Totalitarian Technics: The Hidden Cost of AI Scribes in Healthcare

TL;DR

This paper critically examines AI scribes in healthcare, arguing they shift medical attention towards a calculative, mechanized mode that may undermine clinical expertise and relational care.

Contribution

It offers a philosophical analysis linking AI scribes to broader technics theories, highlighting their role in shaping medical attention and potential consequences.

Findings

AI scribes embody a dominant calculative mindset

They may narrow clinical focus and erode expertise

They contribute to mechanization of healthcare practices

Abstract

Artificial intelligence (AI) scribes, systems that record and summarise patient-clinician interactions, are promoted as solutions to administrative overload. This paper argues that their significance lies not in efficiency gains but in how they reshape medical attention itself. Offering a conceptual analysis, it situates AI scribes within a broader philosophical lineage concerned with the externalisation of human thought and skill. Drawing on Iain McGilchrist's hemisphere theory and Lewis Mumford's philosophy of technics, the paper examines how technology embodies and amplifies a particular mode of attention. AI scribes, it contends, exemplify the dominance of a left-hemispheric, calculative mindset that privileges the measurable and procedural over the intuitive and relational. As this mode of attention becomes further embedded in medical practice, it risks narrowing the field of care, eroding clinical expertise, and reducing physicians to operators within an increasingly mechanised system.