Ask Not For Whom The Robot Cometh…

Did you see the story about the robot doctor that was sent to deliver bad news to a terminal patient? His daughter was with him when the telehealth machine rolled up to his bedside. On the flickering screen, a physician informed the patient that he was going to die, very soon – perhaps too soon to go home. Daughter Catherine was appalled at the coldness of what should have been a human interaction. So were a lot of other people; so was I. The story went viral on social media, prompting somewhat clumsy efforts by Kaiser Permanente to tamp down the overwhelmingly negative response. But there no denying the pain this awful misstep had caused:

"My dad's reaction was, well I guess I'm going to go quickly then and put his head down-- that was it," said daughter Catherine Quintana. 

A prognosis that would have been difficult to accept under any circumstance, became even more painful for the Quintana family of Fremont when the doctor used a robot to deliver the bad news.”

I’m no Luddite, but count me out for this part of the robot revolution. The last place we need to be overtaken by AI is in hospice. We’re dealing with patients at the end of their lives, and families at the end of their emotional ropes: This is not the place to cut corners or shoot for efficiency over human contact, but I fear it’s the way we’re headed.

When was the last time you were in a hospital? Do you recall how often a nurse touched you in a caring way, held your hand or gave your loved one a tender hug? I have watched nurses and aides do vital signs without touching a patient with anything other than the machine they’re using. No eye to eye contact; just get those meds given or treatment done and go on to the next. Aides might give a bath but the RN’s now are often at arm’s length from the patient. What’s wrong with this picture?

What are we “selling” in hospice? Simply access to pain medication? Saving someone from having to call 911 when a family member dies? In a word, convenience?

Or are we selling compassion, the ability to look someone in the eye with empathy and indeed love and tell them the truth, hold a hand, give a hug, share a tear? Humanity – the very best of humanity - is what we are selling and we cannot forget it. I am all for technology that makes jobs easier for the humans who are doing them. I can’t wait for self-driving cars, so that hospice staff can chart on the way to the next patient’s home, or for gizmos that help families dispense medications on time, for instance.

But when it comes time to tell someone they are dying, that they will not be getting well or going home, and there is nothing more to be done? Please, let’s keep that a human interaction, person to person, heart to heart. It’s too big, too overwhelming, too important to hand off to a machine.

Yes, rural hospitals are closing and technology will likely be used to fill in some of the gaps. But no one should have to hear they are dying from a robot. Our healthcare is broken when the bottom line is more important than the health of a community. It is a symptom we have lost our way. And now, some of the not-for-profit hospitals and even hospices are in jeopardy of losing their special tax status because they do not give enough back to the communities they serve. 

Why are we in the business of healthcare, when the care has vanished? Does our responsibility stop at caring only for the physical being? We are so much more than that; we are emotional and spiritual beings living in physical bodies. Hospice has always been about caring for all three aspects – the body, the mind, the soul. 

Don’t lose that - or if you do, you should consider selling cars.