What if the biggest barrier to safer healthcare isn't a lack of technology—but our reluctance to question the humans who deliver it?
Welcome to FreeAstroScience, where we take complex scientific and philosophical ideas and break them down into something you can actually use. Today, we're wading into territory that might make you squirm a little. It made us uncomfortable too. But here at FreeAstroScience.com, we believe the sleep of reason breeds monsters. So let's keep our minds awake—even when the questions get hard.
This isn't just an article about artificial intelligence in healthcare. It's about something much bigger. It's about trust, authority, human limitation, professional power, and what we owe each other when life hangs in the balance. It's about how societies decide who gets to make decisions that affect all of us. And it's about what happens when the people we've trusted to protect us might also be the ones standing in the way of progress.
Grab a coffee. Settle in. This one's worth reading to the very end—because the implications reach far beyond the hospital walls.
Why Are We Even Asking This Question?
Let's start with a number that stopped us cold.
In the United States alone, around 800,000 people die or become permanently disabled each year from diagnostic error .
Not from incurable diseases. Not from accidents. From mistakes.
If airplanes crashed with that frequency, we'd ground every fleet on the planet. We'd demand congressional hearings, international summits, sweeping reform. We'd treat it as an emergency.
But when doctors make mistakes? The response is gentler. "They are only human," we say .
And that's precisely the problem.
Charlotte Blease, a philosopher and associate professor of health informatics at Uppsala University, puts it bluntly in her recent essay for Aeon: medical error is among the leading causes of death worldwide. Yet we've somehow grown indifferent to it .
This isn't about pointing fingers at physicians. Most doctors are dedicated, skilled, and deeply compassionate. But we need to ask a harder question: If human limitations cause these errors, could artificial intelligence help fix them?
And an even harder one: Who gets to decide?
The Hidden Crisis Behind the White Coat
Doctors Are Exhausted—And We're Not Talking About It
We often picture physicians as tireless heroes. The white coat. The calm authority. The person who always knows what to do.
But behind that image, many doctors are barely holding on.
Source: Blease, C. (2025). Aeon Essays
By 2030, the world will face a shortage of approximately 10 million health workers . In parts of Europe, millions of people already lack access to a general practitioner. The system is stretched thin—and getting thinner.
Exhaustion and burnout don't just hurt doctors. They create the perfect conditions for mistakes. Fatigue links directly to errors in diagnosis, treatment, and prescribing .
But Here's the Deeper Issue
Even well-rested, well-resourced doctors make errors. Why?
Because they're human.
We forget things. We misjudge situations. We grow overconfident. Our moods, biases, and blind spots shape what we see and how we interpret it .
These aren't character flaws. They're features of our psychology—traits that once helped us survive in small ancestral groups but stumble badly in the high-stakes, information-saturated environment of modern medicine .
Here's the aha moment: Burnout makes these weaknesses worse, but it doesn't create them. Even at their absolute best, doctors will make errors. That's not a criticism. It's just biology .
And if that's true—if errors are baked into the very nature of being human—then maybe we need to ask what role technology could play in catching what we miss.
The Confidence Paradox: When Certainty Can Kill
Here's something that genuinely shocked us.
One study of intensive-care patients found that doctors who were "completely certain" of their diagnosis were wrong up to 40% of the time .
Read that again.
The most confident doctors—the ones projecting absolute assurance—were wrong nearly half the time. And here's the twist: as physicians gain experience, they tend to consult colleagues less and seek fewer second opinions .
Authority can curdle into overconfidence. Experience can become a trap.
The Confidence-Accuracy Gap
As one pathologist put it, physicians are "walking around in a fog of misplaced optimism" . The very trait we find reassuring in doctors—decisive confidence—may be the thing that leads them astray.
And patients, paradoxically, make it worse. We prefer confident doctors. We find decisiveness reassuring, even when it's misplaced . The white coat is still treated as a symbol of authority. We're comforted by certainty—even when that certainty is built on shaky ground.
The Myth of the Irreplaceable Doctor
For centuries, we've lived under a powerful cultural myth: the irreplaceable doctor.
Physicians aren't just healers. They're cultural icons—secular priests of the body, guardians of mortality, and interpreters of suffering . We look to them not simply for treatment but for reassurance, ritual, even a touch of transcendence.
