Essay

Culture

Identity

29 May 2024

8 min read

Roll on AI, you'll make us more human

I’m not necessarily stupidly optimistic about AI, but there’s a tentative case to be so.

Daniel Kim

Daniel is an advertising strategist turned vicar-in-training.

An AI-generated image of a man folding a paper plan in a relaxed lounger, around him are creative tools and screens giving status updates are visible.

Nick Jones/Midjourney.ai.

I still come across people who insist that there are simply things that AI (artificial intelligence) can’t and will never be able to do. Humans will always have an edge. They tend to be journalists or editors who will insist that ChatGPT’s got nothing on their persuasive intentionality and honed command of nuance, wit, and word play. Of course, machines can replace the humans at supermarket check-out tills but not them. What they do is far too complex and requires such emotional precision and incisive insight into the audience psyche. Okay then. I nod, rolling my eyes into the back of my head.

At this point, it’s just naive to put a limiter on the capabilities of what AI can do. It’s not even been two years since ChatGPT3 was released into the wild and started this whole furore. It’s only been 18 months and OpenAI have just launched ChatGPT4 which can produce a whole persona who can listen, look, and talk back in such a natural and convincing voice that it may as well be a scene from the 2013 film, Her. A future where Joachim Phoenix falls in love with the sultry AI voice of Scarlet Johannsson doesn’t seem too far off. We have been terrible at predicting the speed at which generative AI has developed. AI video generation was one of the clearest examples of that in the last year. In 2023, we were lauding it over the AI models for generating this surreal, nightmarish scene of Will Smith eating spaghetti. “Silly AI! aren’t you cute.” we said. We swallowed our words earlier this year, when Open AI came out with Sora, their video generation model, which spat out photorealistic film trailers that would feel at home on the screens of Cannes.

There might be limits, but that ‘might’ gets smaller and smaller every single month, and we’re probably better off presuming that there is no ‘might’. We’ll be in for less surprises if we live from the presumption that there will be AIs that will make better newspaper editors, diagnostic radiologists, children’s book writers, and art-directors than most, if not all, humans.

With the mass reproduction and generation capabilities of AI, we may recognise that we crave the human touch not because it’s better but because it’s human.

I promised you a “stupidly optimising” take on this. So far, I’ve given you nothing but the bleak dystopian future where the labour market collapses and humans are dispossessed of all our technical, editorial, and creative skills. Where’s the good news?

Well, the stupidly optimistic take is this: the dispossession of all our human faculties by AI will force us to embrace the truest and most fundamental core of what makes us valuable - nothing other than simply our humanity. The value of humanity goes up if we presume that everything can be done better by AI.

In 1936, the German art critic, Walter Benjamin, prophesied the apocalyptic collapse of the art market in the essay: The Work of Art in the Age of Mechanical Reproduction. It was at a time when photographic reproduction of paintings was becoming a mainstream technique and visitors to a gallery could buy a print of their favourite painting. He argued that the mass reproduction of paintings would devalue the original painting by stripping away the aura of work - its unique presence in space and cultural heritage; the je ne sais quoi of art that draws us to a place of encounter with it. Benjamin would gawp at the digital age where masterpieces would be reduced to default iPhone background screens, but he would also be surprised by the exponentially greater value the art market has placed on the original piece. The aura of the original is sought after, all the more, precisely because mechanical reproduction has become so cheap. Why? Because in a world of mass reproduction, we crave human authenticity and connection. With the mass reproduction and generation capabilities of AI, we may recognise that we crave the human touch not because it’s better but because it’s human. And for no other reason.

We continually place our identities in whatever talents we think make us uniquely worthwhile and value-creating for the world.

What are we to make of the AI trials happening in the NHS which spot cancer at rates significantly higher than any human doctor. The Royal College of Radiologists insists that “There is no question that real-life clinical radiologists are essential and irreplaceable”. But really? Apart from checking the AI’s work, what’s the “essential” and “irreplaceable” part? Well, it’s the human part. Somebody must deliver the bad news to the patient and that sure as hell shouldn’t be an AI. Even if an AI could emulate the trembling voice and calming tone of the most empathic consultant, it is the human-to-human interpersonal exchange that creates the space for grief, sorrow, and shock.

