Artificial Intelligence is already being used in clinics to help analyze imaging data, such as X-rays and scans. But the recent arrival of sophisticated large-language AI models on the scene is forcing consideration of broadening the use of the technology into other areas of patient care.
- By ALVIN POWELL | Harvard Gazette
In this edited conversation with the Harvard Gazette, Rebecca Weintraub Brendel, director of the Harvard Medical School Center for Bioethics, looks at end-of-life options and the importance of remembering that just because we can, doesn't always mean we should.
When we talk about artificial intelligence and end-of-life decision-making, what are the important questions at play?
Weintraub Brendel: End-of-life decision-making is the same as other decision-making because ultimately, we do what patients want us to do, provided they are competent to make those decisions and what they want is medically indicated - or at least not medically contraindicated.
One complication would be if a patient is so ill that they can't tell us what they want. The second challenge is understanding in both a cognitive way and an emotional way what the decision means.
People sometimes say, "I would never want to live that way," but they wouldn't make the same decision in all circumstances. Patients who've lived with progressive neurologic conditions like ALS for a long time often have a sense of when they've reached their limit. They're not depressed or frightened and are ready to make their decision.
On the other hand, depression is quite prevalent in some cancers and people tend to change their minds about wanting to end their lives once symptoms are treated.
So, if someone is young and says, "If I lose my legs, I wouldn't want to live," should we allow for shifting perspectives as we get to the end of life?
Weintraub Brendel: When we're faced with something that alters our sense of bodily integrity, our sense of ourselves as fully functional human beings, it's natural, even expected, that our capacity to cope can be overwhelmed.
But there are pretty devastating injuries where a year later, people report having a better quality of life than before, even for severe spinal cord injuries and quadriplegia. So, we can overcome a lot, and our capacity for change, for hope, has to be taken into account.