This mythology shapes how we think about medicine. When we insist that "only a human" can offer care, what we often mean is that we can't imagine a different arrangement .
But history is full of occupations and roles once thought untouchable—clerics, navigators, even bank tellers—that were eventually transformed or replaced .
The question isn't whether doctors are valuable. Of course they are. The question is whether our attachment to the idea of doctors prevents us from seeing their limitations clearly.
Medicine's Long History of Resisting Change
If you think the medical profession will eagerly welcome AI, history suggests otherwise.
Medicine has repeatedly resisted insights that challenge existing theories and practices . Consider this timeline of innovations that doctors initially rejected:
Source: Blease, C. (2025). Aeon Essays
As late as 2021, most US healthcare providers were still using fax machines to share clinical information. The UK's National Health Service still spends millions each year on stamps and paper .
This isn't just about being old-fashioned. Historian David Wootton argued in Bad Medicine: Doctors Doing Harm Since Hippocrates (2007) that the medical profession's reluctance to engage with new advances has repeatedly slowed progress .
The Philosopher's Warning
Thomas Kuhn, in The Structure of Scientific Revolutions (1962), argued that scientific communities need to defend their paradigms until the evidence for change is overwhelming . Otherwise, every fad would destabilize the field.
But medicine's caution often goes beyond prudence. Change gets resisted not only because of the burden of work—a challenge that it would be unfair not to fully acknowledge—but also because it's easier and sometimes protects professional interests .
The Question No One Wants to Ask
Here's where things get uncomfortable.
When we debate whether AI should play a bigger role in medicine, who gets to decide?
Right now, the conversation centers largely on doctors themselves. But Charlotte Blease raises a provocative point: doctors are the most interested party in this debate .
Their status, salaries, and sense of self are bound up in the outcome. Of course they want to believe they're irreplaceable. But as Blease notes: "those most invested in their own survival are rarely the best judges of their own irreplaceability" .
This doesn't make doctors villains. Most physicians are dedicated, brilliant, and deeply humane . But when professional bodies resist patient access to records, block the autonomy of nurse practitioners, or downplay the scale of diagnostic error—they're protecting the guild, not the public .
The Grand Bargain
Richard and Daniel Susskind, in their book The Future of the Professions (2022), describe what they call the "grand bargain" of the professions .
Society grants white-collar workers prestige, status, and generous pay in exchange for expertise and ethical conduct. Doctors enjoy a monopoly on diagnosis and treatment. In return, the public trusts them to act in patients' best interests.
But the bargain isn't always honored.
Professional Lobbying Power
- The American Medical Association spends tens of millions each year to preserve physicians' dominance—outspending many Silicon Valley giants
- In the UK, the British Medical Association campaigns against expanding the role of physician associates, warning they threaten the "unique role" of the doctor
- Meanwhile, millions of patients go without any kind of timely care
Transparency and What It Revealed
Here's a telling example.
When authorities in the US and UK tried to make online patient access to medical records routine, professional bodies resisted. Doctors warned of patient anxiety, confusion, or wasted appointments .
Those objections largely failed to materialize.
What online access did reveal was something more awkward: one in five patients reported finding errors in their records, some of them serious .
No wonder access was so fiercely opposed.
What Do Patients Actually Want?
Richard Susskind, a scholar who studies professional expertise, makes a simple but powerful observation:
"People who seek expert help do not generally approach their professional advisers saying, 'Good morning, I would like some judgment please.' Judgment isn't the end in itself."
What do patients actually want?
Accurate Diagnosis
Getting it right the first time
Effective Treatment
Solutions that actually work
Timely Care
Not waiting months in uncertainty
Peace of Mind
Confidence in the process
A person arriving in the emergency room with crushing chest pain doesn't care whether the diagnosis comes from human intuition or an algorithm. They care that it's correct, fast, and followed by the right treatment .
Process vs. Outcomes
We've grown attached to the rituals of medicine—the waiting room, the white coat, the bedside manner . Susskind argues that medicine often preserves its processes—the rituals of consultation, the authority of the bedside manner, the "art" of medicine—rather than focusing on outcomes .
But some of this is habit, not preference. We accept these rituals because they're what we've always known .