Think utopian with me for a moment. (I know, very counter-intuitive for us). In a society where all our technical skills are superseded, the most valuable skills that a human could possess might be the interpersonal ones. Empathy, compassion, intentionality, love even! The midwife who can hold the hand of a suffering first-time mother could be a more respected member of society than the editor of an edgy magazine or newspaper. As they should be! That’s a tantalising and stupidly optimistic vision of an AI future, but it’s a vision that aligns with what we know to be the true about ourselves. In our personal and spiritual lives, we already recognise that the most valuable aspects of our lives are our human relationships and the state of our inner selves. People on their death beds reflect on what kind of person they’ve been and reach out for the hands of their loved ones - not for their Q4, 2011 balance sheet. Our identities are shaped most deeply by our relationships and our character, and yet, we continually place our identities in whatever talents we think make us uniquely worthwhile and value-creating for the world. It’s good to create value, it’s nice to be good at something, and it’s meaningful to leave a lasting impact, but it is delusional to think that those things make us valuable. Our dispossession by AI might be the dispelling of these delusions!

In a few decades, there may be nothing that humans can do better than AI, other than simply being human in the world.

At least on a philosophical and spiritual level, being stripped of our human exceptionalism might be the most liberating experience for a society that has devalued and instrumentalised humanity to being glorified calculators. Being dispossessed is the truest thing about all of us. We are all being dispossessed daily by the slow march of time. The truest thing about us is that we will, one day, be wholly dispossessed by death itself. That was Heidegger’s fundamental insight into the human condition and this feeling of dispossession is the root of our anxiety and fear in the world. This might be part of the anxiety and ick we feel towards AI. Being dispossessed of our creativity and technical ability is a kind of violence and death against ourselves which we rage against. We can rage against it politically, socially, and economically, but there might be something helpful about resisting the rage from a psychological and spiritual point of view. Experiencing this dispossession might be the key to unlocking an authentic human existence in a world that we can’t control.

I believe in human creativity. I believe that what we make is valuable. I believe in the mesmerising aura of art, cinema, music, and every other beautiful thing that we get up to in the world. I believe in the unique connection between artist and audience and the power of blood, sweat, and tears. I believe in the beautiful and tortuous self-violence of creativity to make something that will make my heart tremble and transport me to places never imagined. I believe in the intuitions of an editor to make the cut at precisely the right moment that suspends the tension and has me gripping the seat. I believe in the bedroom teenagers recording their first demos on Garageband, or the gospel choir taking their congregations to heaven and back. Now, more than ever, I believe in these miracles.

But my belief is not anchored in any unique technical excellence, or some hubris about our exceptionalist mastery of craft. It is rooted in the profound humanity of it all, which radiates, however dimly, with the image of the divine. Writing poetry, humming a new melody, baking a cake or, even discovering a new mathematical conjecture can feel like “divine inspiration” as the leading mathematician, Thomas Fink, asserts. Or as the Romantic German theologian, Schleiermacher, so rhapsodically expressed, it can feel like the soul being “ignited from an ethereal fire, and the magic thunder of a charmed speech’" from above. This transcendent human experience is something that AI can’t usurp or supersede.

In a few decades, there may be nothing that humans can do better than AI, other than simply being human in the world. However, Once we are stripped of everything, we won’t find ourselves naked in the dark, or at least, we don’t have to. We can stand before the world and God with the works of our hands - finite, flawed, and dispossessed - and yet, inestimably valuable and worthwhile for the simple fact of our mere humanity.

*This article was something of a thought experiment. It’s far more natural to take a sandwich-board, bullhorn-wielding apocalyptic take on the rise of AI. The powers-to-be at Microsoft and OpenAI have their own ideological agendas, and it’s not unlikely that in this technological cycle, we’ll live through a profoundly destabilising labour market. We are right to fear the consolidation of wealth to supreme tech feudal lords with their companies of AI employees who cost a fraction of real humans. Civilisational collapse! What I wanted to suggest here is that there might be a unique spiritual and philosophical opportunity afforded to us as we continue to experience the break-neck development of AI and its encroachment into everything we once held as uniquely human skills.*

Help share Seen & Unseen

"Seen & Unseen is a liberating point of view which has opened my mind to new possibilities."

All our content is free for anyone who wants to read it. This is made possible by our amazing community of regular supporters.

Give now

Article

Assisted dying

Care

Culture

Death & life

13 November 2024

8 min read

The deceptive appeal of assisted dying changes medical practice

In Canada the moral ethos of medicine has shifted dramatically.

