DIGITAL TRANSFORMATION AS A SEMANTIC SWITCH IN MEDICINE
DOI: 10.23951/2312-7899-2023-1-113-129
The article raises questions about how language, symptomatology, pathology description systems, and doctor-patient relationship will change in connection with the digital transformation of medicine. The effects of digitalization are analyzed using hermeneutic and semiotic approaches, the “signifying” and “understanding” methods are used to create an alternative view instead of the logic and language of information technology that prevails today. Digitalization begins with electronic medical records, transfers monitoring and control of the patient’s condition to personal medical assistants, and forms databases, which are the basis for the creation of neural networks and medical decision support systems. Telemedicine changes communication formats and transforms the subjectivity of the patient and the doctor. The introduction of digital algorithms changes the narratives of patients, the reading of the signs of the disease. The doctor-patient communication tends to have the patient describe their suffering through answers to test questions. The formalization of the language of medical description and patient narrative turns the “text” of the disease into medical data. There is a risk of translating medicine into a language that will largely be created by IT specialists, and the doctor will become the operator of intelligent systems for collecting and analyzing medical data. The digital transformation of medicine is a deep, qualitative transformation of the entire sphere of human health care, both at the individual and the social and institutional levels. Digital transformation occurs when people begin to think and act according to other codes, medicine becomes visually different. Semantic digital switching is reflected in the ethos of medicine. There is an inversion of subjectivity up to the disclaimer of responsibility, which is transferred to digital systems. The semiosis of medicine is reoriented from moral to economic goals. Digitalization generates new types of relationships between the doctor and the patient, strengthens their autonomy, but can also create conditions for a solidarity relationship of care in medicine. In assessing the risks of digitalization in medicine, a point of divergence is fixed: a deepening of a reductionist, digitally mediated view of the symptoms of live suffering humans and further distancing between the doctor and the patient may occur. Also, geneticized and digital personalization will allow taking into account a multilayer system of individual and culture-specific designations, introducing their interpretation into the world of scientific medicine, reformatting the solidary ties between the subjects of medicine through the responsible disposal of information.
Keywords: digital transformation of medicine, personalized medicine, bioethics, medical semiotics, hermeneutic approach, medical data, medical decision support systems, personal medical assistant, doctor-patient interaction
References:
Artem’eva, T. V. (2019). Emblematic Forms of Moral Concepts in the Epoch of Enlightenment in Russia. Eticheskaya mysl’ – Ethical Thought, 19(1), 76–88. (In Russian).
Avanesov, S. S. (2014). What can be called visual semiotics? ΠΡΑΞΗΜΑ. Problemy vizual’noy semiotiki – ΠΡΑΞΗMΑ. Journal of Visual Semiotics, 1(1), 10–22. (In Russian).
Chelovek.RU. (2022). Humanitarian aspects of the development and implementation of personal medical assistants and telemedicine communication with the patient. Seminar. Chelovek.RU, 17. (In Russian).
Good, B. J., & Good, M. D. (1980). The Meaning of Symptoms: A Cultural Hermeneutic Model for Clinical Practice. In L. Eisenberg, & A. Kleinman (Eds.), The Relevance of Social Science for Medicine. Culture, Illness, and Healing (vol 1, pp. 165–196). Springer.
Gorbuleva, M. S., Melik-Gaykazyan, I. V., & Meshcheryakova, T. V. (2013). Mech i skal’pel’: semioticheskaya diagnostika transformatsii vlastnykh vzaimootnosheniy kak kul’turnykh determinatsiy osnovnykh printsipov bioetiki [Sword and scalpel: Semiotic diagnostics of the transformation of power relationships as cultural determinations of the basic principles of bioethics]. TSPU.
Kugelmann, R. (2003). Pain as symptom, pain as sign. Healt, 7, 29–50.
Melik-Gaykazyan, I. V. (1997). Informatsionnye protsessy i real’nost’ [Information processes and the reality]. Nauka. Fizmatlit.
Melik-Gaykazyan, I. V. (2022). Semiotic diagnostics of the trajectory splitting between a dream of the past and dream of the future. Istoriya, 13:4(114). (In Russian). https://doi.org/10.18254/S207987840021199-7
Meshcheryakova, T. V. (2015). Visualization in teaching bioethics:its forms and functions. ΠΡΑΞΗΜΑ. Problemy vizual’noy semiotiki – ΠΡΑΞΗMΑ. Journal of Visual Semiotics, 1(3), 127–132. (In Russian).
Mesko, B., & Görög, M. (2020). A short guide for medical professionals in the era of artificial intelligence. npj Digital Medicine, 3, 1–8.
Morozov, S. P. et al. (2020). Moscow experiment on computer vision in radiology: Involvement and participation of radiologists. Vrach i informatsionnye tekhnologii, 4, 14–23. (In Russian).
Nayman, E. A. (2014). Ancient medical symptomatology and modern semiotic theory. Schole, 8(1), 473–479. (In Russian).
Nessa, J. (1996). About signs and symptoms: can semiotics expand the view of clinical medicine? Theoretical Medicine, 17, 363–377.
Sidorova, T. A. (2017). Institutionalization of 4P-medicine and the genetization of society. Rabochie tetradi po bioetike. Filosofsko-antropologicheskie osnovaniya personalizirovannoy meditsiny (mezhdistsiplinarnyy analiz) – Philosophical and anthropological foundation of personalized medicine (Interdisciplinary analysis). Workbooks on bioethics, 26, 78–94. (In Russian).
Tishchenko, P. D. (1991). Germenevtika i zdorov’e [Hermeneutics and health]. HELPIKS.ORG. https://helpiks.org/8-36574.html.
Winn, A. N., Somai, M., Fergestrom, N., & Crotty, B. H. (2019). Association of Use of Online Symptom Checkers With Patients’ Plans for Seeking Care. JAMA Netw Open, 2(12):e1918561.
Zhuravlev, A. L., & Nestik, T. A. (2019). Socio-psychological consequences of new technologies adoption: Perspective directions of research. Psikhologicheskiy zhurnal, 40(5), 35–47. (In Russian). https://doi.org/10.31857/S020595920006074-7
Issue: 1, 2023
Series of issue: Issue 1
Rubric: ARTICLES
Pages: 113 — 129
Downloads: 482