‘The Doctor Will Not See You Now’: The Algorithmic Displacement of Virtuous Medicine

Otto, P. and E. Gräf (eds) 3TH1CS - The Reinvention of Ethics in the Digital Age. 2017. iRights.Media, Berlin.

8 Pages Posted: 2 Jan 2019

See all articles by Brent Mittelstadt

Brent Mittelstadt

University of Oxford - Oxford Internet Institute

Date Written: May 30, 2017

Abstract

A push for technological solutions to close growing gaps in medical funding and social care is now commonplace across mature information societies. Medicine is undergoing a transformation owing to diffusion of ‘Big Data’ and algorithmic systems that automate and supplement care traditionally provided by medical professionals.

Information technologies and the private sector are key to this shift. No longer solely the domain of trained medical professionals, medical care and health management are now provided by a mix of public and private, professional and non-professional stakeholders. Technology companies in particular are increasingly entering the medical space, sensing an opportunity to apply complex algorithmic and analytics systems to support and automate medical care. These algorithms replicate and support decision-making by identifying the best action to take in a given situation, the best interpretation of data, and so on. In other words, the algorithms considered here, and involved in ‘Big Data’ more broadly, make generally reliable (but subjective and not necessarily correct) decisions based upon complex rules and large, diverse datasets that challenge or confound human capacities for action and comprehension.

Algorithmic systems allow for the health status and behaviours of users to be digitised, recorded, stored and analysed, creating novel opportunities for data mining, diagnosis and categorisation of patients. Medical decision-making and care are increasingly supported by expert and robotics systems that assist in record management, diagnosis, treatment planning, and delivery of interventions. Home and social care are similarly transformed through the introduction of remote monitoring and management systems. Health can increasingly be monitored, modelled, and managed based on data representations of the patient, supplementing or replacing verbal accounts and face-to-face physical care.

All of these trends point towards a new way of delivering medical care. Complex technological artefacts increasingly support diagnosis, treatment, long-term health management and prevention. The diffusion of information systems is accompanied by a diversification of parties involved in medical care. Greater involvement is seen from the private sector, whose actors develop systems and provide services to medical institutions and individual patients, and non-professional carers responsible for day-to-day management of technologically supported care in the home. While addressing care gaps is no doubt important, it implies a shift of the burden of care away from medical professionals and traditional medical communities, on to technology companies, informal carers, and patients themselves.

Keywords: ethics, bioethics, health monitoring, quantified self, medical ethics, philosophy, telemedicine, telehealth, e-health

Suggested Citation

Mittelstadt, Brent, ‘The Doctor Will Not See You Now’: The Algorithmic Displacement of Virtuous Medicine (May 30, 2017). Otto, P. and E. Gräf (eds) 3TH1CS - The Reinvention of Ethics in the Digital Age. 2017. iRights.Media, Berlin., Available at SSRN: https://ssrn.com/abstract=3298923

Brent Mittelstadt (Contact Author)

University of Oxford - Oxford Internet Institute ( email )

1 St. Giles
University of Oxford
Oxford OX1 3PG Oxfordshire, Oxfordshire OX1 3JS
United Kingdom

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