Ewan Goligher

Ewan is a physician practising in Toronto, Canada.

a doctor consults a tablet against the backdrop of a Canadian flag.

Once again, the UK parliament is set to debate the question of legalizing euthanasia (a traditional term for physician-assisted death). Political conditions appear to be conducive to the legalization of this technological approach to managing death. The case for assisted death appears deceptively simple—it’s about compassion, respect, empowerment, freedom from suffering. Who can oppose such positive goals? Yet, writing from Canada, I can only warn of the ways in which the embrace of physician-assisted death will fundamentally change the practice of medicine. Reflecting on the last 10 years of our experience, two themes stick out to me—pressure, and self-deception.

I still remember quite distinctly the day that it dawned on me that the moral ethos of medicine in Canada was shifting dramatically. Traditionally, respect for the sacredness of the patient’s life and a corresponding absolute prohibition on deliberately causing the death of a patient were widely seen as essential hallmarks of a virtuous physician. Suddenly, in a 180 degree ethical turn, a willingness to intentionally cause the death of a patient was now seen as the hallmark of patient-centered doctor. A willingness to cause the patient’s death was a sign of compassion and even purported self-sacrifice in that one would put the patient’s desires and values ahead of their own. Those of us who continued to insist on the wrongness of deliberately causing death would now be seen as moral outliers, barriers to the well-being and dignity of our patients. We were tolerated to some extent, and mainly out of a sense of collegiality. But we were also a source of slight embarrassment. Nobody really wanted to debate the question with us; the question was settled without debate.

Yet there was no denying the way that pressure was brought to bear, in ways subtle and overt, to participate in the new assisted death regime. We humans are unavoidably moral creatures, and when we come to believe that something is good, we see ourselves and others as having an obligation to support it. We have a hard time accepting those who refuse to join us. Such was the case with assisted death. With the loudest and most strident voices in the Canadian medical profession embracing assisted death as a high and unquestioned moral good, refusal to participate in assisted death could not be fully tolerated.

We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

Regulators in Ontario and Nova Scotia (two Canadian provinces) stipulated that physicians who were unwilling to perform the death procedure must make an effective referral to a willing “provider”. Although the Supreme Court decision made it clear in their decision to strike down the criminal prohibition against physician-assisted death that no particular physician was under any obligation to provide the procedure, the regulators chose to enforce participation by way of this effective referral requirement. After all, this was the only way to normalize this new practice. Doctors don't ordinarily refuse to refer their patients for medically necessary procedures; if assisted death was understood to be a medically necessary good, then an unwillingness to make such referral could not be tolerated.

And this form of pressure brings us to the pattern of deception. First, it is deceptive to suggest that an effective referral to a willing provider confers no moral culpability on the referring physician for the death of the patient. Those of us who objected to referring the patient were told that like Pilate, we could wash our hands of the patient’s death by passing them along to someone else who had the courage to do the deed. Yet the same regulators clearly prohibited referral for female genital mutilation. They therefore seemed to understand the moral responsibility attached to an effective referral. Such glaring inconsistencies about the moral significance of a referral suggests that when they claimed that a referral avoided culpability for death by euthanasia, they were deceiving themselves and us.

The very need for a referral system signifies another self-deception. Doctors normally make referrals only when an assessment or procedure lies outside their technical expertise. In the case of assisted death, every physician has the requisite technical expertise to cause death. There is nothing at all complicated or difficult or specialized about assessing euthanasia eligibility criteria or the sequential administration of toxic doses of midazolam, propofol, rocuronium, and lidocaine. The fact that the vast majority of physicians are unwilling to perform this procedure entails that moral objection to participation in assisted death remains widespread in the medical profession. The referral mechanism is for physicians who are “uncomfortable” in performing the procedure; they can send the patient to someone else more comfortable. But to be comfortable in this case is to be “morally comfortable”, not “technically comfortable”. We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

There is also self-deception with respect to the cause of death. In Canada, when a patient dies by doctor-assisted death, the person completing the death certificate is required to record the cause of death as the reason that the patient requested euthanasia, not the act of euthanasia per se. This must lead to all sorts of moments of absurdity for physicians completing death certificates—do patients really die from advanced osteoarthritis? (one of the many reasons patients have sought and obtained euthanasia). I suspect that this practice is intended to shield those who perform euthanasia from any long-term legal liability should the law be reversed. But if medicine, medical progress, and medical safety are predicated on an honest acknowledgment about causes of death, then this form of self-deception should not be countenanced. We need to be honest with ourselves about why our patients die.

