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  • Writer's pictureJohn Lantos

Outsourcing empathy

Sharma and colleagues report a randomized clinical trial of human-only or human+AI respondents to people who sought counseling on a peer-support website. Both groups first received basic training on empathy, which included empathy definitions, frameworks, and examples. Empathy was defined "the therapists’ sensitive ability and willingness to understand the clients’ thoughts, feelings and struggles from the clients’ point of view." In the training, they gave categories of empathic responses with examples: “Empathic responses typically involve: 1) Reacting with emotions felt after reading a post (e.g., I feel sorry for you); 2) Communicating an understanding of feelings and experiences (e.g., This must be terrifying); and 3) Improving understanding by exploring feelings and experiences (e.g., Are you feeling alone right now?)”

During the study, each participant was asked to write supportive, empathic responses to a unique set of 10 existing seeker posts. While writing responses, participants in the Human + AI (treatment) group received feedback via a real-time robotic empathy coach. Participants in the Human Only (control) group received no such feedback.

The researchers evaluated the empathic nature of responses using both human and automated methods. For the human evaluation, people compared their perceptions of the empathy levels in responses to the same post. For the automated evaluation, they measured responses using an empathy classification model that had been developed to evaluate empathic communication.

They found that AI helped people express empathy. No big surprise there. But the study does raise important questions about how, exactly, AI will be used in medicine. What specific doctoring skills will it replace. Eric Topol’s view is that it will do the tedious tasks and free up doctors to be more humanistic. This study suggests that AI might, in fact, be more humanistic than many people. Vinay Prasad thinks it will make chart documentation obsolete and may be better and formulating treatment plans than most doctors are today. He still holds out hope that the best doctors will be better than AI but that sounds a lot like the early days of chess-playing programs when we held out hope that the Grand Masters would never be beaten. They were beaten, of course, and we know now that computers are better at chess than we are.

I don’t think that chatGPT or any other robot will replace doctors because I don’t think we are clear about what it is that we want doctors to do. That is an interesting morass. We have to know not only what doctors do or don’t do but also how well or poorly they do specific things compared to other professionals or, now, compared to robots. We might ask whether one needs to take a history, offer empathy, make a diagnosis, recommend a treatment, determine which types of lenses best correct myopic vision, or counsel the emotionally distressed. Should only doctors perform physical examinations, or administer anesthesia, or determine whether a patient is ready to be discharged from the hospital? Should we leave it to doctors to determine whether another doctor was negligent in a particular situation? How do we define and measure quality in order to decide whether doctors do these tasks better or worse than other people? All of these tasks have been and may be performed by doctors, but they may also be and often are performed by others. And soon there will be the robots. We may find that many of these tasks, including empathy, can be outsourced to a machine that will do it better and for less money.

In the near future, there will be multiple different types of robots and patients and doctors both will have to consult many of them and then, unfortunately, do what we do today when the data are conflicting and experts disagree – that is, make a decision with imperfect knowledge, quantifiable uncertainty, and urgency.

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