When it matters most—when diagnoses are delayed or missed—process takes a back seat to outcomes. Patients care less about whether wisdom gets dispensed through a kindly doctor or a computer interface than about whether they receive accurate diagnosis, effective treatment, and humane care .
The Real Stakes: Lives Lost to Missed Diagnoses
This isn't abstract philosophy. Charlotte Blease shares her own family's experience:
- Her brother lived with myotonic dystrophy for two decades before anyone diagnosed it
- Her twin sister received a grab bag of wrong labels—"depressed," "tired like everyone else," "wear and tear"—before a visiting locum finally got it right
- Her late partner's stomach cancer was discovered only after years of missed signals about his heart condition. By then, the cancer had already taken root
These aren't system failures in some distant hospital. They're real families. Real suffering. Real lives shortened or shadowed by errors that passed unnoticed.
Her siblings endured years of self-doubt while wrong diagnoses passed as routine . Such omissions, biases, and errors aren't abstractions, as physicians may wish them to be. They are real harms, far too often unseen.
The Hardest Truth
Doctors often tell Blease that their mistakes haunt them.
But here's the harder truth: many errors pass unnoticed entirely .
Studies show that when confronted with data on mistakes, physicians are more likely than patients to dismiss the numbers as exaggerated, or to suggest that errors happen to "other doctors" . Surgeons consistently underestimate their own complication rates .
What looks like denial is actually a protective shield for professional identity—and perhaps for the capacity to keep practicing. Too much humility might even be crushing when it comes to keeping going in medicine.
But that protection comes at a cost. And patients pay it.
The Defense of Human Judgment
Before we even get to evidence on whether AI or human doctors perform better, many doctors bristle .
As Blease notes, their defense is almost always the same: AI lacks what they call judgment. It has no intuition, no hunches, no instinct or presentiment, no "feel" for the patient .
Anaesthetist Ronald Dworkin captured this view:
"Because AI lacks intuition, suspicion, instinct, presentiment and feeling, it lacks judgment in the human sense. It can only work with abstractions—that is, with words. It can never get behind the words. It can never get deep inside matters."
There's something moving about this defense. It speaks to the art of medicine, the human connection, the irreducible mystery of healing.
But Richard Susskind asks a more basic question: What are the problems to which human judgment is the solution?
If accurate diagnosis is the problem, it's unclear whether human judgment—namely that of doctors—must be the only solution .
Broader Implications: Beyond the Hospital Walls
Now let's step back. Because this debate isn't just about stethoscopes and algorithms. It touches something much deeper about how our society works—and who gets to shape its future.
The Crisis of Expertise Across All Professions
Medicine isn't alone. Lawyers, accountants, architects, financial advisors—every profession built on specialized knowledge faces the same question: What happens when machines can do what humans have always done?
The Susskinds' "grand bargain" applies everywhere . We've traded autonomy for expertise. We've accepted that certain questions are too complicated for ordinary people—that we need specially trained gatekeepers to navigate them for us.
But what if those gatekeepers are also bottlenecks?
What if their monopoly on expertise creates artificial scarcity—driving up costs, limiting access, and leaving millions without help?
The grand bargain was supposed to protect us. But increasingly, it protects the professionals more than the public.
Who Gets to Decide When Change Is Needed?
Here's the uncomfortable truth that applies far beyond healthcare.
The people most invested in preserving the status quo are rarely the best judges of whether it should change.
Coal miners aren't the right people to ask whether we should transition to renewable energy. Taxi drivers aren't the right people to ask whether ride-sharing should be legal. And doctors—however brilliant, however well-intentioned—aren't the right people to ask whether AI could do their job better.
This isn't because they're bad people. It's because they're human. And humans have a remarkable capacity for motivated reasoning—for finding sophisticated arguments to support conclusions they wanted to believe anyway.
Blease puts it perfectly: "To presume that doctors should arbitrate their own indispensability is to let the most interested party preside as judge and jury" .
We need independent observers. Philosophers. Sociologists. Patients themselves. People who can notice what insiders either miss or quietly refuse to acknowledge .
The Psychology of Professional Identity
Let's have some compassion here. Because this isn't just about money or power. It's about identity.
When someone spends a decade training for a profession—sacrificing their twenties, accumulating debt, enduring the brutal hierarchy of residency—that profession becomes part of who they are. It's not just a job. It's a calling. A way of understanding themselves in the world.
