When Physicians Are Replaced with a Protocol

 The increasing role of artificial intelligence (AI) in medicine and the potential consequences of this shift. While AI technology could bring efficiency, the author highlights the importance of maintaining human accountability and ethical decision-making in medical practice.

1. Understanding AI in Medicine:

• Current claims about AI being "authorized to practice medicine" are misleading. No AI has been formally licensed as a physician, nor can it accept responsibility for patient care or outcomes.

• The real issue is not the presence of AI, but the erosion of the essential link between clinical judgment, human accountability, and moral responsibility in healthcare.

2. Erosion of Accountability:

• Medical practice has historically relied on human judgment and accountability for decisions affecting patients.

• Recent developments in healthcare suggest a gradual shift towards viewing medical judgment as a product of systems and algorithms rather than individual clinical decisions, blurring the lines of responsibility.

3. AI's Involvement in Clinical Decisions:

• Pilot programs allowing AI systems to assist in prescription renewals raise concerns about accountability.

• The emergence of laws proposing AI as a "practitioner" could normalize the idea that medical actions can occur without a responsible human decision-maker.

4. Challenges with AI Technology:

• The central concern is the shift from personalized clinical judgment to procedural compliance driven by algorithms.

• AI lacks the capability to express moral dilemmas or admit to mistakes, which can lead to a lack of accountability in patient care decisions.

5. Patient Relationships and Trust:

• Traditional healthcare emphasizes the patient-clinician relationship as a personal bond.

• If care becomes automated, patients may become just part of a workflow rather than individuals receiving tailored treatment, eroding trust in healthcare systems.

6. Problems of Ambiguity and Uncertainty:

• Medicine often involves uncertainty and requires human clinicians to make nuanced decisions.

• AI systems may project confidence even in uncertain situations, which can be dangerous and lead to poor patient outcomes.

7. Drifting Towards Automation:

• As AI demonstrates efficiency, there is pressure to expand its role, potentially leading to its increased autonomy in clinical settings.

• There’s a risk of a two-tier healthcare system emerging, where those with resources receive human care, while others are served by automated processes.

8. Importance of Accountability and Ethics:

• The article stresses the need for safeguards, such as regular audits of AI decisions, to maintain accountability within medical practice.

• Future policies should ensure that clear lines of responsibility are established, preventing the dilution of human judgment in favor of efficiency.

9. The Ethical Foundation of Medicine:

• The push for treating patients via procedural adherence rather than individual care could distort the ethical values of medicine.

• Advocates for AI argue it should enhance clinician roles, but it's vital to ensure that human judgment remains the core of medical practice.

The integration of AI in medicine poses significant challenges to accountability and the ethical foundation of healthcare. To ensure that patient care remains compassionate and responsible, it is crucial to prioritize human judgment and responsibility in the face of rapidly evolving technology. The future of medicine should aim to balance the benefits of AI with the inherent value of human interaction and ethical decision-making. 

https://brownstone.org/articles/when-physicians-are-replaced-with-a-protocol/