I thought you all might be interested in my little contribution to a
colloquy in Reason magazine's 2024 issue. You can find the whole thing
here:
https://web.archive.org/web/20240506084929/https://reason.com/2024/05/05/ai-is-like/
AI Is Like the Dawn of Modern Medicine
By Mike Godwin
When I think about the emergence of "artificial intelligence," I keep
coming back to the beginnings of modern medicine.
Today's professionalized practice of medicine was roughly born in the
earliest decades of the 19th century—a time when the production of more
scientific studies of medicine and disease was beginning to accelerate (and
propagate, thanks to the printing press). Doctors and their patients took
these advances to be harbingers of hope. But it's no accident this
acceleration kicked in right about the same time that Mary Wollstonecraft
Shelley (née Godwin, no relation) penned her first draft of *Frankenstein;
or, The Modern Prometheus*—planting the first seed of modern
science-fictional horror.
Shelley knew what Luigi Galvani and Joseph Lister believed they knew, which
is that there was some kind of parallel (or maybe connection!) between
electric current and muscular contraction. She also knew that many would-be
physicians and scientists learned their anatomy from dissecting human
corpses, often acquired in sketchy ways.
She also likely knew that some would-be doctors had even fewer moral
scruples and fewer ideals than her creation Victor Frankenstein. Anyone who
studied the early 19th-century marketplace for medical services could see
there were as many quacktitioners and snake-oil salesmen as there were
serious health professionals. It was definitely a "free market"—it lacked
regulation—but a market largely untouched by James Surowiecki's "wisdom of
crowds."
Even the most principled physicians knew they often were competing with
charlatans who did more harm than good, and that patients rarely had the
knowledge base to judge between good doctors and bad ones. As medical
science advanced in the 19thcentury, physicians also called for medical
students at universities to study chemistry and physics as well as
physiology.
In addition, the physicians' professional societies, both in Europe and in
the United States, began to promulgate the first modern medical-ethics
codes—not grounded in half-remembered quotes from Hippocrates, but
rigorously worked out by modern doctors who knew that their mastery of
medicine would always be a moving target. That's why medical ethics were
constructed to provide fixed reference points, even as medical knowledge
and practice continued to evolve. This ethical framework was rooted in four
principles: "autonomy" (respecting patient's rights, including
self-determination and privacy, and requiring patients' informed consent to
treatment), "beneficence" (leaving the patient healthier if at all
possible), "non-maleficence" ("doing no harm"), and "justice" (treating
every patient with the greatest care).
These days, most of us have some sense of medical ethics, but we're not
there yet with so-called "artificial intelligence"—we don't even have a
marketplace sorted between high-quality AI work products and statistically
driven confabulation or "hallucination" of seemingly (but not actually)
reliable content. Generative AI with access to the internet also seems to
pose other risks that range from privacy invasions to copyright
infringements.
What we need right now is a consensus about what ethical AI practice looks
like. "First do no harm" is a good place to start, along with values such
as autonomy, human privacy, and equity. A society informed by a
layman-friendly AI code of ethics, and with an earned reputation for
ethical AI practice, can then decide whether—and how—to regulate.
*Mike Godwin is a technology policy lawyer in Washington, D.C.*
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