how know-how would possibly have an effect on well being care, typically with a dystopian bent.
Take, for instance, the 2013 sci-fi film Elysium, set in 2154 (spoilers forward). Matt Damon’s character, Max, is uncovered to a deadly dose of radiation when his manufacturing unit supervisor threatens to fireside him if he doesn’t carry out a harmful job. As a result of he can’t afford to lose his job, Max does it, however when he steps into the room, his face tells us what is going to occur subsequent. His well being—and life—can be forfeited to the manufacturing line.
Minimize to Max mendacity on a metallic desk, a robotic looming over him. In an digital voice, the robotic/physician tells him he has mere days to reside. This impersonal message is punctuated by the robotic giving Max medicine to a minimum of present some aid from the signs of radiation poisoning. However as an alternative of putting the bottle of tablets in his outstretched hand, the robotic dispassionately drops it onto his physique. The robotic then exits, leaving Max to grapple together with his sudden change of destiny and imminent demise alone.
I considered this film after I learn the April 28, 2023 article in JAMA Inner Medication, “Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum.”
A lot consideration is being paid to the examine’s conclusions that the chatbot responses have been rated extra empathetic. But it surely’s essential to notice that this was not a comparative examine of “chatbot versus human” in real-world situations however sourced from the net social media discussion board Reddit’s r/AskDocs.
ChatGPT and different generative AI chatbots have, in latest months, captured the general public’s creativeness. The JAMA Inner Medication examine additional captures our consideration as a result of its findings upset the longstanding fashionable tradition paradigm of the dystopian robotic physician of the long run, as portrayed in motion pictures similar to Elysium.
Let’s bounce again to the film for a minute. The elite lives on the utopian house station Elysium, which orbits the Earth and supplies a high-tech paradise away from the squalor of a crumbling and unhealthy planet. Any medical situation could be cured on Elysium by mendacity in a therapy chamber coded to the affected person’s DNA. (The film doesn’t clarify how this tech works; it merely exists on this future, and we’re requested to simply accept it). One can simply envision a sort, benevolent, chatGPT-like digital physician becoming right into a future world like Elysium.
However the chambers exist solely on Elysium and never on Earth. The implication is that the wealthy and highly effective have selfishly chosen to not share the know-how with the lowly working lessons left planet-side, even for kids dying of leukemia. And positively not for Max.
The film makes us think about our present world and the place AI will match into well being care. Whether or not as these instruments progress, they are going to be obtainable equally to all. On my latest rewatch, it struck me how the underlying theme appears much more pressing now than when the film got here out ten years in the past: Is well being care essentially a human proper?
Will the long run maintain a utopian mix of human and machine intelligence as some thought leaders, similar to Dr. Eric Topol, writer of the landmark e-book The Patient Will See You Now, envision? Or, as an alternative, a worsening well being care divide alongside class strains as portrayed in dystopian motion pictures similar to Elysium?
Latest articles have uncovered insurance coverage firms’ use of AI algorithms to not maximize the affected person expertise however to maximise their revenue—exhibiting us this dystopia already exists. From AI-driven denials of medical care coverage to seniors on Medicare Advantage to algorithm-driven denials at Cigna that bypassed physician reviews, present proof exhibits us that not all have altruistic targets for AI within the well being care house.
The solutions are unlikely to be easy. In my speculative novel, The Algorithm Will See You Now (just lately revealed however written earlier than the appearance of chatGPT), I discover how each utopian and dystopian outcomes would possibly coexist. The e-book shouldn’t be solely a few potential future for AI in well being care however an exploration of how simply altruism can change into warped in a profit-driven system.
I feel we must be speaking extra about how finally, the restrictions of AI in well being care might not lie within the know-how however in who we give the facility to wield it. The physicians—or the insurance coverage giants. The medical specialists—or the C-suite.
To reply, as a society, whether or not we really consider well being care is a elementary human proper—and act accordingly.
Jennifer Lycette is a novelist, award-winning essayist, rural hematology-oncology doctor, spouse, and mother (to 3 people and two of the canine persuasion). She could be reached on Twitter @JL_Lycette, Mastodon @[email protected], and LinkedIn. Her first novel, The Algorithm Will See You Now (Black Rose Writing Press), a near-future medical thriller, is out in paperback and e book. Her second novel (title and canopy reveal coming quickly!) can be out in November 2023.
