The imaginary patient. Fantastic health data and where to find them

In the name of an upcoming AI revolution in healthcare and of chatbots and ‘agentic AI’ allegedly capable of providing health advice, the US, international institutions, and the European Commission are pushing for the digitisation of clinical and health data. Unfortunately, ‘digitisation’ is just a new name for mass surveillance, there is no such a thing as ‘agentic AI’ and those surveilling us are not interested in making healthcare more accessible or personalised, which would simply require hiring more healthcare personnel. At best, a machine learning system capable of tracking correlations can be an auxiliary tool in medicine. An extruder of probable text strings can only make us imagine that we are in a doctor–patient relationship, but what a doctor does is certainly not autocomplete. A chatbot is therefore both useless and dangerous, if the objective is healthcare. However, a private healthcare company whose goal is to increase quarterly dividends may consider a chatbot to be a useful cost-reduction tool. Within an instrumental rationality, a healthcare company may find it rational to replace doctors with chatbots, just as it would find it rational to feed prisoners dog food if it ran a prison. After all, financial analysts who think in terms of business logic are seriously asking themselves whether treating patients is a sustainable business model. Announcements of an AI-based healthcare revolution have no scientific basis. However, they are deeply rooted in sectors that are heavily funded by the pharmaceutical industry and technology companies. Here, the interest in promises of automation, in dehumanising patients, in commodifying health and in destroying public healthcare systems converge with the surveillance, control, manipulation and domination goals of the US military–industrial complex. Even if it cannot cure us, generative AI is perfect for all these purposes.