For the Symposium on The Law And Policy Of AI, Robotics, and Telemedicine In Health Care.
The use of Artificial Intelligence (AI) and care robotics are currently viewed as two separate branches of advancements in modern medicine. For now, AI and care robots are considered as advanced tools to augment the skills and intelligence of human professionals who provide most of the care. There will be a time in the not-so-distant future, when AI achieves general or superintelligence. Simultaneously, they will become more independent and mobile, while other specific medical devices/robots will become more miniaturized and advanced. In vivo, in vitro/prosthetics and other therapeutic robots will all likely become more advanced and prevalent.
The use of Artificial Intelligence (AI) and care robotics are currently viewed as two separate branches of advancements in modern medicine. For now, AI and care robots are considered as advanced tools to augment the skills and intelligence of human professionals who provide most of the care. There will be a time in the not-so-distant future, when AI achieves general or superintelligence. Simultaneously, they will become more independent and mobile, while other specific medical devices/robots will become more miniaturized and advanced. In vivo, in vitro/prosthetics and other therapeutic robots will all likely become more advanced and prevalent.
Done right, AI will likely merge with
robotics and these resulting care robots will have so much potential to enhance
care. Envision the common use of robots as care providers throughout the human
lifespan (e.g. nannies, companions/assistants, and other possibilities). This
prospect is both exciting for some people, and terrifying for others. For
better or worse, it is rather common for care robots to become ubiquitous at a
rapid pace once they overcome the hurdles of reaching successful initial adoption.
In formal settings or institutions like
hospitals, AI adoption is complicated and undertaken by a multi-disciplinary
team. Outside of formal settings, AI adoption will be dependent on multiple variables.
These variables may include but are not limited to: competition, government
sponsorship or regulation, and an economy driven market. Once the shock value
wears off and the care robots are found effective and safe, it is likely that the
public will demand “the best, brightest and newest” care robot. Prohibitively
expensive at first, care robot makers might still sell out and profit
tremendously, much like the best smart phone or car companies of today.
Naturally, there already are or will be
glaring issues before, during and after the “robot invasion”. For healthcare in particular, these issues
will include paramount concerns for patient safety and privacy. Reevaluating ethics
for both humans (bioethics) and robots (roboethics) will also become crucial as
more care robots are designed, produced and adopted. For these robots to be
successful, a lot of care and caring will have to be taught to them by their human
creators. These teachings will include what care looks like and how to provide
it safely. The nursing profession and its theories of care can definitely be a
valuable resource for care robot learning.
Nursing, as the most prevalent medical
profession, should take a keen interest on this subject as technology advances
and affects their practice in patient care delivery. There may be a genuine concern
that robots will compete for every job, in every industry. There are arguments
that the extent of robot advancement will make them better than their human counterparts
at everything and every task bar none. They might even flip the script where humanity
will have new robotic overlords or “we [are so] dead” 1. Thankfully, this particular case would be implausible
if humanity is careful when creating AI. From robot design to actual adoption,
explainable/open AI, safety protocols and proper regulations are all important
in preventing the worse case scenarios from coming to pass. The AI Asilomar Principles are a set of
guidelines or declarations for research, ethics and values, which has gained
thousands of signatories to date 2.
They may be too aspirational or idealistic for some people, but they are
definitely worth the attention and good faith effort of those individuals, organizations
and governments involved in the design and creation of AI.
AI and care robots should neither be
viewed solely through optimistic eyes, nor pessimistic ones… but rather, very
pragmatic ones. More than ever, practical considerations should outweigh the
theoretical, and sensibility should override sensationalism. It helps to keep a
rational outlook and a sense of humor, even as new, potentially unexpected issues
arise. The answer to new philosophical questions will be of value to every
major profession including nursing, medicine and law. Once we teach a robot to care
for people, will it be genuinely empathetic or will it merely echo what appears
like empathy as a result of its design? Will
that matter if the effect on human care remains the same? Will there be a
massive deterioration in human contact, care and compassion?