There has also been self-deception about whether physician-assisted death is a form of suicide. Some proponents of assisted death contend that assisted death is not an act of deliberate self-killing, but rather merely a choice over the manner and timing of one's death. It's not clear why one would try to distort language this way and deny that “physician-assisted suicide” is suicide, except perhaps to assuage conscience and minimize stigma. Perhaps we all know that suicide is never really a form of self-respect. To sustain our moral and social affirmation of physician-assisted death, we have to deny what this practice actually represents.

There has been self-deception about the possibility of putting limits around the practice of assisted death. Early on, advocates insisted that euthanasia would be available only to those for whom death was reasonably foreseeable (to use the Canadian legal parlance). But once death comes to be viewed as a therapeutic option, the therapeutic possibilities become nearly limitless. Death was soon viewed as a therapy for severe disability or for health-related consequences of poverty and loneliness (though often poverty and loneliness are the consequence of the health issues). Soon we were talking about death as a therapy for mental illness. If beauty is in the eye of the beholder, then so is grievous and irremediable suffering. Death inevitably becomes therapeutic option for any form of suffering. Efforts to limit the practice to certain populations (e.g. those with disabilities) are inevitably seen as paternalistic and discriminatory.

There has been self-deception about the reasons justifying legalization of assisted death. Before legalization, advocates decry the uncontrolled physical suffering associated with the dying process and claim that prohibiting assisted death dehumanizes patients and leaves them in agony. Once legalized, it rapidly becomes clear that this therapy is not for physical suffering but rather for existential suffering: the loss of autonomy, the sense of being a burden, the despair of seeing any point in going on with life. The desire for death reflects a crisis of meaning. We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

We have also deceived ourselves by claiming to know whether some patients are better off dead, when in fact we have no idea what it's like to be dead. The utilitarian calculus underpinning the logic of assisted death relies on the presumption that we know what it is like before we die in comparison to what it is like after we die. In general, the unstated assumption is that there is nothing after death. This is perhaps why the practice is generally promoted by atheists and opposed by theists. But in my experience, it is very rare for people to address this question explicitly. They prefer to let the question of existence beyond death lie dormant, untouched. To think that physicians qua physicians have any expertise on or authority on the question of what it’s like to be dead, or that such medicine can at all comport with a scientific evidence-based approach to medical decision-making, is a profound self-deception.

Finally, we deceive ourselves when we pretend that ending people’s lives at their voluntary request is all about respecting personal autonomy. People seek death when they can see no other way forward with life—they are subject to the constraints of their circumstances, finances, support networks, and even internal spiritual resources. We are not nearly so autonomous as we wish to think. And in the end, the patient does not choose whether to die; the doctor chooses whether the patient should die. The patient requests, the doctor decides. Recent new stories have made clear the challenges for practitioners of euthanasia to pick and choose who should die among their patients. In Canada, you can have death, but only if your doctor agrees that your life is not worth living. However much these doctors might purport to act from compassion, one cannot help see a connection to Nazi physicians labelling the unwanted as “Lebensunwortes leben”—life unworthy of life. In adopting assisted death, we cannot avoid dehumanizing ourselves. Death with dignity is a deception.

These many acts of self-deception in relation to physician-assisted death should not surprise us, for the practice is intrinsically self-deceptive. It claims to be motivated by the value of the patient; it claims to promote the dignity of the patient; it claims to respect the autonomy of the patient. In fact, it directly contravenes all three of those goods.

It degrades the value of the patient by accepting that it doesn't matter whether or not the patient exists.

It denies the dignity of the patient by treating the patient as a mere means to an end—the sufferer is ended in order to end the suffering.

It destroys the autonomy of the patient because it takes away autonomy. The patient might autonomously express a desire for death, but the act of rendering someone dead does not enhance their autonomy; it obliterates it.

Yet the need for self-deception represents the fatal weakness of this practice. In time, truth will win over falsehood, light over darkness, wisdom over folly. So let us ever cling to the truth, and faithfully continue to speak the truth in love to the dying and the living. Truth overcomes pressure. The truth will set us free.