I interviewed Prof. David Seedhouse this afternoon for the radio. He’s developed a piece of software that will, he says, help make complex ethical decisions in a medical environment.
It’s an interesting concept. Everyone gets to have their say, there’s a fairly iPoddish graphical interface based on pie charts, and the database can be mined for analytical purposes. What was the decision last time this issue came up? Is there a reasonable amount of consensus within the group? What seem to be the main issues? Whose interests are paramount in this case? What are the risks?
It sounds very much like a morality algorithm, which would scare the hell out of me if the notion wasn’t quite so laughable. I read my Roger Penrose. He might be a potty Platonist, but he’s pretty spectacularly convincing on the idea that there’s no sentient or moral computing (just on the maths alone).
So it’s a reference tool. In most Western societies, says Seedhouse, six times as many non-white mental health “consumers” (God, I hate that term. How do you ‘consume’ health?) end up being institutionalised against their will as their European counterparts. How are those decisions being made? Fear?
I guess it would be interesting to database the thoughts, feelings and prejudices of the healthcare profession to find that stuff out.
Still – it concerns me. There’s a Big Brother overtone, sure, but worse is the notion that the final decision will not be based on experience and human contact with the patient concerned – but on an automated averaging system. It might be more democratic that way – but with all the bedside manner of an FX-82 calculator.
Prof. Seedhouse assures me that won’t be the case. Consultants will use the software as a reference tool only. Information gathering – so that their final decisions will be more informed. If only it didn’t sound so much like an arse-covering exercise in case of poor healthcare decisionmaking:
“Normally we’d resuscitate in that situation – but the computer reckoned it was fiscally irresponsible…”
Re computing and ethics. Most ethical decisions in medicine seem to be obvious at the time of their making. It is only in academic retrospect (the sin of this over analytic age) that they are questioned. I say this as someone who sheparded over 50 pediatric hospice patients to their end. If it seems right in the context, it probably is. This said, the context can be as different as a Jehovah’s Witness to the child of a nuclear physicist who wants “everything.” This doesn’t mean the human heart isn’t rational; its just that there are too many limbic parameters that are almost impossible to quantify.
Not making much sense, am I?
Dr. C.
You make good sense – but it’s not the kind of sense that exports intellectual capital in this knowledge economy of ours.