We need to take seriously the potential de-personalisation of our field through the use of AI.
5 MINUTE READ
The current and short-term impact on medicine would be for others to assess but it would be naïve to think that the health industry is exempt from the economic and professional pressures which have driven the integration of AI in other sectors. In my own field of counselling, we have already seen the rollout of AI-powered text message support systems for people experiencing mental ill-health, websites which step clients through set protocols (with recursion as required), and a number of experiments trialling other applications of AI.
Against these trends it may be easy for us to object and say that the personal and interpersonal dimensions of health and care mean that the impact of AI will be less significant in our field/s. Such objections find plenty of support in the empathy required of a clinician, the trust given and received, and even the bonding which takes place between the practitioner and the patient. Health and care are not directly analogous with law, education or the arts.
“Notwithstanding the unique place of health and care in the human psyche, I believe that we still need to take seriously the potential de-personalisation of our field through the use of AI.”
Notwithstanding the unique place of health and care in the human psyche, I believe that we still need to take seriously the potential de-personalisation of our field through the use of AI. In a healthcare system that is already overloaded, the incentives to deploy AI are everywhere. In this brief reflection, I want to restrict myself to the interface between the system and the patient/client, although I recognise that AI may be usefully deployed elsewhere in the system (for example, in the areas of providing professionals with specialist insights or diagnostic review).
There are several key points at which the system and the patient/client meet:
- in the distress and uncertainty of complaint – “Doctor, I notice that I’ve been …”,
- in the ambiguity and occasional shame of describing symptoms – “Well, it’s hard to say …”
- in the confrontation and shock of adverse diagnosis – “Oh! Oh, I don’t know what to say!”
- in the organisational and motivational challenges of treatment – “It’s just so …”, and
- in the exhaustion (or tedium) of follow-up – “Ah yes, well, it sort of slipped my mind!”
It is at these points that the personal rather than the digital is so important. Phenomena such as distress, shame, shock, motivation, exhaustion and boredom are not directly addressed or immediately resolved by information alone. We know that these experiences are best faced or endured with people by our side. When I hear empathy, when I see a tear in my therapist’s eye, when I feel understood, then I am encouraged and emboldened to move forward.
Of course, it is true that AI can and does seek to cloak itself in human expressions that mimic personal presence. I remember my gleeful sarcasm when ChatGPT replied to one of my exploratory enquiries that it was important to remember that “we are all human and that no-one is perfect.” Such digital attempts at empathy are not likely to carry much weight at the bedside.
Against all this, Jesus provides us with a very different vision of how people might move forward in difficult times. Jesus anchors truth, not in the aggregation of data, nor in the cleverness of an algorithm, but in his person! Truth is embodied (Jn.14:6). It does not exist in the abstractions of Greek thought, but in his person, in time and space, culture and human flesh. Pausing here, we note at least two distinct (but overlapping) dimensions to Jesus’ claim to be the truth. There is a theological dimension in which Jesus is the truth – he is true to the image (the exact representation) of his Father in Heaven (Jn.1:18, Col.1:15). There is no loss of fidelity here. The things which are necessary to know about God may be truly and fully seen in Jesus. To know Jesus is to truly know God.
“Jesus is ‘at hand’. His presence with humanity is the corollary of his being true in relationship. Truth is known in the process of Jesus living among people.”
The other dimension in which Jesus may be said to be the truth is the relational sense. Jesus remains true to his friends, true to his commitments, true in the sense of faithful and committed. Truth in this sense means available, accessible, and responsive. Jesus is ‘at hand’. His presence with humanity is the corollary of his being true in relationship. Truth is known in the process of Jesus living among people.
Given Jesus’ embodiment of truth, it is not surprising that he calls people to follow him! The first disciples were to live with him, engage with him, and get caught up in his engagements with others. In this way, they would both hear with their ears and know from their experience, the truth that is uniquely in Jesus. And note too, that this engagement with Jesus was for the most part communal; the disciples were amazed, afraid, and comforted together at various times despite disagreements between them. Subsequent generations of disciples would also join together to engage with the life and teaching of Jesus as recorded in the gospels.
As is evident above, knowing and being together are intimately bound up with what we might call health, wellbeing, or human flourishing as is portrayed repeatedly in John’s gospel. In John chapter 9, Jesus personally seeks out the man who was born blind to counteract the Jewish leaders who had “put him out” of the synagogue. In chapter 10, the Good Shepherd prevents the wolves from “scattering” the sheep, and he unites the sheep into one flock. And in chapter 17 (verses 20-26), Jesus’ pastoral prayer for all believers is that they may be united, loved, gathered, and glorified in a world which (it is presumed) lacks such qualities.
To sum up, Jesus’ approach to the wellbeing of his people is one of engagement, embodied presence, and ultimately costly service! Artificial intelligence however offers disengaged and disembodied service to those in distress. No matter how accurate the content, no matter how lifelike the interface may be, the bot will not comfort me in the tragedy of my mortality. It will not assure me that my distress matters, or that I am ultimately valuable.
As practitioners seeking to walk in the footsteps of Jesus, it is incumbent upon us that we maintain our personal presence with our patients/clients, that we do not excuse ourselves from being touched by the distress of those we serve, that we do not content ourselves with merely being correct in our diagnosis or right about our therapeutic recommendations. As the apostle Paul says, “Knowledge puffs up, but love builds up!” (1 Cor.8:1)
Dr Richard Morrison
Dr Richard Morrison is a counsellor/supervisor in private practice in Newcastle (and online – http://www.relationalcoaching. com.au). He pastored a Baptist church for over twenty years and has also worked in suicide prevention, aged care, disability services, project management and government. His PhD is in the mental health of men who retire early.