“Just do your job”: technology, bureaucracy, and the eclipse of conscience in contemporary medicine

Blythe, Jacob A.; Curlin, Farr A.

doi:10.1007/s11017-018-9474-8

Cited by 14 publications

(22 citation statements)

References 19 publications

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“…Another powerful institutional dynamic may be expected to parallel and reinforce this economic imperative. Organizations tend to concentrate—one might even say fixate—on things that they can measure rather than on the more subtle and intangible aspects of their operations 8 . Time per patient (or per procedure) is easily measured and optimized, whereas “care” is subtle and hard to measure.…”

Section: Essaymentioning

confidence: 99%

High Hopes for “Deep Medicine”? AI, Economics, and the Future of Care

Sparrow¹,

Hatherley²

2020

Hastings Center Report

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In the much‐celebrated book Deep Medicine, Eric Topol argues that the development of artificial intelligence for health care will lead to a dramatic shift in the culture and practice of medicine. In the next several decades, he suggests, AI will become sophisticated enough that many of the everyday tasks of physicians could be delegated to it. Topol is perhaps the most articulate advocate of the benefits of AI in medicine, but he is hardly alone in spruiking its potential to allow physicians to dedicate more of their time and attention to providing empathetic care for their patients in the future. Unfortunately, several factors suggest a radically different picture for the future of health care. Far from facilitating a return to a time of closer doctor‐patient relationships, the use of medical AI seems likely to further erode therapeutic relationships and threaten professional and patient satisfaction.

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Section: Essaymentioning

confidence: 99%

High Hopes for “Deep Medicine”? AI, Economics, and the Future of Care

Sparrow¹,

Hatherley²

2020

Hastings Center Report

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“…The next two essays examine the question of re-enchantment as a possible corrective to the violence of bureaucracy, scientific enquiry, and the institutional or personal formations that cultivate both ways of order and knowing. The term violence is used here purposefully, since the disenchanted world of the physician and her guild, as discussed by Jacob Blythe and Farr Curlin [11], is one whose reified bureaucracies demand obedience, and those who defend such order call for retributive justice to correct abuses and objections. The question of conscientious objection serves as the case in point for Blythe and Curlin.…”

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confidence: 99%

“…Such leadership action, Weber argues, concerns relations between persons who exercise dominance over othersdisciplining the society into order. Politics is therefore interested in the way that those in positions of power might control the population of persons gathered within institutional boundaries, and beyond, while expecting their obedience-"just do your job," as Blythe and Curlin's title suggests [11], is the precise expectation of the ordered vocation. 3 The machinations of modern politics are concerned principally with power.…”

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confidence: 99%

“…In an exercise of hubris and with the penchant to control the physical and economic exchange of persons in a society, the political will of the leader, and her administration, is aimed at the organization of habituation. That is to say, the aim is to habituate persons-or, adopting Blythe and Curlin's idiom [11], providers and consumers-into their roles as mere objects in the apparatus of political life. As such, these persons become objective things put to work toward the technical ends of the state, or the health care industry.…”

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confidence: 99%

“…The exercise of such political will might often be an intelligible response to limitations and harms experienced within a particular political milieu, as Blythe and Curlin observe [11]. They suggest that the product presumption was adopted to correct unjustified medical paternalism and to bend medicine into serving the desires of patients.…”

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confidence: 99%

See 2 more Smart Citations

Understanding modern, technological medicine: enchanted, disenchanted, or other?

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Moyse

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How Should Physicians Respond to Patient Requests for Religious Concordance?

Blythe

Curlin²

2019

AMA Journal of Ethics

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In which ways and in which circumstances should institutions and individual physicians facilitate patient-physician religious concordance when requested by a patient? This question suggests not only uncertainty about the relevance of particular traits to physicians' professional roles but also that medical practice can be construed as primarily bureaucratic and technological. This construal is misleading. Using the metaphor of shared language, this article contends that patient-physician concordance is always a question of degree and that greater concordance can, in certain circumstances, help to obtain important goals of medicine. CaseMs L is a 78-year-old woman who presents to a primary care clinic to establish care with a new physician, as she has recently moved. She is assigned to a newer physician on staff, Dr O, who chats with her briefly and then begins to interview Ms L. Within a few minutes of Dr O's questions about her health history, Ms L mentions her faith. "I found Jesus a long time ago," she says sincerely. "Do you believe in God?" Dr O is surprised but doesn't show it. "Yes, I do. Is it okay if we focus on your medical history for now?" Ms L pauses for a moment and goes on about her faith's importance. "An essential part of who I am is that I believe in God. I believe in Jesus. What God do you follow? Is it Jesus, Allah or another god?" Dr O tries to focus on how to move on to obtain the rest of Ms L's history, and replies, "I believe in Jesus and Allah, too." Ms L straightens her spine and immediately replies, "No, you can't follow both."Dr O doesn't reply and moves on to her review of systems. "Do you know if there is a Christian doctor here?" Ms L interrupts.Dr O replies, "I'm new to this clinic and don't really know the religious affiliations of my colleagues." Dr O pauses and considers whether to continue examining Ms L.

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“Just do your job”: technology, bureaucracy, and the eclipse of conscience in contemporary medicine

Cited by 14 publications

References 19 publications

High Hopes for “Deep Medicine”? AI, Economics, and the Future of Care

High Hopes for “Deep Medicine”? AI, Economics, and the Future of Care

Understanding modern, technological medicine: enchanted, disenchanted, or other?

How Should Physicians Respond to Patient Requests for Religious Concordance?

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