Medical Artificial Intelligence

Clinical judgment, also called clinical reasoning, clinical decision-making, and diagnostic-therapeutic decision-making, lies at the heart of clinical practice and thus medicine. In the past, clinical judgment was considered the expert task of the physician. But the advent of computers in the 1940s and their use in medicine as of the late 1950s gradually changed this situation. In the 1960s, a new discipline emerged that has come to be termed medical computer science or medical informatics, including clinical informatics. Clinical informatics is concerned with all aspects of the application of computing machinery in clinical research and practice. As one of its accomplishments in clinical practice, the physician's capacity for clinical judgment is in the process of being turned over to computers. We are told that in the future, computers will be responsible for making diagnoses and treatment decisions. This prospect, its historical, methodological and philosophical background, and its impact on health care are discussed in the present Part VI which divides into these three chapters: Medical Decision-Making, Clinical Decision Support Systems, Artificial Intelligence in Medicine. An introduction is given to these these three areas to enable a philosophical analysis of the possibility and potential of artificial intelligence in medicine. The introduction includes a brief reconstruction of the history of Medical Decision-Making and of its logical-mathematical foundations, and of how the so-called medical expert systems research emerged therefrom. The logic, the structure, the varieties and the technique of medical expert systems are analyzed to distinguish between ordinary medical expert or decision support systems, fuzzy medical expert systems, neural computation, evolutionary computation, and hyprid decision support systems.

Among all types of machines used in medicine today, the computing machinery plays the predominant role. This also includes its indispensable contribution to the operation of nearly all modern devices used in medical practice and research, e.g., X-ray machines, MRT, heart-lung machines, dialysis machines, surgical robots, pacemakers, and others. There is almost no medical device today without specific chips and computing components. So, the question arises how the dominance of the computing machinery in medicine develop in the future and whether this development be a blessing or a curse when computers become intelligent in the years ahead. It is anticipated that in the not-too-distant future all types of the expert and decision supprt systems mentioned above will be applied in the computing machinery of health care to automate diagnostic-therapeutic decision-making and to bring about medical artificial intelligence so as to enhance the physician performance. Although this is a serious issue that concerns the very nature of health care, there are only a few people who take it seriously. On the contrary, most physicians and medical officials believe that computers as machines will lack intelligence forever. This presumption is thoroughly examined in the final chapter of this Part VI to show why those who deny the possibility of artificial inteligence in medicine "because of" the alleged supremacy of human intelligence, err.

This completes Part VI consisting of 3 chapters and 36 pages.