Deceptive Healing: Should AI lie for our own good?

Derek Parfit, the British philosopher, would sometimes begin his university lectures by presenting his students with a rather bizarre scenario. He'd ask them to imagine that they would be teleported to Mars, their memories, personality traits, and every cognitive aspect would be transferred to a replica — effectively creating a 'digital twin.' This paradoxical situation, often known as Parfit's Teletransportation Thought Experiment, forms the cornerstone of our discussions on the impending fusion of AI and healthcare.

AI, Digital Twins, and Value-Based Healthcare: Promise and Paradox

The advent of digital twins, AI replicas of individual patients, promises to overhaul the current healthcare scenario. This concept of digital twins combined with AI is being hailed as a game-changer in healthcare. It aims to provide personalized, efficient, and value-based care that could result in improved patient outcomes, decreased costs, and even the transformation of lives.

However, this futuristic healthcare model is not without paradoxes. What if our digital twin predicts a future ailment and suggests transformative but preventable experiences? This transformative experience may lead to an objectively better life but presents us with a moral and philosophical dilemma.

A Double-edged Sword: The Implications of AI-Predicted Transformative Experiences

AI's capability to predict our health future introduces an interesting ethical conundrum. Let's imagine an individual who undergoes a life-altering health situation, such as developing cancer. Post-recovery, they report their life has objectively improved—cancer, although initially a devastating diagnosis, became a transformative experience for them. After a year of traumatic treatments, they now see their life in a completely different way. Negative relationships have been abandoned or repaired and a soul destroying job had been replaced with the pursuit of a lifelong dream career.

But if AI predicts such a life-altering health condition and suggests we could avoid it with timely treatment, what decision should we make? Should we bypass the transformative experience for the sake of avoiding suffering, or should we accept the situation, allowing ourselves to change and grow? Surely nobody would chose to be ill if it could be avoided?

Moreover, this raises questions about personal identity. Are we the same people before and after such transformative experiences? If not, how do we make decisions for our 'future selves'? These philosophical inquiries hark back to Parfit's ideas about personal identity, where he posits that we're not the same people throughout our lives but rather a series of connected selves.

The Role of AI in Healthcare Decision-Making: Aiding or Dictating?

AI's potential involvement in healthcare decision-making presents us with two polarizing visions. One is where AI only aids in process improvements and steers clear of any ethical concerns. The other, more controversial scenario, involves AI having a pivotal role in decision-making, potentially overshadowing human agency but resulting overall in objectively better lives.

In this context, Patient-Reported Outcome Measures (PROMs), which emphasize patient perspectives in healthcare, assume a whole new meaning. While they traditionally capture current patient patient views of what their current outcomes are or which they would like to improve, in the future, they could potentially forecast what our future selves would report as the outcome—creating a paradox where AI predictions influence present decisions that alter future outcomes. This situation is reminiscent of the famous 'grandfather paradox' in time travel narratives.

AI's Moral Code: Truthfulness vs. Objective Betterment

The discussion of AI in healthcare would be incomplete without addressing the moral dimension of AI actions. If AI lies or creates fictitious scenarios to guide individuals towards an objectively better life path, is this ethically acceptable? The answer is far from straightforward and depends largely on our moral constructs of truth and deception.

The Illusion of Free Will

If we believe in the concept of predestination, then AI's role in healthcare could be seen as a mere refinement of inevitable outcomes. But, is there room for free will in a world guided by AI?

We need to question whether individuals should be allowed to refuse life-saving treatments, knowing they could lead to transformative experiences. This juxtaposition of personal freedom and societal obligation forms a critical piece of our dialogue on AI's role in healthcare.

Conclusion

Derek Parfit's thought experiments may seem far-fetched, but they are quickly becoming a reality with the advent of AI in healthcare. As we edge closer to this reality, we must continually engage with the ethical and philosophical discussions they provoke, ensuring that the path towards a technologically advanced healthcare future remains grounded in our shared values and principles.

One of the few things that is clear is that AI's role in healthcare isn't black or white; it's a spectrum of greys. It's a fascinating intersection of ethics, identity, and medical intervention, demanding nuanced conversations and careful exploration. With the rapidly evolving AI landscape, we stand at the threshold of transformative healthcare, armed with possibilities and burdened with difficult questions. The answers to these questions will ultimately shape the future of healthcare. As we navigate this intricate maze, the words of John Addison seem pertinent, "We are not human beings, but human becomings." And in this becoming, AI has a significant role to play.

This piece is designed to engage the readers in a thought-provoking discussion on the ethical implications of AI and digital twins in healthcare, drawing on Derek Parfit's ideas about personal identity and continuity.

The author's views are entirely his own.

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