The Crumbling Pillar. Ethical Considerations on Medicine in the Age of AI

Abstract

The promises surrounding the introduction of artificial intelligence in medicine, envisioning a less negligent and more effective practice, seem to leave little room for philosophical discussion. However, among expectations, in silico experiments, and early implementations, AI medical systems have already raised ethical questions. Beyond the usual concerns related to privacy and system security, with “algorithmic medicine” looms the disruption of the physician’s identity and, concomitantly, the redefinition of the doctor-patient relationship. The increasing accuracy demonstrated by several clinical software challenges the doctor’s epistemic authority, with AI becoming progressively more “trustworthy”. The care relationship, once a dyad, transforms into a triad, involving a double transfer of trust: both doctor and patient come to depend on algorithmic outputs. Thus, paternalism reappears, this time automated, with the physician left as a third wheel and relegated to the role of passive executor of computational verdicts. If, as Karl Jaspers posits, medicine rests on two pillars (the techno-scientific and the humanitarian), the clinical introduction of AI not only solidifies the former, which ends up being delegated to digital systems, but also risks weakening and depersonalizing the latter. A critical assessment of the future of medicine is essential not only to understand the direction this practice is taking under the influence of the digital industry but also to identify the values that need to be strengthened to prevent the loss of the humanitarian significance inherent in its origins and purpose.