Issue 40 / 24 October 2011

THE ambiance of our hospitals is universally described as clinical, frequently impersonal and definitely dispiriting.

Inexorably caught up in the busyness of this medical microcosm, patients lose their identity in a form of reductionist verbal shorthand, becoming “the patient with CCF in bed 13 in Ward 3C”.

For the patients, even working out who is a doctor can be a complex exercise among a myriad of other health professionals. Couple this with the strict regimentation of ward activities and it is little wonder that hospitals, whose business is human welfare, are often accused of losing their humanity.

So, a recent media article about robots in hospitals sparked my interest: “The food menu at one of Sydney’s busiest hospitals has undergone radical surgery — and patients will even have meals delivered by robot on posh new plates”, the article said.

Apparently futuristic-looking robots will be used to deliver meals at Sydney’s Royal North Shore Hospital next year. They are described as “computerised trolleys” that guide themselves around the hospital, delivering meals, linen and other supplies.

Set on preprogrammed routes, the robots will have sensors to detect when a person is in the way and will “even ask them to step aside”. Can you imagine the response of busy doctors and nurses?

It’s not unrealistic to imagine robots in hospitals soon performing tasks such as distributing medications and measuring vital signs such as pulse rate, blood pressure, respiratory rate and temperature. After all, we have already grudgingly learnt to accept the electronic commands of corporate customer service, telephone banking and self-serve checkouts in supermarkets.

Yes, given modern medicine’s love affair with technology, it is easy to envisage robots assuming even greater prominence and actually displacing health professionals. We already have robotic surgery performing remarkable feats with great precision.

San Raffaele Hospital in Milan is the first hospital where robots have been used as companions to patients, actively participating in two-way conversations. These robots have also taken on the educational roles of medical practitioners, lightening the load on doctors and nurses.

But does this technological progress, as it accelerates and displaces human interaction, dehumanise medicine? The quest for more technology is often driven by the perception that computers are less likely to err and cost little after the initial capital outlay. To bureaucrats, this substitution must be attractive in their relentless pursuit of cost cutting.

However, we should not forget the wisdom that “to err is human, but to really foul things up requires a computer” (anon).

The effect of artificial intelligence replacing humans means a loss of interpersonal contact, communication and connectivity — that is, a sense of truly belonging. The human face of humanity will be lost.

Doubtless these changes will be incremental, but society must debate the role and extent of artificial intelligence in medicine.

Are robots in hospitals inevitable? Or should we become neo-Luddites and revolt against this so-called advance before the robots take over?

Dr Martin Van Der Weyden is emeritus editor of the MJA.

Posted 24 October 2011

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