Tag Archives: healthcare

Artificial Intelligence and the Medical Humanities: The Ethical Concerns of Data Commodification in Medicine

by Alissa Williams, HI Program Assistant

Dr. Kirsten Ostherr, the Gladys Louise Fox Professor of English, Director of the Medical Futures Lab at Rice University, and an Adjunct Professor at the UT-Houston School of Public Health, gave her talk, “AI and the Medical Humanities: An Emerging Field of Critical Intervention,” at the October Health and Humanities Research Seminar. Discussing the past, present, and future role of artificial intelligence (AI) in medicine, Dr. Ostherr argued that AI and related “datafication” practices are coming to constitute a new social determinant of health, a term that refers to “conditions in the places where people live, learn, work, and play [that] affect a wide range of health risks and outcomes.” (Datafication is the process of collecting information about something that was previously invisible and turning it into data.) Dr. Ostherr’s lecture was an enlightening take on the potential positive impacts of AI, but also a warning as to how dangerous its reach can become if it goes unchecked. The seminar began with a chronological mapping of AI’s appropriation into the medical field and ended with a call to action for scholars across all disciplines, as well as the public, to participate in the advancement and regulation of AI as it relates to medicine and health.

Prior to 2015, the application of AI in the medical field involved “a lot of speculation,” but “little action” according to Dr. Ostherr. While AI was initially thought to be a threat to the job security of health care professionals such as radiologists, some now see it as a potential tool for making health care more efficient, more effective, and more accessible to historically neglected populations. But AI, especially when combined with datafication, also poses potential harm to patients and others. Dr. Ostherr argues that the health data about themselves that individuals both purposefully and inadvertently make available on social media platforms, websites, and personal wellness devices (e.g., Fitbits) can be commodified for exploitative purposes, largely without the permission or even knowledge of the patient whose data is being commodified. While research into the social determinants of health can be used to promote health equity and health justice, it can also be used to reinforce existing forms of bias and exclusion and even create new ones. For instance, companies can use data about the neighborhoods people live in or even their degree of political participation to deny them health insurance, charge them more for it, or even deny them employment.  Rather than using data to improve people’s health and health care, companies can use it to manage their own financial risks. In other words, instead of making healthcare and its infrastructure more accessible to all individuals, including those belonging to historically marginalized groups, AI and datafication can exacerbate the gaps that already exist by amplifying the biases that helped create these inequities.

On the other hand, however, Dr. Ostherr mentioned two websites in her talk, Hu-manity.co and Doc.ai, that have begun to use AI as a means of enabling patients themselves to monetize the sharing of their data under privacy constraints that the patients choose. Although these websites have not yet garnered a prominent following, they serve as examples of the potential AI has to help develop more positive and transparent ways of using individuals’ health data. Dr. Ostherr believes that the health humanities have a crucial role to play in determining how AI and other modes of information technology are used in the fields of health and medicine. Dr. Ostherr emphasizes that this is indeed a collaborative effort that needs to take place between disciplines in order to ensure the needs of the public are met from all angles with diversity in mind.

The Changing Health Disparities Landscape

An opportunity for hope?
By William B. Lawson MD, PhD, DLFAPA

I am old enough and fortunate enough to see and appreciate the changes that have occurred over the past half century in the health care system, especially regarding mental health. I still vividly remember visiting a state mental hospital where a great uncle spent much of his life. The building had all of the negative aspects of an institution including limited resources and communal showers. But then chlorpromazine (thorazine), a drug used for treating certain mood disorders, was invented and he was able to spend the rest of his days at home with his family. Fast-forward several decades, when I began my career as a psychiatrist, I was part of a team that completed a study with clozapine, the first antipsychotic that was demonstrably superior to others.  Again, I saw the wonders of medical technology as people with severe mental illness once relegated to back wards in chronic institutions were able to engage in meaningful relationships and live productive lives. Relative to the rest of medicine, treatment of the mentally ill is relatively young and the wonders of new advances and treatment long seen in antibiotic therapy and cancer treatment are still emerging in psychiatry.

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Training the Medical Eye through Art History

Dr. Susan Rather discusses medical art education in HI’s Faculty Fellows Seminar on Health, Well-Being, Healing
By Saralyn McKinnon-Crowley

In the late 1990s, dermatology Professor Irwin M. Braverman of Yale School of Medicine concluded that his medical students were relying too much on high-tech imaging and not enough on their own visual skills to diagnose skin conditions. Dr. Braverman wanted to ensure that reliance on technology did not supplant traditional diagnostic skills, and hoped that better doctor-patient interaction and keener medical observation would diminish the need for so many diagnostic tests. To help students develop their visual skills, Dr. Braverman designed, in collaboration with the education curator at the Yale Center for British Art Linda Krohner Friedlaender, an elective course in which students would study narrative paintings (paintings that tell a story) and describe the works of art as thoroughly and objectively as possible. Students received no external information about the paintings, not even painting titles. In 2001, Jacqueline Dolev—an alumna of the course—Ms. Friedlaender, and Dr. Braverman published research on the course’s effectiveness in the Journal of the American Medical Association. Students who completed the course, they reported, had improved observational skills and perceived more details about their patients compared to students who had not enrolled. These results suggest that students’ visual diagnostic abilities would have also improved, thereby boosting the efficiency of their patient care.

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How a Twentieth Century Philosophy of Language Can Advance Health, Well-Being and Healing in Schools

Dr. Cynthia Franklin discusses therapeutic intervention in schools in HI’s Faculty Fellows Seminar on Health, Well-Being, Healing
By Saralyn McKinnon-Crowley and Clare Callahan

As Professor and Associate Dean for Doctoral Education in the School of Social Work, Dr. Cynthia Franklin currently works with at-risk students, most visibly at Austin’s Gonzalo Garza Impendence High School, where she implements solution-focused brief therapy (SFBT). Developed by Steve de Shazer and Insoo Kim Berg in the late 1970s, SFBT, as Dr. Franklin described it in the HI Faculty Fellows Seminar, is “a brief therapeutic intervention”—taking place over only four to six sessions—that strives so build solutions to patients’ current and future problems, on the individual level and within “groups, families, communities, and organizations.” Specifically, SFBT works through the co-construction of meaning between patients and therapists and specific action-oriented techniques.

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