INTELLIGENCE OF MEDICINE

 

The Intelligence of Medicine belongs to the broader concept of intelligence of health but, because of its particular aspects, it can be examined independently.
This subject matter is both stimulating and potentially ambiguous. It is certainly worth investigating in depth because of its long and fascinating history. While I cannot cover the topic fully here, I will give an overview of the topics involved.
Where does this specific form of intelligence find its home?
Without doubt, where thought can be expressed freely and leads to advancement in research, and not where thought descends into superstition or compliance.
This human intelligence, whatever the form it has taken throughout the centuries, dwells with particular forcefulness in the places of knowledge that were (and are) universities. This is where thought and language were born and have gradually risen to higher levels. Alongside thought and language, are the methods that have, step by step, defined the concept of “professionalism” linked to the basic needs of people and their communities, upheld through time by the growing world of technology.

Even back in the Middle Ages, the free intelligence of medicine was visible and connected to a knowledge that we can certainly call philosophical, as it channelled rationality and expressed freedom of thought.
At the end of the 13th century, Bologna was at the centre of this meeting of medicine and philosophy. Gentile da Cingoli made the association between arts, which he saw as philosophy, and medical studies, where Taddeo Alderotti has already left his mark.
This unusual alliance, as it was described, between doctors and philosophers gave rise to a new model of medical studies 2.

Over the centuries, this model was shown to be efficient and effective and was careful to interpret the specific requirements of every historical timeframe, despite several interruptions.
In the light of this, I wish to outline the needs/urgencies found in today’s western society – because it is clear that these needs/urgencies are closely bound to our economic, social, political and cultural climate. In developing countries, the topics to address, the ones we must understand, interpret and resolve, are certainly not the same as those of the old continent, or Canada, or Japan or the USA.
An ageing population had led to an increase in illnesses directly linked to longer life expectancy. These same illnesses were much rarer a mere one hundred years ago – if only because most of us died before reaching the age where we are more likely to develop them – but now they are affecting more and more people. Here, we are facing emerging new drug resistant viruses and bacteria, the return of – we thought- eradicated diseases linked to an uncontrolled spreading of pseudo-scientific beliefs, joined by an increasing mistrust in science’s capacity to improve human life. These are just some of the topics that are taking an impregnable hold in our society and are the new challenges for a medicine that must be ever more intelligent.
In order to respond to this increasing complexity, the intelligence of health must include proposals where facilities are more and more advanced, doctors more adaptable and families more involved and knowledgeable.
To achieve this, we must steadily apply the fruits of technological development and our improved drugs. At the same time, we must comply properly and correctly with the need to share objectives and demands, allied in our respect for the person who, in turn, must learn to respect that which society can offer.

The intelligence of medicine differs from intelligence applied to other areas of science. It is not merely the expression of pure research, it also embodies treatment and exercises a social function.
For physics and chemistry, this intelligence can have a single, continuative interlocutor (space, particles, elements), but in medicine, it must start from the individual scientist, who must be fully conscious of the place in medical practice held by the doctor-patient relationship and that between doctor and society.
This intelligence must interact with potential tools, because, in today’s world, it is no longer acceptable to take a passive behaviour towards equipment, instruments, pharmaceutical products and technologies that interface with medicine. We must make it clear that we are dealing, on the one hand, with human beings and their wealth of intelligence, and on the other with tools made through human intellect. By their very nature, these tools work at the behest of humanity, for the good of patients and doctors.

