Artificial intelligence (AI) is starting to affect everything we do. Sometimes I dictate random thoughts and the AI is able to take the thoughts and turn them into an article. One area I have been playing with is how AI can influence directions given to individuals on their health care decisions delegated to others. Specifically, I have been thinking about how AI intersects with health care directives (living wills), do not resuscitate orders (DNRs) and health care proxies (HCPs).
Understanding Living Wills, DNRs and HCPs
Before delving into the impact of AI, it’s essential to have a clear understanding of these documents.
Living Wills
A living will is a document that outlines a person’s wishes regarding medical treatment in situations where they’re no longer able to communicate their decisions. It typically includes preferences about life-sustaining treatments, resuscitation and pain management.
DNRs
DNR orders are medical directives written by individuals to indicate that they do not wish to receive cardiopulmonary resuscitation (CPR) or advanced life-support measures if their heart stops or if they stop breathing. DNR orders are typically discussed with healthcare providers and documented in medical records to guide healthcare professionals during emergencies.
HCPs
A health care proxy, also known as a durable power of attorney for health care, is a document that designates an individual to make medical decisions on behalf of the incapacitated person. In theory, the appointed proxy is responsible for ensuring that the patient’s wishes are followed. However, in practice, the appointed proxy usually makes the decisions based on their own judgment.
AI in Health Care Decision-Making
One of the advantages of AI in general, and its use in health care in particular, is its ability to process vast amounts of data quickly and accurately. In the context of living wills and health care proxies, AI algorithms can analyze patients’ medical histories, treatment preferences and other relevant data to provide healthcare professionals with insight that may otherwise be difficult to ascertain. This enhanced accuracy ensures that medical decisions are made promptly and correctly, reducing the risk of errors and misunderstandings.
Personalized Medical Decision-Making
AI’s ability to personalize medical decision-making will have a significant impact on living wills, DNRs and HCPs. By analyzing individual patient data, AI can tailor recommendations to suit the unique needs and preferences of each patient when the patient can’t make the decision themselves. In other words, it can “help read the mind of a person when they cannot speak their mind.” The hope is that this level of personalization ensures that the medical treatments and interventions align closely with the patient’s values and beliefs, leading to more patient-centered care. The challenge is that any wishes captured are based on peoples’ understanding of the science of medicine and the diagnostic abilities at that time.
Let’s take the following example: I have a DNR saying no measures should be taken if I am in a permanent vegetative state. However, when I signed that DNR, I didn’t know of the new technology that can clone healthy brain cells. How can my wishes from a time when the technology was unknown be fed to AI to make a decision in the present?
Streamlining Emergency Decision-Making
AI’s ability to process information rapidly is particularly invaluable in emergency situations. When patients arrive at emergency departments incapacitated, AI can quickly access and analyze their living wills, DNRs and HCPs to guide medical teams in making swift and accurate decisions. This streamlined approach ensures that patients receive appropriate care in critical moments.
Improving Communication with Health Care Proxies
AI-driven communication tools can facilitate better interactions between healthcare providers and health care proxies. By providing clear and concise summaries of patients’ medical conditions and treatment options, AI can empower proxies to make informed decisions that align with patients’ wishes. This improved communication fosters trust and collaboration between all parties involved.
Integration with Electronic Health Records
The integration of AI with electronic health records (EHRs) can streamline the management of living wills, DNRs and HCPs. AI systems can automatically update and retrieve relevant information from EHRs, ensuring that healthcare providers have access to the latest patient data. This seamless integration enhances the efficiency and accuracy of medical decision-making.
Impact of AI is Revolutionary
The impact of AI on living wills, DNRs and HCPs is revolutionary. AI’s ability to process vast amounts of data, provide predictive analytics and personalize care ensures that patients’ preferences and wishes are respected, even when they’re unable to communicate them. However, the integration of AI in health care also presents challenges related to data privacy, ethical considerations and human-AI collaboration. If used correctly, AI can be a powerful tool to “read your mind” when you can’t speak.
Predictive Analytics for Proactive Care
AI-powered analytics can anticipate potential health issues and complications based on patients’ medical histories and current conditions in ways that individual medical practitioners can’t. In the context of living wills, DNRs and HCPs, AI can either help or hurt the “correct” decision being made based on then-known care.
For example, if a health care decision is driven by religious views and the documents do not explicitly state the thinking behind the decision, the AI algorithm may get the answer very wrong. In contrast, if what’s driving the decision is avoiding routing out a family’s finances, AI may actually help make the right decision.
Challenges and Ethical Considerations
The integration of AI in health care decision-making raises significant concerns about data privacy and security. Living wills, DNRs and HCPs may involve sensitive personal information, and safeguarding this data is paramount. Healthcare institutions and AI developers must implement robust security measures to protect patient data from breaches and unauthorized access.
Human-AI Collaboration
While AI can significantly enhance health care decision-making, the collaboration between human healthcare providers and AI systems is critical. The role of health care proxies remains indispensable, as they provide the human touch and emotional support that AI can’t replicate. Striking the right balance between AI-driven insights and human judgment ensures comprehensive and compassionate patient care. What I see as most helpful is the predictive analysis AI may contribute.
In palliative care settings, where patients’ preferences are of utmost importance, AI has demonstrated its potential to personalize treatment plans. By analyzing patient data, AI systems can recommend pain-management strategies, end-of-life care options and other interventions that align with patients’ living wills and HCPs. This personalized approach enhances patients’ comfort and dignity during their final stages of life.
*This article was originally published in Baker McKenzie’s client newsletter.
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