Image credit: Dominik Lange from Unsplash

When I interned at the Peking Union Medical College Hospital (PUMCH) Palliative Care Center in Beijing last summer, it gave me a unique opportunity to observe firsthand how healthcare is changing. As I watched doctors and nurses put terminally-ill patients to bed, my mind just couldn’t help thinking: What would artificial intelligence do for the future of Palliative Care?

It is true that AI has already revolutionized many fields of medicine, but can it bring added benefit to caring for those in their twilight years -- to make good care even better, without giving up on the human touch which makes such care essential?

The Good: AI's Promising Prospects for Hospice Services

During the time I spent at the Palliative Care Center in PUMCH Beijing, AI had not yet become a major part of things. But I can see its potential. In hospice medicine, one of the biggest problems lies with pain management.

AI predictive models powered by huge amounts of patient data could analyze current information quickly and in almost (if not real) time--they might then help doctors see a patient's pain bout coming on well beforehand, and adjust medication accordingly. Furthermore, AI-driven symptom checklists could be on hand around the clock 24/7 and 365 days a year, ensuring that patients receive appropriate interventions the moment they are needed. While a doctor might not always be right there for immediate aid to all of his patients, with AI, there's no need because someone always is and will even force a small task before resigning too!

Communication could also become easier, a most promising application for AI. In end-of-life decision making, family members often have to cope with complex medical information and feel at a loss. In these cases, chatbots and virtual assistants operated with AI might be just the thing to crack open medical jargon for families and provide both clearer explanations as well as more personalized help. A third area where AI could be of great use is in the taking on some managerial chores, which allows health professionals to devote themselves more completely to patient care.

The development of palliative care in China is a relatively recent phenomenon, starting in the late 1980s when Tianjin Medical University first established the country's research center. The burgeoning discipline met with slow initial progress because of China's resource constraints during those years. Nevertheless, since 2016, new programs; specialized centers have gained momentum and a broader platform.

Founded in 2022, the PUMCH Center for Palliative Care represents a major step towards integrating palliative medicine in China's healthcare system. As this discipline grows, AI's development support may lie in addressing resource limitations as well as increasing access to highly specialized care, particularly in the rural hinterlands where palliative services are so scarce.

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AI's limitations in human-centered care: the downsides

Nonetheless, AI has clear limitations, especially in a field as human-centered as palliative care. As for me, one of the things that struck me most during my internship was how very heavy emotionally end-of-life discussions are. The doctors and nurses comforted families who were in mourning, held patients' hands and reassured that went far beyond medical treatment.

These moments of connection between healthcare providers and patients simply can't be replaced by any technological gadget, however advanced it may one day become. Another major concern centres around the ethical dilemmas inherent in AI-driven decision-making regarding palliative care. Although AI can go through vast amounts of data, it lacks the emotional intelligence to deal with situations that are as delicate as advancing from aggressive treatment to comfort care. Palliative care is about dignity, personal choices and respect for the beliefs on what happens after death -- these are areas in which for the time being at least AI comes up short.

In China, the cultural attitude toward death has played a part throughout time in the way people look at palliative care. Due to traditional beliefs that make family members keep silent on the subject of end-of-life care, most families are not prepared to discuss it. Therefore people serving in the role of human caregivers are further pressed to help build trust and understanding. While AI may facilitate diagnosis and treatment planning, heartfelt, mutually respectful exchanges are at the heart of quality palliative care, and a computer can but replace it.

Finding a Balance

As technology advances, artificial intelligence (AI) has to be gently woven into palliative care. It can improve efficiency, help with symptom control, and support decision-making. Yet it is business-as-usual for human relationships to define AI.

At PUMCH hospital I did an internship, leaving me with the impression that achieving the best integrated healthcare solutions will depend on technological advances made with the compassion of patients and their families foremost. As palliative care in China continues to grow, AI will undoubtedly also be certain to join in. The question is whether AI is to be a tool that both assists more human caregivers, such as doctors and nurses, or whether it will serve in place of human care. Looking forward, we need to ask: How can we make its potential contribute to healthcare while maintaining a healing that is genuinely human? It is our generation's responsibility to answer this question, whether we are future healthcare workers, policymakers or innovators. AI not only has come, it is here to stay. Nevertheless, in palliative care, the human touch must always predominate.