Digital Healthcare and the Illusion of Progress

摘要

We live in a post-humanist world, where the lines are blurred between human and non-human persons. We are in this space where the human and non-human, are all intersecting and creating overlaps that are no longer clearly defined. Posthumanism has existed for a very long time, through indigenous cultures where the earth, the land, trees and waters are treated with the same respect and criteria as those of human persons. So, while we may delude ourselves in thinking that somehow posthumanism has just landed on us because we have found digitalisation, robotics and artificial intelligence (AI), the reality is that the idea has existed for a very long time. However, unlike the respectful and integrated human versus non-human person philosophies of indigenous cultures, our relationship with digital technologies, robotics and AI is far from respectful or integrated through the lens of respect for persons. The rapid adoption of electronic medical records (EMRs), digital scribes and AI-driven decision-making tools (to name but a few) are all finding their place in contemporary healthcare, but without extensive evidence that such ‘innovations’ have given us more time to spend with patients. Indeed, if they have resulted in nurses having more time to spend with patients, this has often resulted in reduced nursing staff levels as evidence of economic efficiency. Research by Kaihlanen et al. (2023) found that while digitalisation can reduce workload and improve information flow, it also leads to increased task duplication, reduced face-to-face interactions, and a mismatch between managerial and frontline perceptions—often resulting in decisions that prioritise efficiency over care quality. While our anthropomorphic paranoia about robots becoming overly human may never be realised, one of the issues we are challenged with is the extent to which we are comfortable with or accepting of non-humans replacing the need for humans to ‘do’ care, to do tasks, to do the writing of patient records and to produce reports of our health status and wellbeing. But as Sharmer (2025) points out, we need to remember that AI has blind spots, and the most significant blind spot is that it hasn't got that innate human capacity for deep creativity and emotion. It is and always will be, (unless anthropomorphism really comes to the fore and robots really do become human beings) dependent on humans to program its creativity. Humans have agency and it is this agency, that gives us the capacity to make decisions about what we do, what we don't do, and when we do it, driven by ethical and moral perspectives, as well as deep emotional engagement as persons—the essence of our personhood. We are comprised of our beliefs, our values, our motivations, our desires, our creativity, our agency, and our selfhood. Paul Tournier (1957: 148) argues ‘we conceal our person behind a protective barrier; we let it be seen only through the bars where we display certain of its aspects, others we carefully hide’. Tournier highlights we don't reveal our authentic self all the time and in all contexts. We choose which parts of ourselves we display at which points in time. Being authentic is a state of becoming and continuous transformation as we grow, develop and mature as persons. So how we choose to display ourselves is an important consideration, because AI algorithms don't allow distinctions in terms of display, they just display what has been programmed and what is put out at a point in time. As persons, we are always in that movement. We are never static; we are never fixed entities in the way an AI agent might be. We are constantly transforming, often unconsciously, and sometimes deliberately and intentionally, depending on what we're doing. But we are never static and we are never fixed. So, when we reduce our models of care to that of responding to task allocations derived from AI-driven assessments in EMRs, we are working towards stripping the humanity from care and losing its hea