Will A.I. be Used for End-of-Life Treatment Protocols?
My best guess is yes, there will be end-of-life protocols to substantially limit or to stop spending health care dollars in the last six months of life.
And using A.I. may start out as a tool to help families decide about treatment options. Certainly, if Medicare for All passes, Congress won’t be dumb enough to do it through a panel this time or to make a “death panel” in the law.
It will likely be explained as being in the realm of “value-based care” or “evidence-based care.”
If your liver is at 100% failure, for example, they will move the patient to palliative care instead of watching them die for one or two or three weeks, depending on the strength and will to live of the individual.
If I had to guess, it would be based on an algorithm, just like 95%+ of all NYSE stock trades are done now.
Once the government is paying the bills, they will be in charge.
They will ration care, just like each of us now rations our own care.
They will say, why spend $30,000 a day on someone in the ICU with total liver failure when the outcome is clear?
If the patient is not on a liver transplant list because they are too old or in such bad health or were never on a list or any number of reasons, or they are on a list but are too far down or there are not enough healthy livers to transplant, nor will there be any chance of getting one before the patient dies, it should be palliative.
So, in my mind, there is no question that evidence-based medicine will be used to ration care to the dying, the definition of which will likely be decided by A.I. looking at a massive amount of past patient data to come up with a protocol that will be used to make these “evidence-based” decisions.
Of course, if an individual wants to pay for the care that the government decides not to, they may or may not be able to, that will depend on which M4A law passes.
Private insurance may or may not exist, or it may exist but the patient did not pay for end-of-life care or chose not to pay the premiums to have private insurance, or, even if the patient has insurance, the insurance company may deny the end-of-life treatment too.
Once everyone understands the A.I. end-of-life treatment protocols, I think many advanced life directives by patients themselves will mimic these protocols.
And even without an advanced-life-directive, my guess is that it will become common practice to follow, without objection or drama, the A.I. guidelines once the government stops paying for this kind of care.
One interesting impact on choices once the government is not paying happened in the U.K. Once the NHS stopped paying for circumcision, i.e., it was no longer free, the percentage of baby boys circumcised in the U.K. dropped to 3.8% today. In 1989, when it was free, the percentage of boys circumcised was 70%.
To be clear, I am not saying end-of-life care decisions equate with the decision to circumcise or not, but the value of care and the costs of prolonging life will be front and center.
The recent viral video about the woman in Nova Scotia begging for treatment is really a woman begging for a chance to live when the health system has decided it is no use to treat her, even though she recounts that the refusal of doctors to take her symptoms seriously resulted in a diagnosis only when her cancer had gone too far for her to be treated, given Nova Scotia’s rationing, end-of-life protocols:
Warning. This is an emotionally disturbing video.