Melbourne MD student looks at the ethical challenges of technology

Empathic and ethical practice is a key attribute taught within the Melbourne MD course. As part of their course in Empathic and Ethical Practice (EP2), students are asked to submit reflective pieces as a body of work in second year. They are asked to consider topics such as systems of care, cross-cultural health and professional aspects of health care. An example of the pieces submitted is featured below from Raymond Su, a second-year medical student from St Vincent’s Hospital Clinical School.

From the narrative beginnings of the healing arts to the French Revolution that gave birth to modern medicine, doctors have classically walked the line between the art of humanity and the science of reality. This juxtaposition is especially stark when we examine the interaction of medicine with the digital millennium and social media, and thus this piece will reflect on technology in the context of Boundary Setting and Chronic Illness.
The impact of information technology on the medical profession is not one that can be ignored, though it is often done so. When once it was unthinkable for medical students to not pore hunchbacked over heavy tomes in hushed libraries, we now have limitless access to resources at our fingertips in the 21st century through Wikipedia, ClinicalKey, UpToDate and other quality repositories.
Therefore, we can say that technology has made information immensely more convenient, right?
Unfortunately, this is not the case. Just as an enzyme accelerates a chemical reaction both ways without affecting equilibrium, so too does technology accelerate both the good and the more malicious facets of information access. Useless and potentially harmful misinformation can now be spread as easily as the truth, and professional and private boundaries have been blurred at the convenience of the system – removing the distinction between private and public internet presence.
I am worried at the resulting professional view that the internet and social media should be avoided for fear of sanction or litigation – effectively cutting ourselves off from the communication highway of the modern world in a Luddite move. Those who do decide to take the risk of entering the brave new world are forced to walk a tightrope of paranoid restraint. But why should this be the case?
Long ago, I once read that there is an interesting disparity in the dichotomy of good versus evil: that once the good have finished tying themselves up in their rules and regulations, they are helpless to the actions of the not-so-virtuous that are not as bound as ourselves. And indeed we do see that to be the case, with the rise of the Tea Party, Scientology, anti-vaccination movements, evolution denialists, and climate change denialists while we shirk from the social media that facilitated their growth.
Going into medicine, I have heard the observation that medicine has traditionally been a politically conservative field – and indeed my experiences thus far have supported this assertion. When all has been said and done, technology in the health system has not been keeping up with the world. The wards run computer technology that is a decade out of date, guidelines have not been pre-empted and debated prior to the ethical impact of new technologies such as Google Glass and other advanced interfaces that lurk on the horizon.
Eliezer Yudkowsky, an AI theorist, once recounted a story where a physics class walked in to a metal plate sitting near a fire and were asked by their teacher to feel it and explain why the metal appeared colder near the fire and hotter away from it. These students, unable to notice their confusion resulting from the contradiction it had with their knowledge, gave answers such as ‘because of how air moves’ or ‘because of the metal’s conductive properties’. None of them thought to say that this just seemed impossible. Unbeknownst to them all, the teacher had simply turned the plate around before they came in. The students were unable to notice their confusion, and therefore could not identify the deception.
This illustrates a subtle idea that as rationalists, we are more confused by fiction than by fact. The corollary of this is that is that when we are confused, something we believe is false. Thus, the ability to recognise confusion is necessary to identify falsehoods not just from what we see, but also from our past education and experiences.
Given the confusion at present regarding the use of internet media, I believe it is time that we examined more closely what epistemological assumptions we’re taking for granted, and not just ignore the big questions because ‘the rules said otherwise’.
Taking these questions forward is integral for our development as both humans and doctors.

By Raymond Su, second-year medical student, Melbourne Medical School

Melbourne Doctor of Medicine (MD) Program

Program: Doctor of Medicine (MD)
Location: Melbourne, Victoria
Next semester intake: February 2016
Duration: 4 years
Entry Requirements
To apply to the Melbourne MD, eligible Canadian applicants must have

• successfully completed an undergraduate degree in any discipline at a recognized university;
• completed prerequisite second-year university subjects (one each) in anatomy, physiology and biochemistry. Subjects from overseas universities will be considered on a case-by-case basis.
• completed the Medical College Admission Test (MCAT) or the Graduate Australian Medical School Admission Test (GAMSAT); and
• received an invitation by the University of Melbourne to sit a multi-mini interview (MMI).

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