Wednesday, March 11, 2009

Health Care Robots

The title of this post isn't a metaphor. It's really about robots.

The most recent issue of "Proto," a web-based magazine on innovation published by the Massachusetts General Hospital, describes the development of "socially assistive" robots in fascinating detail. Early trials show that robots can help children with autism. CosmoBot, a 16-inch-tall robot taught Libby, a six year old with severe autism, to imitate movements in a Simple Simon way. Libby hadn't responded to human teaching efforts, but CosmoBot's patient repetition did the job.

In India I've observed remarkable examples of "socially assistive" human care in which poor people carried out repetitive care tasks with the elderly with skill and sensitivity. The U.S. and Europe have fewer people available to do this kind of work and willing to do it. The MGH article quotes Martha Pollack, dean of the University of Michigan School of Information - “The number of younger adults for every older adult is decreasing dramatically, and we’ve never before seen these percentages of people over 85. Robots will never replace human interaction, but they can augment it.”

When I worked at the Massachusetts Mental Health Center during the summer after my first year at medical school I heard about an experiment that would never get by an IRB today. Subjects from a population seeking psychotherapy were given the option of speaking to a tape recorder and were told that a therapist, who they would never meet, would listen to what they said. That was it. No therapist listened to the tapes. No one did. But when the subjects were asked about their "treatment" a remarkable number reported benefit, and felt cared for by their non-existent "therapist."

Our human nature prepares us to be helped by inanimate objects or non-existent therapists.

Experimenting with robot caretakers could seem like an ultimate form of dehumanization. In my view, the robots themselves are ethically admirable. The ethical uncertainty is how we humans use the robots. Ventilators are a kind of primitive robot carrying out a single repetitive function. When we use them well we help sick people recover and save lives. When we use them mindlessly (robotically) we flog patients and prolong the dying process.

Here's what Carole Samango-Sprouse, director of the Neurodevelopmental Diagnostic Center for Young Children at George Washington University said about Libby, the six year old with autism: “Her mother and the professionals who saw [Libby's new learning] were in tears. It was incredibly encouraging that the robot, through repetition and predictable behavior, was successful in getting her to perform the motions she had seen adults doing for years.”

As Albert Einstein said about atomic energy - "The release of atom power has changed everything except our way of thinking...the solution to this problem lies in the heart of mankind."

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