AI病历助手不仅加重医疗机械化，更正在重塑医生的注意力方式。
Totalitarian Technics: The Hidden Cost of AI Scribes in Healthcare
- 从哲学视角分析技术如何塑造医疗注意力模式
- 指出AI病历系统强化计算型思维，挤压临床直觉与关系性关怀
- 适合关注医疗技术伦理、医患关系的从业者与研究者
人工智能病历助手（AI scribes）被宣传为解决医疗行政负担的方案。本文认为，其真正影响不在于效率提升，而在于重塑医疗注意力本身。通过借鉴伊恩·麦克格里斯特的大脑半球理论与刘易斯·芒福德的技术哲学，本文探讨技术如何外化并放大特定注意力模式。文章指出，AI病历助手体现了左脑主导的计算型思维，强调可测量与程序化，压制了直觉与人际关系。这种注意力模式的深化，正导致医疗视野狭窄化，削弱临床专业判断，并使医生沦为日益机械化的系统中的操作者。
原文摘要 · Abstract (English)
Artificial intelligence (AI) scribes, systems that record and summarise patient-clinician interactions, are promoted as solutions to administrative overload. This paper argues that their significance lies not in efficiency gains but in how they reshape medical attention itself. Offering a conceptual analysis, it situates AI scribes within a broader philosophical lineage concerned with the externalisation of human thought and skill. Drawing on Iain McGilchrist's hemisphere theory and Lewis Mumford's philosophy of technics, the paper examines how technology embodies and amplifies a particular mode of attention. AI scribes, it contends, exemplify the dominance of a left-hemispheric, calculative mindset that privileges the measurable and procedural over the intuitive and relational. As this mode of attention becomes further embedded in medical practice, it risks narrowing the field of care, eroding clinical expertise, and reducing physicians to operators within an increasingly mechanised system.
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