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Tytuł:
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High Hopes for "Deep Medicine"? AI, Economics, and the Future of Care.
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Autorzy:
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Sparrow R
Hatherley J
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Źródło:
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The Hastings Center report [Hastings Cent Rep] 2020 Jan; Vol. 50 (1), pp. 14-17.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2012- : Malden, MA : Wiley-Blackwell
Original Publication: Hastings-on-Hudson, N. Y., Institute of Society, Ethics and the Life Sciences.
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References:
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E. Topol, Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again (New York: Basic Books, 2019).
Ibid., 2. Later in the book, he suggests that robots featuring AI might even perform some surgery (p. 161-62). See also A. Darzi, H. Quilter-Pinner, and T. Kibasi, Better Health and Care for All: A 10-Point Plan for the 2020s. The Final Report of the Lord Darzi Review of Health and Care (London: Institute of Public Policy Research, 2018), https://www.ippr.org/research/publications/better-health-and-care-for-all; X. Liu, P. A. Keane, and A. K. Denniston, “Time to Regenerate: The Doctor in the Age of Artificial Intelligence,” Journal of the Royal Society of Medicine 111, no. 4 (2018): 113-16; A. Verghese, N. H. Shah, and R. A. Harrington, “What This Computer Needs Is a Physician: Humanism and Artificial Intelligence,” Journal of the American Medical Association 319, no. 1 (2018): 19-20; R. M. Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age (New York: McGraw-Hill Education, 2015).
Topol, Deep Medicine, 18.
S. T. Israni and A. Verghese, “Humanizing Artificial Intelligence,” Journal of the American Medical Association 321, no. 1 (2019): 29-30; B. Meskó, G. Hetényi, and Z. Györffy, “Will Artificial Intelligence Solve the Human Resource Crisis in Healthcare?,” BMC Health Services Research 18, no. 1 (2018): 1-4.
J. B. McKinley and L. D. Marceau, “The End of the Golden Age of Doctoring,” International Journal of Health Services 32, no. 2 (2002): 379-416.
There is more than a hint of what Broussard calls “technochauvinism”-the belief that smarter, faster, and cleaner technology is the solution to every problem-in Topol's book, although it also includes passages that acknowledge that the impact of AI on medicine might be less positive than most of the text pretends, as we discuss further below. See M. Broussard, Artificial Unintelligence: How Computers Misunderstand the World (Cambridge, MA: MIT Press, 2018).
T. Diefenbach, “New Public Management in Public Sector Organizations: The Dark Sides of Managerialistic ‘Enlightenment,’” Public Administration 87, no. 4 (2009): 892-909.
J. A. Blythe and Farr A. Curlin, “‘Just Do Your Job’: Technology, Bureaucracy, and the Eclipse of Conscience in Contemporary Medicine,” Theoretical Medicine & Bioethics 39, no. 6 (2018): 431-52.
Topol, Deep Medicine, 21.
Topol calls for a new kind of professional society that would resist the self-interest of trade guilds and better promote patients’ interests (E. Topol, “Why Doctors Should Organize,” New Yorker, August 5, 2019; see also the website of the Osler Alliance, of whose steering committee Topol is a member: https://oslersalliance.org).
Topol, Deep Medicine, 285.
Ibid.; Verghese, Shah, and Harrington, “What This Computer Needs Is A Physician.”.
Compare ideas in Organisation for Economic Co-operation and Development, OECD Science, Technology, and Innovation Outlook 2016 (Paris, France: OECD Publishing, 2016), 85, with those in E. J. Cassell, The Nature of Suffering and the Goals of Medicine, 2nd ed. (Oxford: Oxford University Press, 2004), 76. See also Wachter, The Digital Doctor.
E. J. Cassell, Doctoring: The Nature of Primary Care Medicine (Oxford: Oxford University Press, 1997), 79-80.
R. D. Dias, A. Gupta, and S. J. Yule, “Using Machine Learning to Assess Physician Competence: A Systematic Review,” Academic Medicine 94, no. 3 (2018): 427-39.
J.-F. R. Lu and W. C. Hsiao. “Does Universal Health Insurance Make Health Care Unaffordable? Lessons from Taiwan,” Health Affairs 22, no. 3 (2003): 77-88.
D. Duijmelinck and W. van de Ven, “What Can Europe Learn from the Managed Care Backlash in the United States?,” Health Policy 120, no. 5 (2016): 509-18; M. W. Friedberg et al., Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy (Santa Monica, CA: RAND Corporation, 2013); R. G. Hill Jr., L. M. Sears, and S. W. Melanson, “4000 Clicks: A Productivity Analysis of Electronic Medical Records in a Community Hospital ED,” American Journal of Emergency Medicine 31, no. 11 (2013): 1591-94; A. Verghese, “Culture Shock-Patient as Icon, Icon as Patient,” New England Journal of Medicine 359 (2008): 2748-51.
Topol, Deep Medicine, 288.
T. M. Maddox, J. S. Rumsfeld, and P. R. O. Payne, “Questions for Artificial Intelligence in Health Care,” Journal of the American Medical Association 321, no. 1 (2019): 31-32.
R. D. Truog, “Of Slide Rules and Stethoscopes: AI and the Future of Doctoring,” Hastings Center Report 49, no. 5 (2019): 3.
D. S. Watson et al., “Clinical Applications of Machine Learning Algorithms: Beyond the Black Box,” BMJ 364 (2019): doi:10.1136/bmj.l886.
Verghese, Shah, and Harrington, “What This Computer Needs Is a Physician.”.
Maddox, Rumsfeld, and Payne, “Questions for Artificial Intelligence in Health Care.”.
Wachter, The Digital Doctor.
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Entry Date(s):
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Date Created: 20200219 Date Completed: 20210505 Latest Revision: 20210505
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Update Code:
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20221216
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DOI:
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10.1002/hast.1079
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PMID:
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32068275
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In the much-celebrated book Deep Medicine, Eric Topol argues that the development of artificial intelligence for health care will lead to a dramatic shift in the culture and practice of medicine. In the next several decades, he suggests, AI will become sophisticated enough that many of the everyday tasks of physicians could be delegated to it. Topol is perhaps the most articulate advocate of the benefits of AI in medicine, but he is hardly alone in spruiking its potential to allow physicians to dedicate more of their time and attention to providing empathetic care for their patients in the future. Unfortunately, several factors suggest a radically different picture for the future of health care. Far from facilitating a return to a time of closer doctor-patient relationships, the use of medical AI seems likely to further erode therapeutic relationships and threaten professional and patient satisfaction.
(© 2020 The Hastings Center.)
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