The use of artificial intelligence (AI) in our lives, both in peace and in war, has exploded over the past 10 years, from ATM machines armed with facial recognition to Alexa, your friendly companion which can answer questions, let you know the weather for the day and turn on your television. The problem is that Alexa, among other machines, stores and reports your questions and formulates a profile of you and your interests. AI has been steadily saturating our lives. But as always with a novel technology, predictions for its power and how it can be used are often more fantastical than real. AI’s limitations and possibilities for error are rapidly becoming apparent. While speculation is fascinating, constructing, developing and using AI technology and testing its accuracy in replacing human effort requires careful, evidence based research.
Let’s talk about using AI in the doctor’s office. Patients complain bitterly about the physician who looks into his computer screen and types furiously to create the latest buzz word in our profession, the “electronic medical record. ” The record is stored and, like any digital information, can be hacked and utilized for nefarious purposes. Often it contains wrong data that are copied verbatim and reported time after time as the records are transmitted from one physician to the next. Another iteration of the medical record is the product of the “medical scribe”, a robot that records what is said between physician and patient. Unfortunately, the scribe may “hear” incorrectly (ever follow the instant caption service on TV and see how often it misses the original spoken word?) and often cannot recognize regional accents.
Take facial recognition technology: sounds like a fail-safe idea for secure access to cell phones, ATM’s and at airports. But it seems that the current systems can’t take skin tone into account-a source of misidentification.
Alexa has partnered with the FDA to recommend and keep track of medications for patients but the machine doesn’t recognize many of the names of the drugs ordered/taken.
Robots are everywhere in the world of commerce. The New York Times reports that a company called Powerfront “uses colorful avatars to represent customers, their purchasing history and their shopping activity.” Business knows more about you than you can imagine, tracking your internet use and storing the information for marketing purposes. One expert believes customer’s “emotional profiles” are stored and used to sell products they may find particularly attractive and even irresistible.
The Washington Post reported this week that the Massachusetts State Police has become the first law enforcement agency in the US to put a robotic dog to work. They are testing the capabilities of the machine, which they have attached to be bomb squad unit, for three months to detect “potentially dangerous environments which may contain suspects and ordnance”. Civil rights organizations are becoming alarmed. Apparently much of the robot’s movements are self-generated and not controlled by humans. The possibility of physical harm or intimidation of people has apparently been a concern and been expressly forbidden by agreements made by the robot manufacturer, Boston Dynamics, and their customers.
The bottom line is that artificial intelligence is accumulating information about all of us to a degree that’s intrusive, alarming and can contain significant errors. It is being used to influence choices and purchases we make to an extent that most of us would find astonishing if we had an opportunity to review our individualized profiles. Machines aren’t ready to replace the judgment and control of human intelligence without close supervision and clear boundaries of what’s transparent, fair and legal. Before you consent to “cookies” the next time you access a new website, think twice.
Marianne J. Legato, MD, Ph. D. (hon. c.), FACP is an internationally renowned academic, physician, author, lecturer, and pioneer in the field of gender-specific medicine. She is a Professor Emerita of Clinical Medicine at Columbia University College of Physicians & Surgeons and an Adjunct Professor of Medicine at Johns Hopkins Medical School. Dr. Legato is also the Director of the Foundation for Gender-Specific Medicine, which she founded in 2006 as a continuation of her work with The Partnership for Gender-Specific Medicine at Columbia University. She received an honorary PhD from the University of Panama in 2015 for her work on the differences between men and women.
At its core, gender-specific medicine is the science of how normal human biology differs between men and women and how the diagnosis and treatment of disease differs as a function of gender. Dr. Legato’s discoveries and those of her colleagues have led to a personalization of medicine that assists doctors worldwide in understanding the difference in normal function of men and women and in their sex-specific experiences of the same diseases.
She began her work in gender-specific medicine by authoring the first book on women and heart disease, The Female Heart: The Truth About Women and Coronary Artery Disease, which won the Blakeslee Award of the American Heart Association in 1992. Because of this research, the cardiovascular community began to include women in clinical trials affirming the fact that the risk factors, symptoms, and treatment of the same disease can be significantly different between the sexes. Convinced that the sex-specific differences in coronary artery disease were not unique, Dr. Legato began a wide-ranging survey of all medical specialties and in 2004, published the first textbook on gender-specific medicine, The Principles of Gender-Specific Medicine. The second edition appeared in 2010 and the third edition, dedicated to explaining how gender impacts biomedical investigation in the genomic era, won the PROSE Award in Clinical Medicine from the Association of American Publishers in 2018. A fourth edition is forthcoming.
She also founded the first scientific journals publishing new studies in the field, The Journal of Gender-Specific Medicine, and a newer version, Gender Medicine, both listed in the Index Medicus of the National Library of Medicine. She has founded a third peer-reviewed, open access journal, Gender and the Genome, which focuses on the impact of biological sex on technology and its effects on human life.
Dr. Legato is the author of multiple works, including: What Women Need to Know (Simon & Schuster, 1997), Eve’s Rib (Harmony Books, 2002), Why Men Never Remember and Women Never Forget (Rodale, 2005), Why Men Die First (Palgrave, 2008), The International Society for Gender Medicine: History and Highlights (Academic Press, 2017), and most recently, The Plasticity of Sex (Academic Press, 2020). Her books have been translated into 28 languages to date.
As an internationally respected authority on gender medicine, Dr. Legato has chaired symposia and made keynote addresses to world congresses in gender-specific medicine in Berlin, Israel, Italy, Japan, Panama, South Korea, Stockholm, and Vienna. In collaboration with the Menarini Foundation, she is co-chairing a symposium on epigenetics, Sex, Gender and Epigenetics: From Molecule to Bedside, to be held in Spring 2021 in Italy. She maintains one of the only gender-specific private practice in New York City, and she has earned recognition as one of the “Top Doctors in New York.”