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Let the Computers Decide?

Imagine a computer algorithm that decides whether or not incapacitated patients would want medical care. Doctors could feed the algorithm treatment options as well as their patient's background information and be told whether or not to move forward, thus relieving humans of the decision making responsibility.

The algorithm exists as a simple formula which gives the thumbs up if the chance of recovery is greater than 1%. In a simulated environment it had an accuracy of 78% and beat its human counterparts, spurring Bioethicist David Wendler of the National Institutes of Health and colleagues to more research:

Wendler now wants to collect medical care preferences from people of various ethnic, religious and gender groups, which will help his team refine the formula. He believes that a computer program might one day predict patient's wishes to an accuracy of 90%.

There are ethical problems with letting a computer decide.

"I believe it would be extremely irresponsible to allow machines to make decisions involving life and death," says Bobby Schindler, brother of Terri Schiavo. Schiavo was in a persistent vegetative state for 15 years until she died in 2005 after doctors removed her feeding tube. Her case sparked huge debate in the US.

"If a person becomes incapacitated, is not dying, and can assimilate food and water via a feeding tube, then I believe that we are morally obligated to care for the person and provide them this basic care - regardless of a computer attempting to 'predict' what that person's wishes might be," Schindler adds.

"Essentially, you would be allowing a machine to determine what is ethical, what is right and wrong, which no machine is able to do."

The use of a model, or a generalized knowledgebase system, to make ultimate decisions concerning life and death assumes that the right decision is relative and dependent upon the desire of an individual. Schindler asserts that the bioethics are absolute rather than relative, and that an incapaciated or brain injured person cannot be morally euthanized by withdrawing basic medical care or nutrition.

Now imagine the potential abuse of a computer which is an accepted authority on end of life decisions, especially in a country pushing toward socialized medicine. The inherent shortages created in a controlled health care economy will lead to centralized planning and the computer model could be the planner who decides who will live and who will die.

Posted by tim at March 14, 2007 12:43 PM

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