A.I. and Osteopathy

Author: R. Paul Lee, DO, FAAO, FCA
October 20, 2023

Artificial Intelligence shows that computers grow their own skill set.  Masses of computational collections have produced cyber behavior the origin of which the inventors of AI cannot completely trace. We can now officially declare AI, without human-injected digital restraint, to be out of control. Comparing osteopathic philosophy to this scenario provides insight to both AI and osteopathy.

We know that computers do not experience reality as we humans do but instead use data to project our reality onto an unfeeling mass of intellect/data, which doubles back to repeatedly use that newly created mass of intellect to ask the next questions as it develops. Unlike humans who use emotions along with intelligence to judge the correctness of behavior, AI uses no such limits. Unbridled expansion of data points can lead computers to enter the realm of misinformation, which potentially can lead to taking a wrong turn, and exponentially develop a plan that might lead to catastrophe. This is at the root of those who oppose AI or even those who are part of the industry producing AI. Against the historical custom of CEOs of business, in general, those in the industry developing AI, such as Google, are asking for legislative restraints on AI, an important driver of their financial success, but characterized by building projections of fantasy onto what we know to be true – potentially destabilizing a society that relies more and more on cyberspace.

So, what does this have to do with osteopathic philosophy? Well, what would you say if data were the single standard used to judge the operation of an endeavor having to do with one’s health? For example, what if a certain percentage of people get better using a particular method and express a certain percentage of adversities. Sound familiar? Of course. Pharmaceutical companies use this strategy – percentage-based, or data-based medicine. For that matter, research institutions use the same method of design, and therefore medical educational institutions are also data-based, as well. We are imbued with this type of AI philosophy as practitioners of the healing art we call conventional medicine. It is based solely on physical reality, not emotional or spiritual guideposts, as physical reality is easily represented by data.

Asking the research question already determines the range of the response. “How many cranes fly south for the winter?” is a more limited question than “What drives migration?”, for example. The data derived from the design of the research then determines the limited characteristics of the procedure or chemical that is delivered by the physician driven by the data paradigm to the innocent patient who simply wants a silver bullet. Even though our research questions are predetermined to provide a limited outcome, we have convinced ourselves, in the shadow of the snake oil salesman, that science, an elevated discipline compared to the guessing of Dr. Still’s day, must light our path. Data will guide us.

Let’s not be fooled. If data is the sole standard for determining treatment, we place ourselves in a straight-jacket. Paying attention to only data as our guide to therapy limits us. We do not ask important questions related to thoughts and feelings, spirit and life force: “Does the patient have confidence in the treatment and the doctor?” “Does the mind of the physician and that of the patient have any influence on the outcome?” “Does the expression of empathy by the physician play a role in healing?” “How does the life force perform healing?” These are just a few of the questions that science does not ask in the course of our practice of medicine. These limits are put in place by data from physical reality, not mental or spiritual reality.

Osteopathy is defined by the unity of body, mind, and spirit. Osteopathy is based on the understanding that thoughts and emotions contain knowledge and wisdom. [“Life terrestrial has motion and power; the celestial bodies have knowledge and wisdom” Still, 1892, 251.] Traditional Osteopathy uses these thoughtful and feeling benchmarks to guide our work. According to Dr. Still, the unity of terrestrial and celestial creates biogen – living fascia. As Dr. Sutherland demonstrated, tissues oscillate with the life force. We honor the life force as the self-healing property of the organism and follow its commands. We support the ongoing generative impulse of health, the Tide of primary respiration, to determine what we do with our patients. There might be data points – “this person responded as did the last one to my particular method.” But we may only recognize data points in retrospect and do not necessarily use them prospectively to determine technique. Instead, we use principles of nature to inform our therapy: the body is a unity of body, mind, and spirit; It is self-healing; and structure and function are inter-related. Each patient encounter is unique and our method is determined moment-by-moment by the tissues themselves, not by tables of data, bits and bytes.

Could AI invent osteopathy? Only if we could transmit to computers Dr. Still’s celestial world: mind and spirit. Conventional medicine does a beautiful job of transmitting to computers our terrestrial world which is made of data. It is the celestial world that computers can’t read – only humans can. The celestial cannot be measured or located, only the terrestrial can. Of the three components, body, mind, and spirit, only one, body can produce data. The celestial is what makes osteopathy special. Osteopathy is a human endeavor, forever safe from AI.