There are no ready answers and personal
predictions are never perfect. However, it seems as though there will be an
enduring demand for human professionals for a while longer in certain
professions or occupations. Registered nursing in particular is safer than
others when jobs are outsourced to robots 3.
There is an overall graying population, the retirement of the baby boomer
generation, and the difficulty of outsourcing the highly regulated, technical
and complex skills of immediate bedside nurses to care robots. It is likely
that highly developed care robots may become patient care assistants in charge
of basic tasks and patients’ activities of daily living. Then, in cases of
severe human professional shortages in healthcare, the care robots may serve as
a nurse assistant. This may only be done under the close supervision of human
nurses or as a stopgap measure. Not everyone will be comfortable with this
possibility. No one should delegate the sole administration of IV medications
or narcotics to a robot anytime soon, especially if there are better
alternatives. It is a possibility nonetheless in cases of emergency, disaster
or other rare and unusual situations.
In some industries, there may be fewer
jobs for humans if AI/robots become too prevalent. Some professional jobs may
also move overseas. However, the “lived” human experience and the genuine empathy
of human professionals will both remain valuable assets to professionals in
nursing, medicine, law and many other professions. As for their
responsibilities, it is likely that the basic and time consuming tasks or skillsets
will be delegated to AI/robots. Afterwards, complex tasks will be performed by humans
and machines together. AI/robots will continue to augment human abilities or humans
will continue to supervise the AI/robot’s performance of its tasks. Finally,
there are some licensed tasks, professions or occupations that will likely
remain mostly monopolized by human beings on purpose.
Care robots may all end up with
“non-threatening designs” ala Baymax of Disney’s Big Hero 6 4. However, the more miraculous advancement
would be a robot that can reach the level of care, caring and empathy of humans.
Creating such a robot will be very difficult, to say the least. Then in the
unlikely event that robotic emotional intelligence also reaches the level of
humans and/or the robot is no longer a mere tool but an exceptional human
creation, care robots should be granted protection and legal personhood. An AI
that is capable of genuine love would likely qualify, just as “David” does in the
film, AI: Artificial Intelligence by Steven Spielberg 5. In real life, there are already decades’ worth of
resources and arguments regarding any subject or issue in AI, be they from the
internet, current events, technological advancement, film/fiction, academic
literature, and expert or entrepreneur opinion. Some predictions are so
influential, they may ultimately become self-fulfilling prophecies.
This nurse in particular, cautiously
predicts a reasonably safe future for humanity using well-designed and
carefully created care robots, resulting in one small step at a time for care
robots, one giant leap overall for humanity.
Paul Vincent Tongsy, BSN, RN, CCRN, PHN, is a Masters in Legal Studies Student at Loyola Law School Los Angeles. You can reach him by e-mail at ptongsy at lls.edu
Paul Vincent Tongsy, BSN, RN, CCRN, PHN, is a Masters in Legal Studies Student at Loyola Law School Los Angeles. You can reach him by e-mail at ptongsy at lls.edu
Bibliography
Online
Articles
1
Catherine
Clifford, 9 of the most jaw-dropping
things Elon Musk said about robots and AI in 2017, CNBC, Dec. 18, 2017,
https://www.cnbc.com/2017/12/18/9-mind-blowing-things-elon-musk-said-about-robots-and-ai-in-2017.html
2 Future of Life
Institute, Asilomar AI Principles,
2017, https://futureoflife.org/ai-principles/
3 Sue Chang, This chart spells out in black and white
just how many jobs will be lost to robots, MarketWatch, Sep. 02, 2017,
https://www.marketwatch.com/story/this-chart-spells-out-in-black-and-white-just-how-many-jobs-will-be-lost-to-robots-2017-05-31
Films
4 Big Hero 6
(DisneyWorks, 2014) movies.disney.com/big-hero-6
5 A.I. Artificial
Intelligence (Amblin / Stanley Kubrick, 2001). https://www.youtube.com/watch?v=_19pRsZRiz4