By - Dr Naresh Purohit
(Visiting Faculty-BITS Pilani (Raj) for
Hospital Healthcare System Management Programme)
Recently the world has been subject to a tsunami of new ideas and technology regarding Al. Till date those who have been pointing to these changes were derided as conspiracy theorists. But now the change has become mainstream and being projected as progressive development that will lead to a well regulated and disciplined, peaceful society.
Imagine a situation where we have to accept and tolerate the worst of atrocities just to stay alive. Till now we have been proud of our freedom. Now we have to submit to slavery.
The digital prison has arrived. It is a nightmare come true. The 2023 SDG Summit is excited about the implementation of Agenda 2030.
It is time to debate the invasion of technology into all aspects of our lives.
While AI and robots are already a part of society, a digital currency linked to an unique Digital ID to be issued to every individual in the world is being fast tracked. The motive is to regulate income and expenditure ostensibly to enable a universal basic income and combat climate change.
No wonder a humongous unemployment crisis looms ahead as AI and robotics decimate jobs and the banking/ finance sector suddenly becomes redundant with the introduction of the Reserve Bank controlled digital currency.
In recent months, the conversations around artificial intelligence (AI) and how it may transform our lives have become quite common. From computer and data scientists to philosophers and ethicists, there is no shortage of predictions, excitement and anxieties. ChatGPT has added a new and important dimension to the conversation about data, knowledge, creativity and our way of doing things.
As with many new tools, the realm of public health is well within the range of impact of new developments in AI.
However, it is rather painful to note that nearly all articles, op-eds and stories that focus on the potential rewards of AI fail to even mention the deep ethical questions that emerge from not just the use of AI in public health in general, but questions that are particularly relevant to Indias public health system.
It is to be noted that medical ethics in the country are far from where they ought to be. A whole spectrum of medical malpractice that includes, but is not limited to, financial corruption, negligence, physical and verbal abuse of patients, overcharging for services, kickbacks and unauthorised perks from pharma industry is rampant.
The regulatory framework that should underpin all medical mal- practices is either completely absent or absent in essence. In this environment, a potent new tool needs to be handled with great care. Increased reliance on AI for diagnosis may sound cool to many, but the system is far from perfect.
There is no hiding to the fact that ones life is subject to intense scrutiny. The Digital ID is not limited to financial transactions, it extends to assets, and other IDs such as driving licence, health cards, insurance, ration cards, electricity, water, and everything concerning people and their family.
Imagine the level of disruption if ones ID is suddenly disabled. The entire family perishes without a shot being fired. Worse, as being pointed out by experts, the AI based system is not error/ bias free. One can fall victim to mistakes.
Things get complicated when the planned epidemic arrives. Then one becomes fodder for yet another exercise. Testing, tracking, isolating, treatment, and vaccination. The population becomes cattle and the coming 15 minute neighbourhoods become cattle sheds.
The world is being converted into the most frightening penitentiary that can ever be devised. One will be within it, or languishing as an untouchable outside it.
Israel has begun using AI for military operations. China is into robot soldiers. Robotic dogs are being displayed in the USA and their value in policing society is being emphasized. Chinese citizen are becoming accustomed to robots keeping an eye on them.
Dipping into patient records to improve delivery sounds good in a perfect system – but in a country where data privacy is still in its infancy, how would we ensure that the patient and their data is protected? Similarly there are important ethical questions about wearable devices and rapid reporting systems.
Perhaps the most important thing to consider for us is the oldest principle where it all starts – do no harm. It is not only to be considered at the level of a patient, but society as a whole. Does reliance on AI create more haves and have-nots? Does having a smartphone become a pre-requisite for good care? .
What about those who are too poor ? Does a set of new tools make it harder for poor to get care they desperately need?
Before we jump on (yet another) bandwagon because everyone else is doing it, let us first make sure that we have the safety nets in place.
There are examples all over the globe when fascination with a technology, without an ethical framework, did more harm than good. We absolutely need to improve our healthcare system and increase its efficiency so it works for everyone. This requires an effective ethical framework more than the newest gadget.
In the literary and education spheres ChatGPT is intruding into intellectual space putting white collar jobs in peril. India has Al TV Anchors. In Japan and the USA robots are delivering sermons. Nothing seems to be outside the purview of the new kid on the block.
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