What Luddites Can Teach Us About Resisting an Automated Future
“If your concept of ‘progress’ doesn’t put people at the center of it, is it even progress?” The electronic medical record (EMR) promised all kinds of benefits for healthcare. It’s unclear how many of those benefits have been realized but it has certainly made clinicians’ work feel more menial. Artificial intelligence (AI) promises the same. We recurrently place our faith in technology to free us up to… do what? Realize a humanity in our work that we didn’t learn to exercise in the first place?
How Did the World Run So Low on Cholera Vaccine?
This would never happen with a cancer immunotherapy. This is perhaps in part because of the priority we place on treating cancer above infectious diseases (at least in developed countries), but also because of how much or how little money can be made in either venture.
“Ridding the Race of His Defective Blood” - Eugenics in the Journal, 1906-1948
A remarkable account of the history of eugenics in the New England Journal of Medicine. If natural selection acts on subsequent generations to produce particular outcomes, then surely humans can intervene to influence those outcomes? Turns out that idea, which seems so mundane and beneficent (it’s what we do with crops and livestock, right?), is the seed of much horror. A year after this historian’s survey, Leopold Alexander published his essay in NEJM on “Medical Science Under Dictatorship.” The two read together offer a striking perspective of the end result of a eugenic philosophy.
Deeper dives into nuanced clinical topics often turn up a pearl or two, and this episode of GeriPal is no different. Y’all might be proactively referring patients who could develop dysphagia due to, say, a degenerative neurologic condition, but I’ll be honest: I’ve been far more reactive in my practice. I ask basic screening questions about swallowing and, if they screen negative, I don’t give it much more thought. Apparently that’s not enough! I’m going to think of referring to SLP earlier in the disease course.