Reform of the clinic: doctor, AI, patient ‘triadic relationship’
By Orhan Onder  |  Jul 20, 2022
Reform of the clinic: doctor, AI, patient ‘triadic relationship’
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Dr Orhan Onder argues that during the shift from the conventional doctor-patient dyadic clinic to the new doctor-AI-patient triadic clinics, theoretical investigations must be prioritized to forestall future ethical breaches and other adverse effects.

ISTANBUL, TURKEY - Canguilhem, a well-known medical philosopher, quotes French vascular surgeon and physiologist René Leriche, in his book; “Health is a life lived in the silence of the organs,” and adds “disease is what irritates men in the normal course of their lives and work, and above all, what makes them suffer.”1 

Medical clinics are the place where diseased-people turn for remedy when the silence of their organs is broken. However, clinics are not fixed in a certain setting and are always transforming. They are closely related to the concept of disease and the epistemic processes in the way medical knowledge is produced. Back in antiquity, when people believed that evil spirits were the main cause of disease, the belief that doctors had shamanic powers and held esoteric knowledge affected the patient-doctor relationship and the form of the clinic. 

People used to believe that healing power was a god’s gift and a special type of talent that freed the patient from ill-causing spirits. Starting with the Renaissance, in the modern era, the scientific method shifted, and the theory of disease also changed. The germ theory of disease, for instance, overtook the miasma (bad-air) theory. Developed diagnostic methods deglamorized doctors and dispossessed their hands of the magic, which resulted in a change in clinical dynamics again. Today, with the breakthrough in artificial intelligence (AI) research, the permeation of AI applications in healthcare necessitates the reformation of clinical dynamics again. What types of changes in clinics await is a big question yet to be answered. In this article, several foundational aspects of clinics are scrutinized in this regard.

Algorithms in medicine first emerged in the 1970s as expert systems. These rule/knowledge-based algorithmic systems mostly used statistical methods and soon after suffered from frame, ramification, and qualification problems. Recent

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