Humans meet the sinister side of CAD

June 20, 2001

It is a fact of capitalism that vendors tend to sell their products to whoever wants to buy them. Seldom in diagnostic imaging has there been a moral imperative to do otherwise. Ultrasound equipment is sold to radiologists as well as to cardiologists,

It is a fact of capitalism that vendors tend to sell their products to whoever wants to buy them. Seldom in diagnostic imaging has there been a moral imperative to do otherwise. Ultrasound equipment is sold to radiologists as well as to cardiologists, vascular surgeons, ob/gyns, and ophthalmologists. Gamma and PET cameras go to radiologists, cardiologists, oncologists, and neurologists. Radiologists might want to control the technology, but that argument has not been sufficient to restrict the rights of other people.

The possibility that CAD systems such as R2’s ImageChecker might be sold to malpractice lawyers, however, is a much different situation. In this instance, the equipment would not be used for its intended purpose: to identify disease so as to improve the health of patients. Rather it would be used against physicians and to line the pockets of those who would professionally injure medical practitioners.

I am appalled but not surprised by this prospect. It is almost inevitable that the darker side of technology arises to counterbalance the good, often in unpredictable ways. Who would have guessed a century ago that the discovery of processes for nitrogen fixation, the crucial step in the manufacture of plant fertilizer, would also pave the way for the discovery of TNT? Mass-produced fertilizers helped avert the worldwide famine that would almost certainly have occurred at the turn of the last century, but the technology also laid the foundation for two world wars and horrific acts of terrorism.

While the damage that might result from lawyers’ misuse of CAD would be far subtler and less egregious than the misuse of some other technologies, it may be more sinister, because it would pit human against machine. Conclusions reached by algorithms would be compared to interpretations made by people. Such an adversarial circumstance taps a deep-seated fear going back to the Luddites of the early 1800s, who rallied against the burgeoning textile industry in England and later against threshing machines used by farm workers. Technology threatened their livelihood and way of life. Luddites fought back, but the economic benefits of the machines they fought against were judged by society as more valuable-and the Luddites lost.

How CAD is used in the future is unlikely to be based on morality or ethics. Now, as two centuries ago, fear may militate against certain uses of technology, but ultimately the applications to which technologies are put will be determined by society-and the economic viability of the services being rendered.