Asking doctors to consider whether AI might replace them isn't just asking them to evaluate technology. It's asking them to contemplate their own obsolescence. To imagine a world where the thing they've built their life around no longer matters in the same way.
No wonder the response is defensive. No wonder the arguments for human irreplaceability feel so urgent and sincere.
But—and here's where compassion meets honesty—the feelings of professionals cannot outweigh the needs of patients. The purpose of medicine isn't to give doctors meaningful work. It's to heal people.
As Blease writes: "Career satisfaction, prestige or pay are not arguments for preserving a profession... The privileges of physicians, or special pleading based on meaningfulness, is an argument that must be independently investigated" .
The Question of Accountability
Here's something we don't talk about enough: What happens when AI makes mistakes?
Right now, when a doctor misdiagnoses you, there's a human being to hold accountable. You can file a complaint. You can sue for malpractice. There's at least the illusion of recourse.
But when an algorithm gets it wrong, who's responsible? The programmer? The hospital that bought the software? The company that built it? The regulatory agency that approved it?
This isn't a reason to reject AI in medicine. But it's a genuine complication that deserves serious thought.
We'll need new legal frameworks. New ways of tracking errors and assigning blame. New mechanisms for compensation when algorithms fail.
The Inequality Question
AI could make healthcare more equal—or it could make it worse.
On one hand, algorithms don't get tired, don't have bad days, and don't unconsciously treat patients differently based on race, gender, or weight. Studies consistently show that human doctors exhibit biases that affect diagnosis and treatment. A well-designed AI might be more equitable.
On the other hand, AI systems are trained on historical data—and historical data reflects historical biases. If past doctors were less likely to take women's chest pain seriously, an AI trained on their decisions might learn the same pattern.
And then there's access. Will AI-powered healthcare reach the communities that need it most? Or will it become another premium service—available to the wealthy in urban centers while rural areas continue to struggle?
The technology is neutral. The distribution won't be—unless we fight for it.
The Environmental Cost
We should also mention something that rarely comes up: AI has an environmental footprint.
Training large language models requires enormous amounts of electricity. Data centers consume water for cooling. The hardware depends on rare earth minerals.
AI carries serious ethical and political risks—from deepening inequalities to new forms of harm, from lost jobs to environmental costs . These concerns deserve scrutiny.
If AI in healthcare means more energy consumption, more carbon emissions, more resource extraction—is the tradeoff worth it?
We think it can be, if we're thoughtful. But it's another complication that deserves attention.
What We Lose If AI Wins
Let's sit with the loss for a moment. Because there would be one.
The doctor's office is one of the few places left where a stranger looks you in the eye, asks how you're doing, and actually wants to know. Where someone touches your body not with violence or desire, but with care. Where you can confess your fears and have them taken seriously.
That matters. It's not nothing.
Many patients—especially elderly patients, especially lonely patients—value the human connection of a medical appointment as much as the medical advice. The ritual of being seen. The reassurance of a warm hand and a concerned face.
If we replace that with a chatbot, something precious disappears from the world.
We should acknowledge that loss. We should mourn it, even as we ask whether the tradeoff might still be worth it for the lives saved and the errors prevented.
Maybe the answer is a hybrid model—AI handling diagnosis and data analysis, humans providing comfort and compassion. Or maybe we'll discover that what feels like an irreplaceable human connection is actually more transferable than we thought.
But we won't know until we try. And we won't try if we pretend there's nothing at stake.
What We Gain If We're Brave Enough to Ask
Now let's imagine the upside.
What if diagnosis became faster and more accurate?
No more waiting months for a specialist to catch what a general practitioner missed. No more patients doubting themselves for years because doctors kept telling them nothing was wrong. No more families blindsided by advanced cancer that should have been caught early.
What if expertise became democratized?
A patient in rural Wyoming receiving the same quality of diagnostic reasoning as a patient at the Mayo Clinic. A teenager in sub-Saharan Africa accessing medical knowledge that's currently locked behind expensive professionals and geographic barriers.
What if doctors were freed from drudgery?
Physicians spend enormous amounts of time on paperwork, data entry, and administrative tasks. AI could handle that, letting doctors focus on what they're actually good at—the human parts. The explaining, the comforting, the guiding.
