What is Clinical Medicine? What Should it Be?

"Much attention has recently been given to discussing the effects, potential and actual, of artificial intelligence on clinical medicine. Many, like Sparrow & Hatherley, have begun anticipating and addressing the challenges arising from integrating AI into medicine, including concerns about privacy, bias, power, responsibility, trust, and empathy. Sometimes a dilemma is presented between, as Hatherley puts it, substitutionism and extensionism: either AI will surpass physicians in performing clinical tasks,"

"making physicians obsolete, or AI will extend and improve upon physicians' capabilities. But to better appreciate the effects of AI on clinical medicine, one needs, I believe, a more comprehensive understanding of the nature and ambitions of the latter: If we understand what clinical medicine is or should be about, we will be in a better position to understand how AI might influence issues such as privacy, bias, power, responsibility, trust, and empathy, as well as what AI can and cannot substitute for or extend."

Artificial intelligence prompts examination of its effects on clinical medicine, including concerns about privacy, bias, power, responsibility, trust, and empathy. A common framing contrasts substitutionism, where AI surpasses and renders physicians obsolete, with extensionism, where AI augments physician capabilities. Proper assessment of AI's influence requires a comprehensive understanding of the nature and ambitions of clinical medicine. The physician-patient relationship and the craft of medicine are central to that understanding. Historical shifts moved from paternalistic models toward fact-provider models that emphasize patient autonomy, where physicians provide non-value-laden medical information and patients choose interventions based on their values.

Read at Apaonline