Medical Care and the Boundaries of Technology

In a recent post entitled “A View from the Other Side: Roboticized Care,” I recounted my recent encounters with the healthcare system from the perspective of a patient. Some of those observations deserve further reflection.

Technology is, indeed, a wonderful gift, benefiting mankind in innumerable ways. But technology has transgressed its boundaries largely because we have failed to set or enforce boundaries for it. From the time of the Garden humans have had a problem with boundaries, there transgressing the only boundary we were given: do not eat. Technology now offers us the opportunity to transgress another boundary, one that is actually part of our nature: the physical limitations of our embodiment–our boundedness to time, space, and skin. Despising our boundaries and our boundedness, we seek to transcend them through the machinations of technology. This, in truth, was the essence of Satan’s temptation of Jesus—to tempt Jesus to use his powers to escape the limitations of His human boundedness. But God chose a bounded and self-limiting way of relating to us.

But not only are we physically bounded, we are relationally bounded. By God’s design, we are not the wholly autonomous beings we have come to believe, but are social, relational, bounded beings, created by a relational, Trinitarian God for fellowship with Himself and others. It is through our relational interdependence that our lives acquire meaning and significance. Moreover, in this interdependence our choices and actions are limited by and reinforce the dignity of our fellow participants. To be truly human is, therefore, to live within the boundaries of our bounded, mortal, embodied life, while simultaneously being open to God and to our neighbor.

Which brings us to the issue of medicine. In medical care, it is “care” that is the crucial component–“medical” is a mere adjective describing the sphere in which that care occurs. To care for someone is to provide for his or her needs out of concern for that person. While it may be true that physical needs can be effectively addressed and provided for by technology, the emotional, psychological, and spiritual needs of those who are suffering requires the care and concern of flesh and blood persons who know experientially what it is like to live in mortal, perishable bodies–bodies that break down, bodies that die. Only the body that is receptive to disease and death is receptive to the suffering of the other.

Furthermore, for centuries we have known of the importance of human touch in caring and curing–even Augustine viewed sensation as the most basic form of knowledge–yet that element of medicine is being routinely eliminated as technology replaces physical diagnosis and fears of contamination reduce physical contact. Furthermore, any claim that “face robots” will positively impact “care” is based on a reductive presupposition that humans are nothing more than robots, and that robots can therefore be designed to perform any task, including “caring,” that humans can do, and not only better but more effectively and efficiently. But a mechanical entity cannot relate to or comfort one who is facing the limitations and vulnerability of their own embodiment, no matter how well programmed they may be. And the touch of cold, hard metal cannot replace that of living flesh and blood. For our bodies are the location of our personal presence, a presence that can be neither explained nor replicated by mechanical processes. In medicine, attempts to transgress the boundaries of our being by replacing humans with robots threaten the human element that is the essence of medical care.

Medical care has always consisted of two components: the art and the science–the human and the technological. Recognizing this we must not allow technology to surreptitiously replace the human component of medicine, but must strive to set and enforce boundaries for the technological component. Technology may be able to cure, but it cannot care. And care is crucial to healing. Moreover, our attempts to transcend the weaknesses and limitations of our human embodiment, to substitute technology and robots for human care may, in fact, leave us less than human as we become ever more roboticized–ever more like the machines we emulate rather than like Him who is our Exemplar.

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