What if we saved 800,000 lives a year?
Or even half that. Or a quarter. How many families spared the grief that Blease describes? How many siblings not losing two decades to undiagnosed disease? How many partners not dying of cancer that was missed while everyone focused on the wrong thing?
The potential is enormous. But we'll never realize it if we let the professionals most threatened by change control the conversation.
The Path Forward: Reimagining Medicine
We're not here to say AI will save medicine overnight. We're not here to demonize doctors or glorify technology.
We're here to ask questions that deserve honest answers.
Technology will not save us if it simply reproduces medicine's old flaws in digital form. Every innovation arrives with its own complications, even as it solves others .
But what won't help is straw-manning the technology, or deferring endlessly to the very profession whose survival is at stake . Doctors cannot be the only ones asked to judge their own replaceability.
Reimagining Practice, Not Destroying Profession
The point isn't to destroy a profession. It's to reimagine a practice.
If Dr Bot is to have a role, it won't be as an imitation priest in a white coat, but as part of a wider reckoning with what medicine is for and who it should serve.
The goal has never been to preserve how medicine works. The goal is to make it work better for patients.
A New Social Contract
Perhaps what we need is a new grand bargain.
Not one where professionals get prestige in exchange for expertise they guard jealously. But one where society invests in the best available methods—human, machine, or hybrid—and the benefits flow to everyone who needs care.
In that world, doctors don't disappear. They evolve. They become guides, interpreters, advocates—the human face of a system that's more capable than any individual could be.
The skills that matter most—empathy, communication, ethical judgment—don't become obsolete. If anything, they become more valuable.
But the skills that can be automated—pattern recognition, data synthesis, recall of vast medical literature—get handed off to machines that never tire, never forget, and never let ego cloud their judgment.
A Reflection: Who Deserves to Decide?
As we wrap up, let's sit with the central question of Blease's essay—and of this conversation.
Who should decide the future of AI in medicine?
Not just doctors, whose livelihoods and identities depend on one outcome.
Not just tech companies, whose profits depend on another.
Not just politicians, who often lack the technical understanding to evaluate the stakes.
All of us.
Patients. Philosophers. Scientists. Citizens. Families who've lost loved ones to missed diagnoses. People who've waited months for care that should have come in days.
This is a conversation that belongs to everyone who has ever been sick, or loved someone who was, or feared what might happen when their turn comes.
Final Thoughts: The Sleep of Reason
We started with an uncomfortable question, and we'll end with a reflection.
The philosopher Francisco Goya titled one of his most famous etchings: "The sleep of reason produces monsters."
What does that mean here?
It means we can't afford to sleepwalk through this conversation. The stakes are too high. Too many lives depend on getting this right.
It means questioning our assumptions—even the comforting ones. Even the ones that feel sacred.
It means holding two truths at once: that doctors are often extraordinary, and that the system fails more people than it should.
And it means remembering that progress has never come from defending the status quo. It has come from asking hard questions, even when the answers make us uncomfortable.
What We Owe Each Other
If you've made it this far, here's what we hope you take away.
This isn't a debate between humans and machines. It's a debate about what we owe each other—patients and caregivers, citizens and institutions, the present and the future.
We owe each other honesty about what works and what doesn't.
We owe each other the humility to admit that no individual, no profession, no technology has all the answers.
We owe each other the courage to ask uncomfortable questions—and the grace to listen to uncomfortable answers.
And we owe each other—especially those who will get sick tomorrow, next year, decades from now—the willingness to keep improving, even when improvement threatens what we've built.
If the purpose of medicine is patient care, does it matter who—or what—holds the stethoscope?
That question deserves an honest answer. Not from those whose livelihoods depend on one outcome. But from all of us—patients, philosophers, scientists, and citizens—willing to look clearly at what medicine is for and who it should serve.
This article was written specifically for you by FreeAstroScience.com, where we explain complex scientific and philosophical ideas in terms anyone can grasp. We believe in keeping minds active—never turning off your critical thinking, even when the questions get hard.
Because the sleep of reason breeds monsters. And in healthcare, those monsters have names: missed diagnoses, delayed treatments, lives cut short.
Come back soon. We've got more questions worth asking. And we'd rather ask them together.
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