Topic: Computers will soon choose if we live or die...

[Centurus]

The computer that decides if we live or die
POSTED: 6:52 a.m. EDT, June 21, 2007
By Michelle Chan for CNN
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LONDON, England (CNN) -- A serious injury leaves a loved one in a coma. Relatives may face the hardest decision of their lives: to wait it out or turn off the life-support machine.

But now, that critical decision may be turned over to a sophisticated computer program. New software should soon be able to predict more accurately than loved ones how comatose patients would choose to be treated, if they were able to make the decision themselves.

Bioethicist David Wendler at the U.S. National Institutes of Health in Washington D.C., and his colleagues, used very elementary past research to build up patterns in patients' choices. "There was very little data available and the approach we used was incredibly simplistic," Wendler concedes. "But even with a little amount of data, we did very well."

The study compared how accurately their computer-based tool predicted a patient's preferred treatments compared with what loved ones said. Results showed both methods got it right around two-thirds to three-quarters of the time.

Wendler hopes to build up a broader data bank of personal profiles, which will include age, gender, religious and ethnic background, to advance the software. He is confident that will enable more accurate patient predictions. "We have very good reason to believe we can get significantly better results," Wendler says. "Maybe ten or fifteen percent more accurate than (next of kin)."

Dying wish
Patients have gained more control over their medical care in recent years but many still fail to sign a directive looking to the future. Few discuss treatment preferences they would elect if they lost the ability to make decisions. Without a self-directed advance medical plan for a patient, relatives are often asked to step in and act on a loved one's behalf.

"We've always gone with the idea that people who know the patient best are also best positioned to make the decision about treatment," Wendler says. "My concerns were that this process puts a burden on families. I wanted to develop an alternate approach."

Wendler is acutely aware of the problems a software program like this might pose for the community at large. "Some people say, 'of course this is good' and others think 'this is crazy'," Wendler says.

Who knows best?
Irrespective of medical advances, some relatives may, on principle, always want to make end-of-life treatment decisions for incapacitated relatives. Others may prefer to see the computer-generated results to help them come to a decision. "We could give them supplementary information like: 'people like your father want this kind of treatment," Wendler says. That extra information might diminish doubts or offer support to an overwhelmed family member. "Results will be different depending on if they're twenty or ninety years-old," Wendler adds, "or if the treatment they face is a tasteless pill versus painful chemotherapy or invasive surgery."

The computer tool could also potentially replace the relative or next of kin. Patients could choose this option in advance of their degeneration instead of turning over the decision to a loved one. Some may see it as unburdening family or simply more accurate. There is also the segment of patients who do not have surrogates who can act on their behalf.

For Wendler and his team, the next step is a broad poll and to refine the computer model. As the head of the Unit on Vulnerable Populations in the Department of Bioethics in the NIH Clinical Center, Dave Wendler understands the need to keep his work transparent. "Developing a community-based process is essential," he says. "Poor, non-empowered groups are worried this process will be used to cut off treatments. But I am trying to identify what is the best way to make decisions for these patients."

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Don't know about any of you, but does anyone else here think that something like this could be perverted by insurance companies to always give the decision to pull the plug?

[FCM_SFHQ_XC]

I am not gonna let some computer decide if I live or die. I don't care how smart it is.
Truly it should ALWAYS be either the patients decision or the families decision depending on what the situation is.
And as Centurus said, a little reprogramming, and next you know, certain people will then be able to tell the Computer what to say.

[Just plain old Punisher]

Computers aren't intelligent. They aren't capable of understanding the imporance of the decisions they make, they only do what they're programmed to do. Therefore, we wouldn't really be placing decision making in the hands of a computer -- we would be placing decision making in the hands of the people who programed the model.

These sorts of things are never easy, and no AI will make it easier. Often the families of the comatose patient don't follow the wishes of their family member.

[Panzergranate]

I've written AI programmes before now and one can weight them to bas decission making in any dorection one wants. Rather like the media can bias the electorate to vote in any direction they want!!

And if the programme is runnig on a MS Windows platform....

I was diagnosed, last year, with a terminal spinal consition.... My neck vertibrae are slowly fraying through my spinal cord.

I have about 20 years left of which the last 5 or so will be a living hell.

I had a surgeon tell me that facts straight. I can have the two damaged vertenrae removed, which would be a medical first, but there would be a 50/50 chnce of dying on the table, and the specialist said, quote, "And that would be a good result for you!!" There is a 48% chance of me surviving but they acidentally cut someting like the speach centres, motor control for limbs, etc.

But there is a 2% chance of being fixed, albeiet with a head that can't turn anymore.

He told me that when the agony vecomes unbearable then that is when it would be a good time to do it.

All this is because I fell down stair when I was 4 years old and fractured my neck, it wasn't picked up on at hospital back then in 1966 and now I'm paying for it in spades.

My sense off pain stopped when I was 14 for no apparent reason.

I lost my sense of body temperature last year after a month long ache attack.

I also lost the feeling from the right forefinger and middle finger pads. (They have special wiring according to the neurloogist).

If you want to know what this feels like pick up a six pack of beers and hold it out at arms length to your side. Feel those lactic acid sensors screaming in your arm to put it down after a few minutes. Now imagine that but stronger for anywhere from an hour to 6 weeks at a time and no pain killer on earth touches it.

But the arm still works fine. It's all shorted wiring.

I'm slowly being disconnected from my body. In 20 years time it'll fray through the autonomic system and I'll hopefully die pretty quickly. I don't fancy dragging it out hooled up to a machine or in an iron lung, trapped in living hell because of misplaced morality or legal crap. One could be fined or go to jail for keeping an animal like that.

BUt at the moment I'm still able bodied and try to enjoy the priveldges this brings taht we all take for granted.

Perhaps this is a good idea but it has to be well figured out. And best run on a Macintosh or Sun as well!!

As a person who's heading that way, I can see things from both perspectives.