ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: BMJ, 2018; k4563

Machines that can learn and correct themselves already perform better than doctors at some tasks. This opinion article maintains that machines will never be able to replicate the inter-relational quality of the therapeutic nature of the doctor-patient relationship.

Artificial intelligence (AI) has the potential to be more accurate than doctors at making diagnoses and performing surgical interventions, and can do this at a speed that humans cannot match. Today’s physicians cannot approximate this knowledge by keeping up-to-date of current medical research, while maintaining close contacts with their patients. Machine learning is also not subject to the same level of potential bias seen in human learning that reflects cultural influences and links with particular institutions.

Doctors form relationships with patients on the basis of trust; but machines and systems can be more trustworthy than humans if they can be regarded as unbiased and without conflicts of interest. Many patients rate correct diagnosis higher than empathy or continuity of care. Moreover, AI-driven systems could be cheaper than hiring and training new staff. The authors raise the argument that “Doctors as we now know them will become obsolete eventually.”

Others think that the inter-relational quality of the doctor-patient relationship is vital and cannot be replicated. They agree that machines will increasingly perform tasks that human doctors do today, such as diagnosis and treatment, but say doctors will remain because they are better at dealing with the patient as a whole person. Doctors can relate to the patient as a fellow human being and can gain holistic knowledge of their illness as it relates to the patient’s life.

“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 importantly there is no cure for some patients. Care is about helping them have the best quality of life possible with their condition and for the longest time. “Who wants to receive a terminal diagnosis from a robot?”