The word “intelligence” has a two-fold meaning. It indicates the set of physical and mental faculties that allow human beings to think, comprehend or explain facts and actions, to elaborate abstract models of reality, to understand and be understood by others and to judge. Intelligence is also is the fact or possibility of understanding something and being understood.
Intelligence is, therefore, an intrinsic feature (when we engage in producing something to be understood) and an extrinsic feature (when we understand something outside our own self).
The intelligence of medicine is a concept belonging to the latter case. It implies the partial reproduction of our own innate intellectual activity. This is achieved through tools that are continuously evolving, as well as our human ability to understand the dynamics of health and sickness, and to act in a way that is most likely to protect our own health and that of others.
In this second meaning, the concept of intelligence of medicine is as old as humankind. When we first made our appearance on our planet, we had to put in place behaviour such as to determine what systems would truly be effective in ensuring our survival.
The first meaning of intelligence of health is, on the contrary, relatively new, and has its roots in the last century, when the first computer programmes were used to solve complex problems.
The development of intelligence – with its staunchly rooted offshoot artificial intelligence – meant that the tools linked to this new reality became used in all the fields of human knowledge, especially and to our greatest benefit in the medical sphere.

The intelligence of medicine is progressing, for example, more and more obviously in cancer treatment, where patients’ life expectancy has shot up dramatically following the advancements in innovative therapies and highly effective, personalised diagnostics, which only a few decades ago were beyond our imagination.
The intelligence of medicine has also upturned the surgical sector, with the arrival of robots that, while unable to carry out surgical procedures totally independently, provide essential assistance working alongside medical teams. Backed by this technology, surgeons can operate more effectively and with greater safety, the outcome is better and there are fewer complications post-surgery.
Lastly, the intelligence of medicine has opened the doors to new possibilities in the field of genomics, and we can use information extrapolated from our own gene pool more and more effectively to prevent and cure illnesses, unlocking new therapeutic possibilities.

In the light of this brief outline, when we talk about intelligence of medicine, we must make this observation: “The pervasive technology that defines our era places us in front of a non-sensical dilemma on the relationship between man and machine” 2.

I believe that we can all share this statement. Machines will always be complementary to our life, and talking about intelligence augmented through technology is an assertion that must be accepted in a secular perspective. This progress implies greater power and potential. Over the next decades, it will allow human intelligence to voice its entirety and completeness and so express its creativity more fully.

Naturally, none of us is able, for the moment, to know what will happen down the line with artificial intelligence and robotics. Each of us, however, knows or should know, how much we can ask of scientists, especially in these extraordinary times.
Scientists know and want to address what is happening. These are not sudden discoveries that are sprung on them, but developments in knowledge, and are the outcome of human work and greater knowledge. Living, knowing and investigating are all tightly liked and flow throughout human history. Human intelligence has never stopped evolving…
We cannot decide to simply let life take its course, leaving it to others (who are in any case only a few) the task to develop research sectors that we expect will, in future, become necessary, if we want to apply the full potential of such advanced discoveries.
The decisive moment has come to verify their effectiveness. We can create and govern change, retaining what we must preserve and welcoming the new in an informed and constructive manner, without being mere passive recipients.
In this context, the mission of intelligence is, therefore, intrinsically linked to the sectors and the many subject matters involved.
Everything that belongs to sectors dedicated to humanity must be given double consideration, because the development of human intelligence is the prerequisite for the development of everything else.
We must not underestimate empathy, which must be practiced as an essential part of medicine, so much so as to be placed in first place. Apart from discoveries and their importance, what is important is the relationship that must exist between patient, doctor, the patient’s treatment and the management of health and medicine, up to end of life and dignity in dying.
The revolutionary events that have enveloped the world of medicine through technological developments mean that, in some cases, the situation is dramatic. Treating illness is so strongly dependant on new instruments and technologies geared towards finding the symptoms of diseases, and so offer diagnosis, that it may erode or even cripple the doctor’s role.
We can already see that the rapid pace of technological evolution at the service of the intelligence of health has set in motion a certain process of ambivalence. As is often the case, intelligence can be a double-edged sword.

 

Fabio Roversi-Monaco
PresidentGenus Bononiae. Musei nella Città

 

[1] C. Crisciani, L’alchimia dal Medioevo al Rinascimento: scientia o ars? , in Il Rinascimento italiano e l’Europa. Le Scienze, vol. 5, ed. by A. Clericuzio, G. Ernst, with the collaboration of M. Conforti, Treviso, 2008, pp. 111-128.
[2] From an interview by Dr. Luca Altieri, Director of Marketing IBM.