Artificial Intelligence and the future of healthcare

Increased accuracy and timeliness of diagnosis, more personalized care, development of preventive medicine, and less invasiveness of interventions. These are just some of the aspects that will characterize future healthcare as a result of the increasingly widespread use of artificial intelligence (AI) and machine learning systems. However, the impact on the work of healthcare professionals and the doctor-patient relationship has yet to be clarified. A joint research has started to fill this gap. It involves Università Cattolica del Sacro Cuore (project "Public Functions/Private Powers. Interdisciplinary Profiles on Governance without Governance in the Algorithmic Society," coordinated by Professor Gabriele Della Morte) and the Laboratory of Fundamental Rights at the Collegio Carlo Alberto, in collaboration with the Department of Culture, Politics, and Society at the University of Turin (the coordinators are Vladimiro Zagrebelsky and Professor Mario Cardano).

The study was conducted through the administration of 34 interviews with healthcare professionals and patients and focused on two clinical areas particularly invested by digital transformation: radiology and robotic surgery. Preliminary results of the research highlight some interesting aspects, such as those related to the issue of autonomy and professional responsibility. «Studies exploring collective representations of AI highlight a widespread fear concerning the risk of algorithms and artificial intelligence devices replacing workers. However, in the medical field, the healthcare professionals interviewed recognized artificial intelligence systems applied to healthcare as valuable allies for clinical practice, capable of improving clinical outcomes and workflows. Yet, without making the physician's job obsolete,» Linda Lombi, a Health Sociologist and member of the research team for Università Cattolica, says. 

In the first place, this is because even where AI systems are used, the responsibility for clinical decision-making or surgical outcomes remains with the practitioner. «Regarding the 'smart' medical devices currently used or being tested, the doctor still retains a good level of control over the outputs of the machine,» argues Nicolò Amore, a criminal lawyer and member of the Fundamental Rights Laboratory research group. «However, there is a need to rethink training paths, management models, and regulatory tools to more efficiently manage the advent of AI-medicine, also to avert risks of hyper-responsibility of the health care professional and consequent, pernicious, defensive medicine».

However, AI is destined to profoundly change clinical practice, especially for the possibility of reducing the amount of time allocated to routine activities or work organization once someone becomes familiar with the use of new technologies. This time could be used for clinical research and communication with the patient, which today is increasingly contracted, negatively impacting the relationship between professional and patient. «Both specialists and patients involved in the study recognize the doctor-patient relationship as an indispensable element of care, even in the case of technologically dense treatments such as those carried out in robotic surgery. Trust in the human professional, structured through the relationship with the specialist and their team, proves to be as important as trust in the opportunities that the most advanced technology can offer» Eleonora Rossero, a health sociologist within the Fundamental Rights Laboratory project, observes. 

In light of the now imminent if not already observable changes that will intervene in clinical practice, the need to understand the consequences of the introduction of new technological actors at the micro (the therapeutic relationship), meso (professional boundaries), and macro (the evolution of the health care and legal systems, both national and international, regarding AI) levels seems more urgent than ever.